| ObjectiveBy observing the effect of conventional therapy combined with Gushu Cream in promoting the regression of ecchymosis after total knee arthroplasty,to confirm the ef-ficacy and safety of Gushu Cream in the treatment of ecchymosis after TKA,and in order to find an effective and safe method for accelerating regression of ecchymosis after TKA,and to provide a basis for the clinical application and promotion of Gushu Cream.MethodsA total of 60 patients with unilateral primary total knee arthroplasty were selected from December 2017 to December 2018 in the department of Quanzhou Orthopedic H ospital of Fujian University of traditional Chinese medicine.60 patients who met the inclusion criteria were divided into control group(conventional medical treatment group)and experimental group(Gushu Cream group)by single and double numbers in the order of adimission,with 30 patients in each group.The control group was treated with sodium aescinate for 1 week(2mg/kg ivgtt Qd),and direct oral Jieqi capsules(900mg tid,self-made medicine)and Celecoxib capsules(200mg bid)for 2 weeks.The exp-erimental group was given Gushu Cream applied to the swelling and ecchymosis of knee twice a day in addition to the control group,from the 3rd to the 14 th day after operation.Observation indicators: the range of ecchymosis,the swelling degree of thigh and leg,pain score,skin temperature of two groups were compared at 1st,3rd,5th,7th and 14 th day after operation and HSS scale before operation,3rd,7th and 14 th day after operation.Result1.A total of 60 cases were included(In the process of the treatment),4 cases in the experimental group and 3 cases in the control group who dropped out of the study,and 53 cases have actually completed.2.There was no significant difference in general data between the two groups which were comparable.3.Ecchymosis : The area of ecchymosis was the smallest in the first day after operation,the largest in the fifth day after operation,and then gradually decreased;there was significant difference between the groups at different time points(all P<0.05).There was no significant difference in the range of ecchymosis between the two groups on the 1st,3rd,5th day after operation(all P> 0.05).The area of ecchymosis in the experimental group was smaller than that in the control group on the 7th and 14 th day after operation(all P<0.05).There was a significant difference between the two groups(P<0.05).There was a grouping effect,and there was an interaction between grouping factors and time factors(P<0.05).4.Swelling: The changes of thighs and legs were the same.The swelling of thighs and legs was the most obvious on the third day after operation,then gradually subsided.There was no significant difference between the 5th day and the 1st day after operation(P>0.05),and there was significant difference between the other different time points(P<0.05).There was no significant difference between the two groups on the 1st,3rd and 5th day after operation(P> 0.05).On the 7th and 14 th day after operation,the swelling of the experimental group was lighter than that of the control group(all P<0.05).There was significant difference between the two groups(P<0.05).There was grouping effect,and there was interaction effect between grouping factors and time factors(P<0.05).5.Pain: After operation,the VAS score reached the highest on the 5th day,and then decreased on the 7th day,but increased on the 14 th day.There was a significant difference between the groups at different time points(all P<0.05).There was no significant difference between the two groups on the 1st,3rd,5th and 7th day after operation(all P>0.05).On the 14 th day after operation,the VAS score of the experimental group was lower than that of the control group(P<0.05).There was a significant difference between the two groups(P<0.05).There was a grouping effect,and there was an interaction between grouping factors and time factors(P<0.05).6.Skin temperature: The skin temperature was the highest on the first day after operation,then gradually decreased;there was significant difference between the two groups at each time point(all P<0.05);there was no significant difference between the two groups on the 1st,3rd,days after operation(all P>0.05).Skin temperature of the experimental group was lower than that of the control group on the 5th,7th and 14 th day after operation(P<0.05);there was significant difference between the two groups(P<0.05).There was grouping effect,and there was interaction effect between grouping factor and time factor(P<0.05).7.HSS score: Compared with pre-operation,the HSS score of the two groups inc-reased gradually after operation;there was significant difference between the two grou-ps at different time points(all P<0.05);there was no significant difference between the two groups on the 3rd day after operation(P>0.05),and the score of the experim-ental group was higher than that of the control Group on the 7th and 14 th day after operation(all P<0.05);there was significant difference between the two groups(P<0.05),that is,there was grouping effect,and there was interaction effect between groupin g factors and time factors(P<0.05).8.The Curative effect evaluation: On the 14 th day after operation,HSS score: the ex-perimental group: excellent in 2 cases,good in 22 cases,common in 2 cases,poor in 0 cases;the control group: excellent in 1 case,good in 15 cases,common in11 cases,poor in 0 cases.The HSS score of the experimental group was better than that of the control group,with statistical significance(P<0.05);the clinical efficacy of TCM: the experimental group: 3 cases were cured,20 cases were markedly effective,3 cases were effective and 0 cases were ineffective;the control group: 1 case was cured,14 cases were markedly effective,12 cases were effective and 0 cases were ineffective.The clinical efficacy of the experimental group was better than that of the control group,and the difference was statistically significant(P<0.05).9.Safety evaluation: There was one case of skin allergy after using Gushu Cream for 3 days in experimental group,and the symptoms disappeared after withdrawal.There was no adverse reaction in the control group.There was no significant difference in safety evaluation between the two groups(P>0.05).ConclutionConventional therapy combined with Gushu Cream is safe and effective for promoting early regression of ecchymosis after TKA.It can alleviate swelling and pain,reduce skin temperature and accelerate early recovery after TKA.It has clinical research and application value. |
PDF Full Text Request