CAJ | 학술논문

目的观察四黄蜜外敷用于全膝关节置换术(total knee arthroplasty,TKA)后无菌性炎症的临床疗效.方法将30例全膝置换术后患者按简单随机化方法分为两组各15例,治疗组外敷四黄蜜(由大黄、黄芩、黄柏、黄连按相同比例共研为末加蜜制成,置于无菌塑料纸上,厚约0.5 cm,敷皮温最高处),6h后取下,间隔约2h再敷,24 h换一贴.对照组每天持续外敷冰块,以将膝关节完全包围为度,两组患者均治疗2周,分别观察治疗前,治疗后3d、7d、14d的临床疗效.结果治疗后治疗组VAS评分在第3天(4.12±1.08)分、第7天(3.34±0.61)分；第3天肤温(37.56±0.40)℃、活动度(98.56±324)°,与对照组同期疗效比较,差异有统计学意义(P＜0.05).消肿程度在第3天(5.80±2.00)％、第7天(9.33±2.55)％、第14天(12.13±2.70)％,均优于对照组同期疗效(P均＜0.05)；治疗组疼痛缓解率为93.33％、满意度为66.67％,虽均高于对照组的86.67％、46.67％,但差异无统计学意义(x2分别为1.33、3.04,P＞0.05).结论四黄蜜外敷治疗全膝置换术后无菌性炎症早期疗效较明显.
목적 관찰사황밀외부용우전슬관절치환술(total knee arthroplasty,TKA)후무균성염증적림상료효.방법 장30례전슬치환술후환자안간단수궤화방법분위량조각15례,치료조외부사황밀(유대황、황금、황백、황련안상동비례공연위말가밀제성,치우무균소료지상,후약0.5 cm,부피온최고처),6h후취하,간격약2h재부,24 h환일첩.대조조매천지속외부빙괴,이장슬관절완전포위위도,량조환자균치료2주,분별관찰치료전,치료후3d、7d、14d적림상료효.결과 치료후치료조VAS평분재제3천(4.12±1.08)분、제7천(3.34±0.61)분；제3천부온(37.56±0.40)℃、활동도(98.56±324)°,여대조조동기료효비교,차이유통계학의의(P＜0.05).소종정도재제3천(5.80±2.00)％、제7천(9.33±2.55)％、제14천(12.13±2.70)％,균우우대조조동기료효(P균＜0.05)；치료조동통완해솔위93.33％、만의도위66.67％,수균고우대조조적86.67％、46.67％,단차이무통계학의의(x2분별위1.33、3.04,P＞0.05).결론 사황밀외부치료전슬치환술후무균성염증조기료효교명현.
Objective To observe the clinical efficacy of external application of sihuang-honey for aseptic inflammation after total knee arthroplasty.Methods 30 cases of total knee arthroplasty patients were recruited into two groups,of 15 cases in each group.The treatment group was treated with sihuang-honey (made of rhubarb,scutellaria,phellodendron,coptis according to the same proportion of powder with honey ),which was placed on a sterile plastic sheet,0.5 cm thickness.The sheet was applied on the knee of the highest skin temperature for 6 hours,removed it for 2 hours interval,and reapplied on it,for altogether 24 hours before changing another sheet.The control group were treated by continued covering ice on the knee every day,with the ice completely surrounded the knee.Both groups were treated for 2 weeks.Clinical efficacy was observed before the treatment,and 3 d,7 d,14 d after the treatment.Results After the treatment,compared with the control group,the treatment group was effective in terms of VAS score (4.12± 1.08) points in 3d,(3.34±0.61)points in the first 7 days; skin temperature (37.56±0.40) ℃,activity (98.56±3.24) ° in 3d,and the difference was statistically significant (P＜0.05).The degree of swelling in 3 d (5.80±2.00) ％,7 d (9.33±2.55)％,14 d (12.13 ± 2.70)％ in the treatment group were better than the control group (P＜0.05); The rate of pain relief of treatment group was 93.33％ and satisfaction was 66.67％,although better than 86.67％ and 46.67％ of the control group,the difference was not statistically significant (x2 were 1.33,3.04,P＞0.05).Conclusion Sihuang-honey was effective for the treatment of aseptic inflammation after the surgery of total knee arthroplasty.