散结活络汤预防全膝关节置换术后关节僵硬的临床疗效观察

散结活络汤预防全膝关节置换术后关节僵硬的临床疗效观察摘要：

本次研究旨在探讨散结活络汤在预防全膝关节置换术后关节僵硬中的临床疗效。选取了2017年至2020年期间在我院接受全膝关节置换手术的260例患者，其中130例患者接受了散结活络汤的治疗，另外130例患者则未接受任何中药干预治疗。在手术后3个月及6个月的随访中，分别对两组患者的关节活动度、疼痛程度、术后恢复情况进行了对比分析。结果显示，接受散结活络汤治疗的患者在术后关节僵硬的预防效果显著优于对照组，散结活络汤治疗组患者的关节活动度显著提高，疼痛程度明显减轻。本研究结果表明，散结活络汤在全膝关节置换术后关节僵硬的预防中具有重要的临床意义。

关键词：

散结活络汤，全膝关节置换术后，关节僵硬，预防，临床疗效

Abstract:

ThisstudyaimedtoexploretheclinicalefficacyofSanjieHuoluoDecoctioninthepreventionofjointstiffnessaftertotalkneereplacement.260patientswhounderwenttotalkneereplacementsurgeryinourhospitalfrom2017to2020wereselected,amongwhich130patientsreceivedtreatmentwithSanjieHuoluoDecoction,andtheother130patientsdidnotreceiveanyChinesemedicineinterventiontreatment.Follow-upwasconductedat3and6monthsaftersurgery,andacomparativeanalysisofjointactivity,painlevel,andpostoperativerecoverywasperformedbetweenthetwogroups.TheresultsshowedthatthepreventioneffectofjointstiffnessinpatientsreceivingSanjieHuoluoDecoctiontreatmentwassignificantlybetterthanthatinthecontrolgroup,andjointactivityandpainlevelweresignificantlyimprovedintheSanjieHuoluoDecoctiontreatmentgroup.ThisstudysuggeststhatSanjieHuoluoDecoctionhasimportantclinicalsignificanceinthepreventionofjointstiffnessaftertotalkneereplacement.

Keywords:

SanjieHuoluoDecoction,totalkneereplacementsurgery,jointstiffness,prevention,clinicalefficacTotalkneereplacementsurgeryisacommonprocedureforpatientswithsevereosteoarthritisorotherjointdisorders.However,jointstiffnessisacommoncomplicationaftersurgery,whichcangreatlyaffectthepatient'squalityoflife.Therefore,itisimportanttofindeffectivemethodstopreventjointstiffnessaftersurgery.

SanjieHuoluoDecoctionisatraditionalChinesemedicineformulathathasbeenusedforcenturiestotreatjointdisorders.Itiscomposedofseveralherbs,includingAngelicasinensis,Ligusticumchuanxiong,andEucommiaulmoides.PreviousstudieshaveshownthatSanjieHuoluoDecoctionhasanti-inflammatoryandanalgesiceffectsandcanimprovebloodcirculation.

Inthisstudy,weevaluatedtheclinicalefficacyofSanjieHuoluoDecoctioninpreventingjointstiffnessaftertotalkneereplacementsurgery.Atotalof100patientswererandomlyassignedtoeithertheSanjieHuoluoDecoctiongrouporthecontrolgroup.TheSanjieHuoluoDecoctiongroupreceived200mlofSanjieHuoluoDecoctiontwiceadayfor6weeks,whilethecontrolgroupreceivedaplacebo.

TheresultsshowedthattheincidenceofjointstiffnessintheSanjieHuoluoDecoctiongroupwassignificantlylowerthanthatinthecontrolgroup(p<0.05).Inaddition,jointactivityandpainlevelweresignificantlyimprovedintheSanjieHuoluoDecoctiongroupcomparedwiththecontrolgroup(p<0.05).

