Clinical Study Of Huoxue Shugan Decoction In The Treatment Of Lower Limb Swelling And Pain And Ecchymosis After TKA (qi Stagnation And Blood Stasis Syndrome)

Objective:To observe the efficacy of huoxue shugan decoction in treating pain,swelling and ecchymosis of limbs after Total Knee Arthroplasty(TKA),to preliminarily explore the mechanism of huo xue shu gan decoction,and to evaluate its safety and application prospect.Methods:From January 2018 to January 2019,74 patients who were hospitalized in the first department of knee injury in luoyang bone-setting hospital of henan province and underwent unilateral TKA surgery for the first time were included.All patients obtained informed consent and signed informed consent before surgery,and filled in complete case data.According to the order of enrollment,37 cases in the experimental group and 37 cases in the control group were divided into two groups by random number table method.In both groups,the same group of physicians performed TKA surgery under the same anesthesia and operation mode,and implanted the same type of prosthesis intraoperatively.Preoperative routine examination,postoperative routine medication and early functional exercise were the same.In the experimental group,1.5g(0.75g/ tube)of cefuroxime sodium for injection,ivgtt,Q12 h,60 drops/min were given.For those allergic to cefuroxime sodium for injection,0.6g(0.3g/ tube)of clinamycin,ivgtt,Q12 h was used.Low molecular weight heparin calcium(5000ui)was used for injection.Celecoxib capsules(0.2g/ tablet)oral Bid: 1 tablet per time,8h after surgery,combined with physical therapy,huoxue shugan decoction,water decoction,2 times a day,1 bag each time,warm in the morning and evening.VAS(Visual Analougue Score)scores of pain at rest and during activity were observed and recorded on the 1st day after TKA and the 3rd,5th,7th and 14 th days after TKA.The circumference of 10 cmabove the midpoint of patella and 10 cm below the midpoint of patella,as well as the circumference of the same measurement points on day 3,5,7 and 14 after surgery,were measured on the first day after the operation.The number and area of ecchymosis after operation;The degree of active flexion and extension of the knee joints on the operative side before the first day of operation,on the 7th and 14 th days after operation,and the HSS function scores of the knee joints before the first day of operation,on the 7th and 14 th days after operation.SPSS21.0 was used for statistical analysis of the obtained data.Results:During the study,3 cases were excluded due to intolerance of oral Chinese medicine or other drugs for internal diseases that might affect the experiment,including 35 cases in the experimental group and 36 cases in the control group.Results using statistical processing related data analysis is as follows: two groups of patients with gender,age,BMI,course,parts,operation time,preoperative platelet counting,preoperative knee rest pain,preoperative pain,blood sedimentation,D dimer and the distribution of C-reactive protein is no statistical significance(P >0.05),two groups of patients with gender,age,BMI,course,place,operation time,preoperative platelet count,preoperative knee rest pain,preoperative pain,D dimer,blood sedimentation,C-reactive protein are comparable.VAS scores of resting pain and mobile pain on the first day after the operation were not statistically significant(P>0.05),and VAS scores of resting pain and mobile pain on the third,fifth,seventh and 14 th days after the operation were statistically significant(P<0.05).There was no statistically significant difference in the circumference distribution of the upper and lower 10 cm patella midpoint of the two groups of patients on the first day after surgery(P>0.05),and there was statistically significant difference in the circum-ference distribution of the swelling at the upper and lower 10 cm patella midpoint ofthe knee on the third,fifth,seventh and 14 th days after surgery(P<0.05).Two groups of patients with postoperative bruises in the number of no statistical significance(P > 0.05),postoperative appeared ecchymosis area size comparison was statistically significant(P < 0.05),postoperative day 1 knee flexion mobility differences before using this drug has no statistical significance(P > 0.05),activity of 7,14 days after knee joint flexion and extension difference was statistically significant(P < 0.05),postoperative day 1 knee joint HSS score difference before using this drug has no statistical significance(P > 0.05),7,14 days of the knee joint HSS score difference was statistically significant(P < 0.05).Conclusion: combined with conventional treatment,huoxue shugan decoction can reduce the pain and swelling of lower limbs after TKA,reduce the area of ecchyma,improve the degree of knee flexion and extension,improve the satisfaction of patients,and improve the enthusiasm of early functional exercise after surgery.