Clinical Study Of Shiquandabu Decoction Combined With Tranexamic Acid On Reducing Perioperative Blood Loss (Syndrome Of Qi-Blood Deficiency) In Total Hip Arthroplasty

Objective: To evaluate the efficacy and safety of Shiquandabu Decoction combined with tranexamic acid in reducing perioperative blood loss of total hip arthroplasty,and to provide certain clinical reference for the prevention and treatment of perioperative blood loss in orthopedics by Traditional Chinese Medicine(TCM).Methods: Firstly,the strict inclusion criteria and exclusion criteria were established.Based on these criteria,50 patients who were treated in The Fifth Ward of Hip Injury Center of Luoyang Orthopedic-traumatological Hospital from January2019 to January 2020 were selected as the research objects.According to the random number table,they were divided into experimental group and control group,25 cases each.In control group,rapid intravenous drip 10 minutes before operation combined with intraarticular injection at the end of operation of tranexamic acid(100 ml,1g)were performed,and then the drainage tube was clamped for 4 hours.On the basis of control group,the experimental group began to take Shiquandabu Decoction one day before the operation,and continued to take it to the 6th day after the operation except the operation day.The preoperative general data,perioperative hemogram(red blood cell,hemoglobin,hematocrit),D-dimer,dominant blood loss,hidden blood loss,total blood loss,blood transfusion rate,average blood transfusion volume,Harris hip joint score,TCM syndrome score,TCM syndrome efficacy and adverse reactions were recorded.All data were analyzed by spss21.0 statistical software.Results: 1.Compared with the preoperative general data of the two groups,the difference was not statistically significant(P>0.05),which was comparable.2.RBC,Hb,HCT:Compared with the preoperative,postoperative day 1,postoperative day 4HB,RBC,HCT of the two groups,the difference was not statistically significant(P >0.05);The difference between the two groups on postoperative day 7 was statistically significant(P<0.05),which the experimental group was higher than the control group.3.D-dimer:There was no statistical difference between the two groups on preoperative,postoperative day 1 D-dimer(P>0.05);The difference between the two groups on postoperative day 4,postoperative day 7 was statistically significant(P<0.05),which the experimental group was lower than the control group.4.Blood loss and transfusion:There was no statistical difference between the two groups in the dominant blood loss and transfusion rate(P>0.05),while the total blood loss,the hidden blood loss and the average blood transfusion in the experimental group were lower than those in the control group(P<0.05).5.Harris hip score:Compared with the preoperative Harris hip score of the two groups,the difference was not statistically significant(P>0.05);While compared with that of postoperative day 7,the difference was statistically significant(P<0.05),which the experimental group was higher than the control group;TCM symptom score:Compared with that of postoperative day 1,There was no statistical difference between the two groups(P>0.05);While compared with that of postoperative day 7,the difference was statistically significant(P<0.05),which the experimental group was lower than the control group;The therapeutic effect of TCM symptoms on postoperative day 7: Compared with the two groups,the experimental group was higher than the control group,with a statistically significant difference(P<0.05);6.Incidence of adverse reactions after operation: 13.64% in the experimental group and 30.43% in the control group,but there was no statistically significant difference between the two groups(P<0.05).Conclusion: Shiquandabu Decoction combined with tranexamic acid can not only effectively reduce perioperative blood loss of total hip arthoplasty,but also relieve postoperative anemia,decrease the average blood transfusion,and help patients recover.