| Objectives:1.To investigate the types and distribution characteristics of TCM constitutions in patients with constipation after single knee arthroplasty,Objective to understand the main body types of constipation patients after knee arthroplasty,To provide the theoretical basis for the next clinical intervention.2.According to different body types,The clinical intervention program was designed on the basis of dialectical therapy.The patients with constipation after single knee arthroplasty were treated with targeted clinical intervention,to prevent constipationMethods:The study was divided into two parts,The first part is the constitution type of constipation patients after single knee arthroplasty,and Distribution characteristics and related factors.From August 2017 to December 2018,336 cases of patients with constipation after single knee arthroplasty in the department of bone and joint of a third-class first-class hospital in a city were selected by convenient sampling method for questionnaire survey.Measuring tools include:TCM constitution questionnaire scale,Patient general condition questionnaire,TCM syndrome type questionnaire.SPSS21.0 statistical software was used to analyze the data.The second part is a clinical intervention study on constipation after single knee arthroplasty.From January 2019 to October2020,106 patients with constipation after single knee arthroplasty in the department of bone and joint of a third-class a hospital in a city were selected by randomized blind method,According to the constitution type of patients after total knee joint surgery,Conducting clinical empirical studies,Clinical intervention was designed on the basis of dialectics,The Methods for evaluating interventions to improve the single knee arthroplasty patients after the feasibility of constipation and biased constitution integral.Results:Part one:Results of the analysis of the constitution types of constipation patients after single knee arthroplasty1.General distribution of patients’ constitution typesThis study shows that:The blood loss,diet bias and sleep were statistically significant for the distribution of constitution types in patients with constipation after single knee arthroplasty.(P<0.01)2.Constitution type of constipation patients after single knee arthroplastyIn this study,a total of 400effective questionnaires were collected from patients with constipation after single knee arthroplasty.There were 12 cases(3.57%)with normal constitution,Biased constitution 324 cases(96.43%),Yang deficiency in biased constitution in 21 cases(6.25%).Yin deficiency Poisoning in 111cases(33.04%).Deficiency of mass in 103 cases(30.66%),Sputum quality in 19cases(5.65%),blood stasis in 40 cases(11.91%),Hot and humid mass in 16cases(4.76%),Qi-stagnation quality in 11 cases(3.27%),Characteristic features in 3cases(0.89%),Yin deficiency and qi deficiency were the majority,accounting for about 63.7%of the total constipation patients after single knee arthroplasty.3.The relationship between TCM syndrome type distribution of constipation and TCM constitution typeIn this study,the distribution of TCM syndrome types in constipation patients was from high to low,with 121cases(36.01%)of blood deficiency and mystery,106 cases(31.55%)of qi deficiency and mystery,54 cases(16.07%)of heat mystery,23 cases(6.85%)of gas mystery,and 32 cases(9.52%)of cold mystery.Among them,72 cases(59.5%)of constipation were characterized by deficiency and mystery of qi,15 cases(12.4%)of blood stasis and 12 cases(9.92%)of phlegm and dampness.The TCM syndromes of constipation were characterized by deficiency and mystery of qi,70cases(66.04%)of Yin deficiency and mystery of qi,10 cases(9.43%)of qi deficiency and mystery of qi,and 6 cases(5.66%)of blood.Part two:results of intervention for constipation patients with constitution types of Yin deficiency and qi deficiency after single knee joint replacement1.After the intervention,there were statistically significant differences between the intervention group and the control group in the time and frequency of the first bowel((t=9.327,6.911 P<0.01,P<0.01).2.Comparison of defecation symptoms between the two groups at different time points after intervention:three days,one week and two weeks after intervention,the difference in defecation interval,defecation time,fecal characteristics,shortness of breath,fatigue,lazy talk,dizziness,paleness of face between the intervention group and the control group was statistically significant(P<0.01).3.Comparison of life quality scores between the two groups after intervention:the difference in scores of physical discomfort,psychosocial discomfort,anxiety,and satisfaction between the intervention group and the control group was statistically significant three,one and two weeks after intervention.(P<0.01)4.Comparison of the efficacy of constipation in the two groups after one week of intervention:after one week of intervention,the total effective rate of constipation recovery in the intervention group was 94.3%,and that in the control group was 73.6%,with statistically significant differences(z=3.214,P<0.05)5.Comparison of TCM constitution scores between the two groups showed that the difference of TCM constitution scores between the two groups was statistically significant(t=9.427,P<0.01;t=2.858,P<0.05).The difference of TCM constitution scores between the two groups was statistically significant(t=6.971,P<0.01;t=10.412,P<0.01).The difference of TCM constitution scores between the two groups was statistically significant in qi-deficiency and yin-deficiency two weeks after intervention(t=12.534,P<0.01;t=1.418,P<0.01)Conclusion:1.The blood loss,diet bias and sleep in patients with constipation after single knee arthroplasty had an effect on the distribution of constitution types.2.The constitution types of constipation patients after single-knee arthroplasty were qi deficiency and Yin deficiency.The distribution of TCM syndromes of constipation was dominated by qi deficiency and blood deficiency.3.For patients with constipation after single knee joint replacement with qi-deficient and yin-deficient constitution,astragalus angelica herb bowl navicular moxibustion can effectively improve the symptoms of constipation,improve the cure rate of constipation,and effectively correct qi-deficient or/and yin-deficient constitution,which is conducive to the treatment of both symptoms and root causes,and improve the quality of life and satisfaction of patients. |
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