| 摘要: |
| 目的 探讨在膝关节置换术后规范康复训练的基础上增加穴位温灸和冰硝散局部外敷对膝关节整体功能恢复的影响。方法:随机将80例初次单膝关节置换患者分为观察组和对照组，每组40例。两组术后均给予基础护理措施，并指导患者进行股四头肌锻炼等康复训练，观察组行特定穴温灸和患膝局部冰硝散外敷治疗。分别于术前1 d、术后1、3、7 d记录并比较两组患者股四头肌肌力、VAS疼痛评分，比较术前及术后第3天、第7天髌上10 cm、髌周、髌下10 cm周径，比较术后7天美国特种外科医院(HSS)评分，比较两组患者术后首次下地、直腿抬高时间，比较住院时间及不良反应发生情况。结果:术后第1天，两组患者视觉模拟评分法(VAS)评分比较差异无统计学意义(P=0.710)，术后3 d和7 d时，观察组VAS评分均低于对照组，差异有统计学意义(均P＜0.01)。术后第3天、第7天，两组髌上10 cm、髌周差异有统计学意义(P＜0.05)；术后第3天，两组髌下10 cm周径比较有统计学差异；术后第7天，两组髌下10 cm周径比较无统计学差异(P=0.963)。术后第7天，观察组HSS评分高于对照组，差异有统计学意义(P=0.001)；观察组平均首次直腿抬高时间和首次下地时间均短于对照组，差异有统计学意义(P＜0.001)。观察组的住院时间为(9.23±1.74)d，短于对照组的(12.38±2.07)d，差异有统计学意义(P=0.037)；观察组术后7 d内发生深静脉血栓形成(DVT)1例，对照组发生2例，差异无统计学意义 (P=0.077)。结论:温灸联合冰硝散外敷减轻膝关节置换术后疼痛、肿胀疗效确切，并能够促进术后肌力及功能恢复，加速康复进程，缩短住院时间。 |
| 关键词: 膝关节置换 芒硝 冰片 温灸 快速康复 |
| DOI：10.3969/j.issn.1007-6948.2024.02.015 |
| 投稿时间：2023-07-11 |
| 基金项目:山东省中医药科技发展计划项目(2019-0791)；2018年国家中医药管理局全国名老中医药专家孙文学传承工作室建设项目 (国中医药人教函〔2018〕134号)；威海市第四批中医重点专科建设项目(威卫办〔2019〕87号) |
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| Clinical study on moxibustion combined with external application of mirabilite and borneol powder to enhanced recovery after total knee arthroplasty |
| JU Chang-jun，KONG Hui，ZHAO Jin-wei |
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| Abstract: |
| Objective To investigate the clinical effect of warm moxibustion therapy combined with external application of mirabilite and borneol powder in postoperative rehabilitation of TKA. Methods 80 eligible patients with unilateral TKA were randomly divided into control group and observation group with 40 cases in each group. All patients were treated with routine medical and nursing measures, and were instructed to take rehabilitation such as quadriceps femoris exercise postoperatively. In addition, the observation group was treated with warm moxibustion at specific acupuncture points and external application of mirabilite and borneol powder.The quadriceps femoris muscle strength and the VAS scores of the two groups were recorded and compared at 1 day before operation, 1st, 3rd, and 7th days after operation. The circumference of 10cm suprapatellar, peripatellar and 10cm infrapatella were recorded and compared at before operation and 3rd, and 7th days after operation, and HSS scores at the 7th day after operation were compared between the two groups. The time of first landing, first straight leg raising and the average days of hospital stay were recorded and compared between the two groups after operation. At the same time,complications of the two groups were recored. Results There was no statistically significant difference between the two groups in terms of baseline information (P>0.05). There was no significant difference in the VAS score between the two groups at 1st day after operation (P=0.710), and the VAS scores of observation group were lower than that of control group at 3rd day and 7th day postoperatively, the difference was statistically significant (P＜0.001). The circumference of 10cm suprapatellar, peripatellar and 10cm infrapatella of observation group were lower than that of control group at 3rd day after operation，and the circumference of 10cm suprapatellar, peripatellar of observation group were lower than that of control group at 7th day after operation，the differences were statistically significant (P＜0.05) . But there was no statistical difference between the two groups in the circumference of 10cm infrapatella (P=0.963). On the 7th day after operation, the HSS scores of observation group was higher than the control group, and the difference was statistically significant (P=0.001). The average time of first landing, first straight leg raising and the average days of hospital stay of observation group were all shorter than these of control group , the differencee were statistically significant (P=0.037). There were 1 case and 2 cases DVT happened in observation group and control group respectively, the difference was not statistically significant (P=0.077). Conclusion Warm moxibustion therapy combined with external application of mirabilite and borneol powder can relieve pain and swelling after TKA exactly, and also can promote postoperative muscle strength and functional recovery, accelerate the rehabilitation process, and shorten the hospital stay. |
| Key words: Total knee arthroplasty mirabilite borneol moxibustion quick recovery |
