| Objective: To explore the clinical efficacy and application prospect of Siwu Decoction in perioperative blood management of primary total hip arthroplasty through clinical observation,and optimize perioperative blood management of total hip arthroplasty by using the advantages of integrated traditional Chinese and Western medicine and following the concept of rapid rehabilitation.Methods:60 patients who underwent primary total hip arthroplasty in the Affiliated Hospital of Shandong University of traditional Chinese medicine(Shandong hospital of traditional Chinese Medicine)from October2020 to December 2021 were collected according to the inclusion and exclusion criteria.They were randomly divided into observation group and routine treatment group,with 30 cases in each group.The patients in the two groups were treated with the same routine treatment scheme,mainly including improving routine examinations such as blood routine and ECG before operation to evaluate the operation risk;The first total hip arthroplasty was performed by the same surgical team,and 50 ml of tranexamic acid was injected into the joint during the operation;The drainage tube was clamped for 4 hours and pulled out after 24 hours;Routine nursing after operation,such as stomach protection,anticoagulation,rehydration and other routine treatment.On the basis of routine treatment,the observation group took the self-made Siwu Decoction conbined(plus or minus with syndrome)orally from the day before the operation to the 14 th day after operation.The changes of hemoglobin(HB)and hematocrit(HCT)were recorded before operation,1,3,7 and 30 days after operation,and the liver and kidney function was monitored to evaluate the safety of medication.Visual analogue scale(VAS)and hip Harris score were performed before and after operation to evaluate the postoperative pain and functional improvement;At the same time,TCM syndrome score was performed to evaluate the curative effect of Siwu Decoction combined before and after treatment.Spss25 was used for statistical analysis 0 software analyzes the valid sample data.result:1.The HB and HCT indicators of the two groups were significantly improved after treatment compared with the first day after surgery,and the difference was statistically significant(P>0.05),and on the third day after surgery,there was no significant difference in HCT indicators between the two groups(P>0.05).The HB indexes in the observation group were significantly better than those in the conventional treatment group at the 3rd,7th and 30 th days after surgery(P<0.05),and the HCT indicators were also significantly different from the conventional treatment group at 7 or 30 days after surgery,and the difference was statistically significant(P<0.05);The blood index of the two groups changed correspondingly over time,showed a downward trend 1or 3 days after surgery,and then gradually improved,and the difference in change was statistically significant(P<0.05);there was an interaction effect between the treatment factors and the time,and with the prolongation of the treatment time,both groups of indicators were improved,but the change in the observation group was significantly greater than that of the conventional treatment group(P<0.05);2.The two groups of patients underwent TCM Syndrome Evaluation on the 1st and 30 th day after operation.There was no significant difference in TCM syndrome score on the first day after operation(P > 0.05),and the TCM syndrome score on the 30 th day after operation was significantly higher than that on the first day before operation(P < 0.05);In the comparison of 30 days after operation between the two groups,the observation group was significantly better than the conventional treatment group(P < 0.05),and the total effective rate after 30 days was 100% in the observation group and 85% in the conventional treatment group.The observation group was also significantly better than the conventional treatment group(P < 0.05);3.After surgical treatment,VAS scores in both groups were significantly improved and gradually decreased with time;The VAS score of the two groups on the 30 th day after operation was significantly improved compared with that of the same group before operation(P < 0.05);There was no significant difference in VAS score between the two groups on the 1st and 30 th day after operation(P > 0.05).On the 3rd and 7th day after operation,the VAS score of the observation group was significantly lower than that of the routine treatment group(P < 0.05);The Harris score of the two groups on the 30 th day after operation was significantly improved compared with that before operation(P < 0.05),and the score of the observation group was higher than that of the routine treatment group on the 30 th day after operation(P < 0.05);Conclusion: the modified Siwu Decoction combined can effectively improve the Hb and HCT index levels of patients after the first tha operation.On the basis of routine treatment,it can further enhance the hematopoietic ability of patients and accelerate the improvement of anemia symptoms.At the same time,it can improve the early postoperative analgesia,contribute to the functional exercise of postoperative hip joint and realize the purpose of rapid surgical rehabilitation.It is worthy of further popularization and application. |
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