Therapeutic Effect Of Taohong Siwu Decoction Wupi Decoction On Early Limb Swelling After Total Knee Arthroplasty

Objective To observe the effect of early oral administration of Taohong Siwu Decoction and Wupiyin on the swelling of the affected limb,the impact of knee HSS function score and plasma D-dimer after total knee arthroplasty.Limb swelling provides a theoretical basis for the use of"chemical phlegm and water"drugs.Provide reference for the rehabilitation of clinical TKA.Methods This subject selected our department of orthopedics from February 2017to February 2019 to diagnose advanced knee osteoarthritis and the first total knee replacement surgery,60 patients were hospitalized,respectively recorded the patient's age,gender,height,weight,surgical site(about).According to the diagnostic criteria,inclusion criteria,exclusion criteria,and shedding criteria,60 patients were divided into a treatment group(30 patients)and a control group(30 patients)by random number table method.In the control group,the elastic bandage was pressure-wrapped,the affected limb was elevated,the quadriceps function was exercised,and the intravenous infusion of mannitol injection was used for symptomatic treatment.The treatment group was treated with Taohongsitang and Wupiyin on the basis of the control group,and the treatment period was 14 days.On the 1st day before surgery,the circumference of the 10cm limb of the affected limb was measured on the 1st,3rd,7th and 14th postoperative day,and the swelling value was calculated.The degree of swelling of the patient was recorded on the 1st,3rd,7th and 14th postoperative day.Graded;patients with knee HSS functional scores were recorded 1 day before surgery,3,7,and 14 days after surgery;changes in plasma D-dimer were recorded at 1,3,7,and 14 days after admission..Statistical analysis was performed using SPSS 23.0 for statistical analysis;P<0.05 was used as the standard for statistical differences.Results A total of 60 patients were enrolled in the study,and 57 were actually completed.Among them,1 patient was discharged from the treatment group in advance,and 29 patients were actually completed.The control group did not cooperate with blood draw in 2 cases,and actually completed 28 cases.1.Statistical analysis of the general data of the two groups was as follows:age(t=0.344,P=0.732),BMI(t=0.289,P=0.774),gender(X~2=0.148,P=0.701),surgical site(Left/right)(X~2=0.160,P=0.689),drainage(t=-0.275,P=0.784),limb circumference 1 day before surgery(t=-1.400,P=0.167),plasma D-at admission Dimers(t=-1.499,P=0.486)were not statistically different(P>0.05),and the baseline data of the two groups were comparable.2.Limb swelling value:The third day after operation(t=-2.574,P=0.013)and the seventh day(t=-2.385,P=0.021)were significantly different from the control group(P<0.05).There was no significant difference in the first day(t=-0.726,P=0.471)and the 14th day(t=0.175,P=0.477)(P>0.05).The interaction time and grouping of the two groups had interaction effects.(F=2.662,P=0.248);there were grouping effects of limb circumference changes in both groups(F=8.548,P=0.005);there were time effects of limb circumference changes before and after surgery(F=43.015,P=0.000).3.Degree of limb swelling:moderate swelling on the third day after surgery(X~2=4.095,P=0.043<0.05),the difference was statistically significant.The frequency of different swelling degrees at other time points was not statistically significant(P>0.05).4.Plasma D-dimer:On the third day after surgery(t=-2.457,P=0.018),the seventh day(t=-3.272,P=0.002)was statistically different(P<0.05);postoperative On day 1(t=-2.457,P=0.018),the difference was not statistically significant on day 14(t=-0.069,P=0.945)(P>0.05);time and group interaction between the two groups(F=4.440,P=0.003),there was a difference in the overall plasma D-dimer change between the two groups,ie grouping effect(F=12.50,P=0.001),plasma D-dimer before and after surgery The changes were significantly different and had a time effect(F=389.511,P=0.000).5.HSS function score of knee:postoperative day 3(Z=-1.996,P=0.046),day 7(Z=-2.549,P=0.011),day 14(Z=-2.079,P=0.038)The difference was statistically significant(P<0.05).There was no interaction between the two groups in the scoring time and grouping(F=10.321,P=0.000).The overall HSS functional scores in the two groups had a grouping effect(F=7.867,P=0.007),preoperative and postoperative stages.There was a time effect on the knee HSS function score(F=339.775,P=0.000).6.Complications:The incisions in both groups were healed by first stage.There were no complications such as deep vein thrombosis,major bleeding,incision and intra-articular infection during the treatment.Conclusion1.Taohong Siwu Decoction combined with Wupiyin combined with basic treatment or conventional treatment of limb swelling after total knee arthroplasty has achieved good clinical results.2.The efficacy of Taohong Siwuhe Wupiyin in treating and treating limb swelling after TKA is better than that in the control group.The use of Huali Water Method in the treatment of limb swelling after TKA is effective,safe,economical and practical,and is in line with the concept of rapid rehabilitation.