| Objective Through clinical observation of Invigorating Qi and promoting blood circulation, clearing heat and removing dampness herbs on elderly patients with severe KOA after Total knee arthroplasty limb skin temperature, erythrocyte sedimentation rate,evaluation of the effect of C reactive protein, blood rheology indexes and clinical outcomes after surgery,Discussion of Invigorating Qi and promoting blood circulation,clearing heat and removing dampness herbs in total knee arthroplasty on inflammatory indexes, blood hypercoagulability and blood rheology and morphology and the mechanism of effect of prevention after total knee arthroplasty complication,And the superiority of total knee replacement in treatment of elderly Chinese medicine combined with severe knee osteoarthritis clinical curative effect.Method Selection of elderly patients with severe KOA patients undergoing artificial total knee arthroplasty with 60 cases of the research standard of patients, randomly divided into two groups, Chinese medicine group, the control group with 30 cases in each group,On the day of admission to the knee joint HSS grading; Two groups of preoperative examination erythrocyte sedimentation rate, C reactive protein, lower limb skin temperature, coagulation index and the index of hemorheology, and routine lower extremity vascular ultrasound probe and Harris score,30 cases in the treatment group,invigorating qi and promoting blood circulation, clearing heat and removing dampness herbal oral administration for second days in total knee arthroplasty,30 cases of the control group, only take artificial total knee replacement, were given conventional treatment of two cases of postoperative.Two groups of patients after second, 4, 6, 8, 10,12, 14 days to measure and record the knee joints in the specified area of the skin temperature; first days, third days, seventh days, tenth days, second weeks respectively for CRP and ESR monitoring; first days after operation and change day of the blood rheology indices of fourteenth postoperative. Two weeks after surgery, knee HSS score to the patients in the two group.Results Monitoring of blood rheology indexes: the day before surgery and after surgery, no statistical differences were compared between two groups(P>0.05); 1 days after operation and compared two groups of patients before operation, blood rheology indexes were increased(l P <0.05); after 1 weeks and 1 days after surgery compared two groups of patients with blood, the index of hemorheology were decreased(P<0.05);after 1 weeks, the Chinese medicine group hemorheological indexes were lower than the control group, the difference was statistically significant(P<0.05).Sedimentation monitoring: 1 days preoperatively and postoperatively, no significant difference between the two groups of patients the erythrocyte sedimentation rate(P>0.05) compared; one day after operation compared with those before operation,two groups of patients with erythrocyte sedimentation rate were increased(P <0.05);respectively on postoperative first days, third days, seventh days, tenth days, fourteenth days of the traditional Chinese medicine group patients of control group patients do erythrocyte sedimentation rate and ESR paired t test, the results show the two differences(P < 0.05).CRP monitoring: 1 days preoperatively and postoperatively, no significant difference between the two groups of patients with CRP contrast(P>0.05); one day after operation compared with those before operation, two patients in group CRP were increased( P <0.05); paired t test respectively on the first postoperative day, third days,seventh days, tenth days, the fourteenth day of the traditional Chinese medicine group and the control group of patients with C reactive protein in patients with C reactive protein, the results showed that the two have difference(P<0.05).Lower limb skin temperature monitoring: 1 days before and after operation, two groups of patients with lower limb skin temperature compared no significant difference(P>0.05); one day after operation compared with those before operation, two groups of patients with limb skin temperature were increased(P <0.05); respectively on postoperative second days, fourth days, sixth days, eighth days, tenth days, Twelfth days,fourteenth days of the traditional Chinese medicine group knee skin temperature andskin temperature control knee group had paired t test, the results show the two differences(P<0.05).HSS score: preoperative, traditional Chinese medicine group and the control group of patients with knee score no difference(P>0.05), two weeks after operation compared with those before operation, two groups of patients with knee HSS scores were better than preoperative, the difference was statistically significant( P <0.05). That total knee arthroplasty can greatly improve the elderly severe KOA patients of limb function,improve the quality of life. Two weeks after the operation, traditional Chinese medicine group and the control group the HSS score compared with the difference(P<0.05). That total knee arthroplasty with Chinese herbs can improve function of limbs.Conclusion after total knee arthroplasty with Invigorating Qi and promoting blood circulation, clearing heat and removing dampness herbs can significantly improve the TKA postoperative inflammation and blood hypercoagulability, effectively reduce the TKA postoperative infection, deep vein thrombosis and other serious risk of complications, severe arthritis can obtain knee score better with total knee replacement for the treatment of traditional Chinese medicine the old, traditional Chinese medicine has the safe, effective, economic price, convenient use, and is worthy of clinical use. |
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