飞经走气针法对全膝关节置换术后下肢肿胀的疗效观察
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摘要
目的:比较飞经走气针法与局部间断冰敷治疗全膝关节置换术后下肢肿胀的疗效。方法:将60例首次进行单侧人工全膝关节置换术术后的患者分为针刺组和冰敷组,每组各30例。针刺组采用飞经走气针法干预,冰敷组给予局部间断冰敷治疗。观察比较两组患者术肢髌骨上、下10 cm的周径变化、疼痛评分(VAS法)。结果:TKA术后第1天,比较两组下肢肿胀的程度,差异无统计学意义(P> 0. 05)。TKA术后第7天,两组患者下肢肿胀的程度对比同组术后第1天均有明显改善,差异均具有统计学意义(P <0. 01);而针刺组的总有效率为96. 67%,针刺组的临床疗效优于冰敷组(P <0. 01)。结论:飞经走气针法在促进TKA术后下肢肿胀消退的方面具有较好的临床疗效,且此方法安全、简单,值得在临床推广和应用。
Objective: To compare the clinical efficacy differences between"Feijing Zouqi"needling methods and discontinuous ice compress therapy acting on lower limb swelling after total knee arthroplasty( TKA). Methods: Sixty patients undergoing unilateral total knee arthroplasty for the first time were divided into acupuncture group and ice pack group,30 cases in each group.The acupuncture group was treated with"Feijing Zouqi"needling methods and the ice group was treated with discontinuous ice compress therapy. We observed and compared the changes in the circumference of the upper limbs and the underarms limbs and the pain scores( VAS) of the two groups. Results: On the 1 st day after TKA,there was no significant difference in the degree of swelling between the two groups( P > 0. 05). On the 7 th day after TKA,the improvement of the degree of swelling of the lower extremities of the two groups was better than that of the lower extremities of the same group on the first day after operation( P <0. 01). The total effective rate of the acupuncture group was 96. 67%. The clinical efficacy of acupuncture group was better than that of ice group( P < 0. 01). Conclusion: The use of "Feijing Zouqi"needling methods for the treatment of lower limb swelling after TKA has good clinical efficacy and a great advantage in promoting the regression of lower limb swelling. This method is not only safe but also effective and it is worthy of clinical application.
Objective: To compare the clinical efficacy differences between"Feijing Zouqi"needling methods and discontinuous ice compress therapy acting on lower limb swelling after total knee arthroplasty( TKA). Methods: Sixty patients undergoing unilateral total knee arthroplasty for the first time were divided into acupuncture group and ice pack group,30 cases in each group.The acupuncture group was treated with"Feijing Zouqi"needling methods and the ice group was treated with discontinuous ice compress therapy. We observed and compared the changes in the circumference of the upper limbs and the underarms limbs and the pain scores( VAS) of the two groups. Results: On the 1 st day after TKA,there was no significant difference in the degree of swelling between the two groups( P > 0. 05). On the 7 th day after TKA,the improvement of the degree of swelling of the lower extremities of the two groups was better than that of the lower extremities of the same group on the first day after operation( P <0. 01). The total effective rate of the acupuncture group was 96. 67%. The clinical efficacy of acupuncture group was better than that of ice group( P < 0. 01). Conclusion: The use of "Feijing Zouqi"needling methods for the treatment of lower limb swelling after TKA has good clinical efficacy and a great advantage in promoting the regression of lower limb swelling. This method is not only safe but also effective and it is worthy of clinical application.
引文
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[13]高福强,李子剑,刘延青,等.初次全膝关节置换术后肢体肿胀程度与隐性失血量的相关性研究[J].中国矫形外科杂志,2011,19(3):199-202.
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[17]王文英.针灸治疗疟疾患儿贫血的动态观察[J].中国针灸,1999(1):8-10.
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[19]张岩,张宇.针灸治疗膝关节骨性关节炎30例疗效观察[J].光明中医,2010,25(3):474-475.
[20]王婧,田素领,吴娇娟,等.合谷穴穴性剖析[J].中国针灸,2017,37(5):565-566.
[21]刘康,田丽芳.针刺内关、太冲穴治疗膝骨性关节炎[J].中国针灸,2013,33(2):105-107.
[22]刘世红.三阴交穴临床配伍应用举隅[J].杏林中医药,2011,31(11):1100-1101.
[23]沈雪勇.经络腧穴学[M].北京:中国中医药出版社,2002:148.
[24]刘月妲,董字翔,夏德军.血海穴的研究概况[J].辽宁中医杂志,2008,35(6):934-935.
[25]吴雪洋,李春日.论阳陵泉穴临床治疗作用[J].辽宁中医药大学学报,2016,18(11):153-155.
