| Objective: To analyze the curative effect of using modified Danggui Buxue Decoction in the treatment of hemorrhagic anemia after unilateral total hip arthroplasty(THA).Methods: Sixty patients who were admitted to Inpatient Unit of Orthopedics Department,Affiliated Hospital of Chengdu University of TCM from January 2016 to December 2017 and developed anemia with blood deficiency following initial unilateral THA,and who met the eligibility criteria were selected;those patients receiving treatment with Modified Danggui Buxie Decoction were assigned to the observation group,and those receiving treatment with Iron Polysaccharide Complex Capsules were assigned to the control group,each group including 30 patients.In the observation group,Modified Danggui Buxie Decoction(150ml tid)was initiated at postoperative day 1 and given continuously for a total of 2 weeks;in the control group,Iron Polysaccharide Complex Capsules(150mg qd)was initiated at postoperative day 1 and given continuously for a total of 2 weeks.The changes in hemoglobin(Hb),hematocrit(Hct),and reticulocyte count(Ret#)were observed at postoperative days 3,5,14 and 30,and the hepatic and renal functions were monitored to evaluate drug safety.At postoperative days 1 and 30,Visual Analogue Scale(VAS)score and Harris hip score were calculated to evaluate the improvements in pain and hip function,and TCM symptom scores were calculated;at postoperative day 30,patients in the two groups were compared for treatment response in terms of postoperative TCM symptom scores and anemia.Throughout the treatment and follow-up periods,complications and adverse reactions were recorded on an ongoing basis.Results: Post-treatment Hb,Hct and Ret# presented significant improvements from those at postoperative day 1(P<0.05),had no statistically significant differences between the two groups at postoperative day 3(P>0.05),and were better in the observation group at postoperative days 5,14 and 30 days,with statistically significant differences(P<0.05).At postoperative day 30,the mean score for“palpitation” was 0.43±068 in the observation group,which was lower than 0.63±0.56 in the control group yet indicating no statistically significant difference(P>0.05);the mean scores for “lusterless complexion”(0.47±0.63 VS 0.83±0.59),“dizziness”(0.37±0.49 VS0.83±0.70),“dispiritedness and lassitude”(0.40±0.50 VS 0.80±0.66),and“pale lips,tongue and nails”(0.40±0.50 VS 0.80±0.66)were all better in the observation group(all P<0.05);the overall response rate for anemia was 96.7% in the observation group,which was significantly higher than76.7% in the control group,with statistically significant difference(P<0.05);the overall response rate for TCM symptom scores was 96.7%,which was significantly higher than 80.0% in the control group,with statistically significant difference(P<0.05);compared to the pre-treatment scores,there were decreases in VAS score in both groups(P<0.05),and decreases in Harris score in both groups(P<0.05);the post-treatment VAS score was significantly lower(P<0.05),and the post-treatment Harris hip score was significantly higher(P<0.05)in the observation group.During the treatment period,the incidence of adverse reactions was 6.7% in the observation group,which had no statistically significant difference from 10.0% in the control group(P>0.05).Throughout the treatment and follow-up periods,no severe complications such as thromboembolism or infection,or any abnormalities in renal function(ALT,AST)or renal function(Cr,BUN)were observed.Conclusion: For patients undergoing initial unilateral THA,Modified Danggui Buxie Decoction could significantly enhance Hb,Hct,and Ret#,quickly recover the hematopoietic capability,and improve the symptoms of anemia,which is of particular significance for patients with mild to moderate blood loss anemia.It also could reduce pain and improve hip function,and is associated with favorable safety profile,suggesting its significant clinical applicability. |
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