Effects Of Bu Yang Huan Wu Decoction On Hidden Blood Loss And Functional Recovery For The First Unilateral Total Knee Arthroplasty

ObjectiveThe purpose of this study was to observe the clinical effect of Bu Yang Huan Wu Decoction on hidden blood loss and functional recovery for the first unilateral total knee arthroplasty(TKA)in order to reduce hidden blood loss and promote functional recovery.It can give patients more treatment options and takes advantage of the motherland's medicine.Methods62 patients who admitted to be hospitalized in our hospital from November 2017 to November 2018 and who met the inclusion and exclusion criterias.These patients were divided into the control group and the experimental group randomly.It have 31 cases in each group.The control group:30mins before the operation,the tranexamic acid and glucose injection(tranexamic acid 1.0g:GS100ml)was used at a speed of 40-50drops/min.And the patients would received 1.0g of tranexamic acid injection dissolved in 0.9% sodium chloride injection 20 ml by intra-articular injection after closed incision,and the drainage tube was closed for 2h.The experimental group:Bu Yang Huan Wu Decoction that was based on the control group was used on the first day after operation.Taking the decoction twice a day,sooner or later.Hemoglobin,hematocrit,D-dimer were monitored before the operation and 3,7,14 days after the operation.The blood flow velocity of the femoral vein was measured before and after the operation.The HSS score was performed before operation and 3rd,7days,14 days,1months after the operation.Also we should record the intraoperative blood loss and postoperative drainage.The relevant formula was used to calculate the amount of hidden blood loss.All datas were statistically analyzed by SPSS20.0statistical software.Results1.There were no significant differences in gender,age,height,weight,surgical site and preoperative indexes between the two groups(P>0.05),which were be comparabled.2.HGB and HCT:The HGB and HCT of the experimental group were higher than those of the control group on the 7th and 14 th days after the operation.The difference was statistically significant(P<0.05).The comparison of HGB and HCT was statistically significant(P<0.05)in preoperative and postoperative 3,7,14 days.The HGB and HCT on 3,7,14 days after operation were lower than preoperative,and it was the lowest on the 3th days after operation.It gradually increased after 7 and 14 days.3.Blood loss:There was no significant difference in intraoperative blood loss between the two groups(P>0.05).There was no significant difference in postoperative drainage(P>0.05).There was significant difference in hidden blood loss(P<0.05).4.D-dimer:The D-dimer of the experimental group on the 7th,14 th days after the operation group was significantly lower than the control group(P<0.05).D-dimer on the 3rd days after the operation was significantly highest,and the difference was statistically significant(P<0.05).5.The degree of swelling of the knee joint:The degree of swelling of the experimental group on the 3,7th,14 th days after the operation was significantly lower than those of the control group(P<0.05).the calf circumference on the 3rd,7th days after operation was larger than those before operation(P<0.05).6.Blood flow velocity of femoral vein:the blood flow velocity of the femoral vein of the experimental group on the 7th days after surgery was faster than the control group.the difference was statistically significant(P<0.05).during the experiment,there was no DVT in either group.7.HSS score:The HSS scores of the experimental group was significantly higher than those of the control group on the 7th,14 th days and 1month after operation.The difference was statistically significant(P<0.05).The HSS scores on the preoperative were higher than the preoperative scores,and the difference was statistically significant(P<0.05).Conclusion1.Compared with the simple use of tranexamic acid,BuYang HuanWu Decoction can effectively reduce the decrease of postoperative HGB and HCT and then reduce postoperative hidden blood loss.It can not only reduce D-dimer and the swelling of the knee under the affected limb,but also speed up the blood flow of the femoral vein.It can improve the hypercoagulability of the blood so that find a "balance point" between hemostasis and anticoagulation.It was beneficial to promote the recovery of postoperative knee function.2.BuYang HuanWu Decoction did not cause adverse obvious reactions in patients after TKA.It was worthy of clinical promotion.