| Objectives This experiment expected that Duhuojisheng decoction can alleviate pain and promote rapid recovery of patients through the clinical observation of the analgesic effect and rehabilitation effect of Duhuojisheng decoction on the patients with liver and kidney deficiency and muscle and vein stasis syndrome after total knee replacement.Methods 1 The study group(n = 30)and the control group(n = 30)that patients with liver and kidney deficiency and muscle and vein stasis syndrome after total knee replacement were enrolled in this study.2 Routine basic treatment of Western medicine on control group,including anti-inflammation,detumescence,and rehydration.The study group was treated with traditional Chinese medicine granule 6 hours after operation on the basis of the control group,while the control group was blank.Two groups were given the same CPM rehabilitation measures by professional rehabilitation doctors after six hours operation.When discharged from hospital,patients will get rehabilitation training CD to guide their rehabilitation training,and regular telephone calls were made to record the rehabilitation training situation.3 The ROM value,VAS score and PCIA times were observed at 6 h,24 h,48 h and 72 h after operation.The changes of knee pain and rehabilitation function were evaluated by HSS function score at 1 week,1 month,3 months and 6 months after operation.After 4 weeks of treatment,the curative effect of TCM symptoms in the two groups was observed,the occurrence of adverse reactions after operation was observed and recorded,and the safety indexes such as liver and kidney function were observed and recorded.Results 1 A total of 63 patients met the criteria.After 6 months follow-up,3 cases lost follow-up,the loss of follow-up rate was 4.76%,and 60 cases were included in the study.There were 30 cases in the study group(12 males and 18 females)and 30 cases in the control group(16 males and 14 females).There was no significant difference in sex,age and course of disease between the two groups(P > 0.05).2 There was no significant difference in HSS score between the two groups before operation.The scores of HSS function were significantly higher than those before treatment in the two groups at 1 week,1 month,3 months and 6 months after operation,and the study group was better than that in the control group at the same time(P < 0.05).3 There was no significant difference in the value of ROM between the two groups before operation(P > 0.05).The knee joint flexion was different between the two groups at different time points.The knee flexion of the control group increased gradually from 30.37 to 39.87,61.37 and 80.73.The knee flexion of the study group increased gradually from 31.30 to 50.53,73.43 and 97.10.After operation,the knee flexion of the control group increased gradually from 30.37 to 39.87,61.37 and 80.73,respectively.The results showed that the ROM value of knee joint improved in both groups.The ROM value of the two groups increased gradually with the prolongation of time.The comparison between the two groups showed that there was a time effect at each time point,F < 49.170,P < 0.05.The ROM value of knee joint in the control group was lower than that in the study group.4 No significant difference in preoperative VAS between the two groups(P > 0.05).Postoperative pain will reach peak at 24 hours and then trends to decrease.The peak of pain feeling in the study group was significantly lower than that in the control group,and the VAS score in the study group was lower than that in the control group.However,the pain was not significantly improved in both groups in 72 hours after operation.5 After 4 weeks of treatment,the results of TCM symptoms in the two groups showed that the treatment group was clinically cured for 7 cases,markedly effective for 12 cases,effective for 10 cases and ineffective for 1 case,with a total effective rate of 96.67%.In the control group,3 clinically cured cases,12 markedly effective cases,12 effective cases and 3 ineffective cases.The total effective rate was 93.33%.The rank sum test showed that Z was 2.95 and P was 0.03,indicating that the difference was statistically significant(P < 0.05).6 There was no significant abnormality for liver and kidney function in the two groups 1 month after operation,and no significant change compared with that before treatment.The results showed that there were no complications such as cardio-cerebral,pulmonary vessels,bedsore and urethral infection in both groups.Part of the patients in the control group had nausea and vomiting after operation due to the intravenous analgesia pump was intolerant.These symptoms were relieved after using the corresponding antiemetic drugs and did not appear after pulling out the analgesia pump.However,there was no such symptom in the study group.Within 24 hours after operation,3 cases were asked to use remedial opioids(pethidine 100 mg intramuscular injection)in the study group(10.00%)and 11 cases in the control group(36.67%).The usage of remedial opioids in the study group was significantly lower than that in the control group.P < 0.05,the difference was statistically significant.Conclusions 1 There is a positive effect for postoperative administration of Duhuojisheng decoction on analgesia in patients with total knee replacement and less demand for opioid analgesic drugs after operation.No complications occurred on patients who took Duhuojisheng decoction after operation.These results lead that Duhuojisheng decoction has a safe analgesic effect without side effects and it is worth popularizing and applying in clinical practice.2 Taking Duhuojisheng decoction after operation shows a positive effect on the rapid rehabilitation of patients with total knee replacement.The degree of joint flexion and function of knee joint was significantly improved compared with the control group after taking medicine.The effect of Duhuojisheng decoction on promoting rehabilitation after knee replacement is worthy of affirmation.Figure 5;Table 9;Reference 126... |
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