加味补气养血汤联合氨甲环酸对全膝关节置换术后气虚血瘀型患者隐性失血的影响OA
Modified Buqi Yangxue decoction combined with tranexamic acid reduces occult blood loss after total knee arthroplasty in patients with Qi-deficiency and blood-stasis pattern
目的:探讨加味补气养血汤联合氨甲环酸对全膝关节置换术(TKA)后气虚血瘀型患者隐性失血的影响.方法:将 56 例行单侧 TKA 的膝骨关节炎患者随机分为两组(n=28).对照组术中静脉滴注氨甲环酸;治疗组在此基础上围手术期加服加味补气养血汤.比较两组中医症状积分、视觉模拟疼痛评分(VAS)、膝关节 HSS 评分及血红蛋白(Hb)、红细胞压积(Hct)变化,计算失血量并观察并发症.结果:治疗组术后引流量、隐性失血量及总失血量均低于对照组(P<0.05).两组术中失血量比较,差异无统计学意义(P>0.05).术后 1 d 两组中医证候积分比较,差异无统计学意义(P>0.05).术后 7、14 d 治疗组中医证候积分均低于对照组(P<0.05).术后两组 HSS 评分均较术前升高,且治疗组高于对照组(P<0.05).术前及术后各时间点两组 VAS 评分比较,差异无统计学意义(P>0.05).术后 7、14 d,治疗组 Hb 及 Hct 水平高于对照组(P<0.05),术后 3 d 两组比较,差异无统计学意义(P>0.05).两组均未接受异体输血及发生严重并发症.结论:加味补气养血汤联合氨甲环酸可减少 TKA 术后隐性失血,稳定 Hb 和 Hct 水平,改善中医证候并促进膝关节功能恢复,是围术期安全有效的辅助治疗方案.
Objective:To explore effect of Modified Buqi Yangxue decoction combined with tranexamic acid on hidden blood loss in patients with Qi deficiency and blood stasis syndrome after total knee arthroplasty(TKA).Methods:Fifty-six patients with knee osteoarthritis undergoing unilateral TKA were randomly divided into two groups(n=28).The control group were intravenously infused with tranexamic acid during the operation.The treat-ment group were given modified Buqi Yangxue decoction in addition to the control group during the perioperative pe-riod.The TCM symptom scores,visual analogue scale(VAS)for pain,HSS score of the knee joint,and changes in hemoglobin(Hb)and hematocrit(Hct)were compared between the two groups.The blood loss was calculated and complications were observed.Results:The postoperative drainage volume,hidden blood loss volume and total blood loss volume in the treatment group were all lower than those in the control group(P<0.05).There was no statisti-cally significant difference in intraoperative blood loss between the two groups(P>0.05).There was no statistically significant difference in TCM syndrome scores between the two groups on the first day after surgery(P>0.05).The TCM syndrome scores in the treatment group were lower than those in the control group on the 7th and 14th days af-ter surgery(P<0.05).The HSS scores of both groups were higher than those before surgery after surgery,and the treatment group was higher than the control group(P<0.05).There was no statistically significant difference in VAS scores between the two groups at each time point before and after surgery(P>0.05).The levels of Hb and Hct in the treatment group were higher than those in the control group on the 7th and 14th days after surgery(P<0.05),and there was no statistically significant difference on the 3rd day after surgery(P>0.05).Neither group re-ceived allogeneic blood transfusion or had serious complications.Conclusion:Modified Buqi Yangxue decoction com-bined with tranexamic acid can reduce hidden blood loss after TKA,stabilize Hb and Hct levels,improve TCM syndrome and promote the recovery of knee joint function,and is a safe and effective perioperative adjuvant treatment plan.
刘昕岩;程韶;王吉利;李基威;班赛博;郑博文;许文龙;王上增
河南中医药大学,河南 郑州 450000河南中医药大学,河南 郑州 450000河南中医药大学,河南 郑州 450000河南省中医院,河南 郑州 450000河南中医药大学,河南 郑州 450000河南中医药大学,河南 郑州 450000河南中医药大学,河南 郑州 450000河南省中医院,河南 郑州 450000
医药卫生
膝骨性关节炎全膝关节置换术加味补气养血汤氨甲环酸隐性失血量膝关节功能
Knee osteoarthritisTotal knee arthroplastyModified Buqi Yangxue decoctionTranexamic acidHidden blood lossKnee function
《陕西中医》 2026 (5)
625-629,5
河南省自然科学基金资助项目(232300420269,222300420486)河南省科技攻关项目(252102310454)河南省高校科技创新团队(24IRTSTHN040)河南省中青年卫生健康科技创新领军人才培养项目(LJRC2024020)河南省中医药科学研究专项课题(2021ZY2010,2019ZY2035)郑州市科技惠民计划项目(2023KJHM0009)
评论