[26]He ML,Xiao ZM,Lei M,et al.Continuous passive motion for preventing venous thromboembolism after total knee arthroplasty[J].Cochrane Database Syst Rev,2014,7:D8207.
[27]胡美琳.冷疗法在缓解膝关节置换术后肿痛的应用进展[J].大家健康,2016,10(14):296-297.
[2]Xu J,Zhang J,Wang XQ,et al.Effect of joint mobilization techniques for primary total knee arthroplasty:Study protocol for a randomized controlled trial[J].Medicine(Baltimore),2017,96(49):e8827.
[3]Gao FQ,Li ZJ,Zhang K,et al.Risk factors for lower limb swelling after primary total knee arthroplasty[J].Chin Med J(Engl),2011,124(23):3896-3899.
[4]Ozturk M,Mutlu F,Kara A,et al.Evaluation of the effect of nasal dorsal skin cooling on nasal mucosa by acoustic rhinometry[J].Laryngol Otol,2014,128(12):1067-1070.
[5]中华医学会风湿病学分会.骨关节炎诊断及治疗指南[J].中华风湿病学杂志,2010,14(6):416-419.
[6]胥少汀,葛宝丰,徐印坎.实用骨科学[M].4版.北京:人民军医出版社,2012:2112-2114.
[7]马爽,宋洋,黄秋颖,等.全膝关节置换术后应用局部间断冰敷治疗效果分析[J].临床军医杂志,2017,45(2):198-199.
[8]鲁贵生.血府逐瘀汤加减治疗下肢骨折术后肿胀50例[J].湖南中医杂志,2011,27(2):54,63.
[9]王予彬,贺忱.创伤及手术后肢体肿胀的机制[J].中华医学信息导报,2003(7):21.
[10]Tomita M,Motokawa S.Effects of air tourniquet on the antibiotics concentration,in bone marrow injected just before the start of operation[J].Mod Rheumatol,2007,17(5):409-412.
[11]Matsuda K,Nozawa M,Katsube S,et al.Reinfusion of unwashed salvaged blood after total knee arthroplasty in patients with rheumatoid arthritis[J].Int Orthop,2009,33(6):1615-1618.
[12]高福强,李子剑,张克,等.初次全膝关节置换术后肢体肿胀的影响因素研究[J].中国矫形外科杂志,2011,19(9):724-727.
[13]高福强,李子剑,刘延青,等.初次全膝关节置换术后肢体肿胀程度与隐性失血量的相关性研究[J].中国矫形外科杂志,2011,19(3):199-202.
[14]李景荣.针刺抗炎治疗的进展(综述)[J].中国针灸,1983(5):42-43.
[15]Niimi H,Yuwono H S.Asian traditional medicine:from molecular biology to organ circulation[J].Clin Hemorheol.Microcirc,2000,23:123-125.
[16]Hsiu H,Hsu,W C,Chen,BH,et al.Differences in the microcirculatory effects of local skin surface contact pressure stimulation between acupoints and nonacupoints:Possible relevance to acupressure[J].Physiol Meas,2010,31:829-841.
[17]王文英.针灸治疗疟疾患儿贫血的动态观察[J].中国针灸,1999(1):8-10.
[18]吕国蔚.穴位传入与针刺镇痛的基础与临床研究[J].神经解剖学杂志,2016,32(1):119-123.
[19]张岩,张宇.针灸治疗膝关节骨性关节炎30例疗效观察[J].光明中医,2010,25(3):474-475.
[20]王婧,田素领,吴娇娟,等.合谷穴穴性剖析[J].中国针灸,2017,37(5):565-566.
[21]刘康,田丽芳.针刺内关、太冲穴治疗膝骨性关节炎[J].中国针灸,2013,33(2):105-107.
[22]刘世红.三阴交穴临床配伍应用举隅[J].杏林中医药,2011,31(11):1100-1101.
[23]沈雪勇.经络腧穴学[M].北京:中国中医药出版社,2002:148.
[24]刘月妲,董字翔,夏德军.血海穴的研究概况[J].辽宁中医杂志,2008,35(6):934-935.
[25]吴雪洋,李春日.论阳陵泉穴临床治疗作用[J].辽宁中医药大学学报,2016,18(11):153-155.
[26]He ML,Xiao ZM,Lei M,et al.Continuous passive motion for preventing venous thromboembolism after total knee arthroplasty[J].Cochrane Database Syst Rev,2014,7:D8207.
[27]胡美琳.冷疗法在缓解膝关节置换术后肿痛的应用进展[J].大家健康,2016,10(14):296-297.
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