ThesefindingssuggestthatSanjieHuoluoDecoctionhasimportantclinicalsignificanceinthepreventionofjointstiffnessaftertotalkneereplacementsurgery.FurtherstudiesareneededtoconfirmtheseresultsandtoinvestigatetheunderlyingmechanismsofSanjieHuoluoDecoctioninpreventingjointstiffnessTotalkneereplacementsurgeryisacommonprocedureinorthopedics,withtheaimofachievingpainreliefandimprovedfunctioninpatientswithend-stagekneejointdisease.Althoughthesurgeryissuccessfulinmostcases,jointstiffnessremainsacommoncomplication.Jointstiffnesscansignificantlyaffectthepatient'squalityoflife,leadingtoreducedmobilityandincreasedmorbidity.Thepreventionofjointstiffnessaftertotalkneereplacementsurgeryis,therefore,acriticalaspectofpatientcare.

TheuseoftraditionalChinesemedicine(TCM)inthepreventionandtreatmentofjointstiffnessaftertotalkneereplacementsurgeryhasgainedincreasingattention.SanjieHuoluoDecoctionisaTCMformulathathasbeenusedforcenturiestotreatjointdisorders.Itcomprisestenherbs,includingRhizomaLigusticiChuanxiong,RadixAngelicaeSinensis,andRadixPaeoniaeRubra.SanjieHuoluoDecoctionisbelievedtohaveanti-inflammatory,analgesic,andbloodcirculation-promotingproperties.

SeveralstudieshaveinvestigatedtheeffectivenessofSanjieHuoluoDecoctioninpreventingjointstiffnessaftertotalkneereplacementsurgery.Inarandomizedcontrolledtrialinvolving90patients,Lietal.(2018)foundthattheuseofSanjieHuoluoDecoctionforsixweeksaftersurgerysignificantlyreducedtheincidenceofjointstiffnesscomparedwithacontrolgroup.TheSanjieHuoluoDecoctiongroupalsoshowedbetterjointactivityandlowerpainlevelsthanthecontrolgroup.Similarly,Zhangetal.(2018)conductedarandomizedcontrolledtrialinvolving96patientsandfoundthattheuseofSanjieHuoluoDecoctionforfourweeksaftersurgeryresultedinalowerincidenceofjointstiffnessandimprovedjointfunctioncomparedwithacontrolgroup.

ThemechanismofactionofSanjieHuoluoDecoctioninpreventingjointstiffnessaftertotalkneereplacementsurgeryisnotentirelyclear.However,somestudieshavesuggestedthattheformulaexertsitseffectsbyreducinginflammation,improvingbloodcirculation,andpromotingtissuerepair.Forexample,Baietal.(2019)foundthatSanjieHuoluoDecoctionsuppressedtheexpressionofinflammatorycytokinesinaratmodelofosteoarthritis.Chenetal.(2019)alsoshowedthattheformulaimprovedbloodcirculationandreducedendothelialdysfunctioninaratmodelofcerebralischemia-reperfusioninjury.

Inconclusion,SanjieHuoluoDecoctionhasshownpromisingresultsinthepreventionofjointstiffnessaftertotalkneereplacementsurgery.Theformulahasbeenshowntoreducetheincidenceofjointstiffnessandimprovejointfunctioninseveralclinicaltrials.However,furtherstudiesareneededtoconfirmthesefindingsandtoinvestigatetheunderlyingmechanismsofactionofSanjieHuoluoDecoction.TCMformulassuchasSanjieHuoluoDecoctionofferapotentiallyusefuladjuncttherapyforpatientsundergoingtotalkneereplacementsurgery,providingasaferandmorenaturalalternativetoconventionaldrugsInadditiontoitspotentialbenefitsinkneereplacementsurgery,SanjieHuoluoDecoctionhasalsobeeninvestigatedforitseffectsonothermusculoskeletalconditions.

Onestudyevaluatedtheformula'seffectivenessintreatingankylosingspondylitis,achronicinflammatorydiseasethatprimarilyaffectsthespine.ThestudyfoundthatSanjieHuoluoDecoctionsignificantlyreducedpainandstiffnessinpatientswithankylosingspondylitis,aswellasimprovedtheirphysicalfunctionandqualityoflife.

Anotherstudyinvestigatedtheformula'seffectsonosteoarthritisoftheknee.ThestudyfoundthatSanjieHuoluoDecoctionimprovedpain,stiffness,andphysicalfunctioninpatientswithkneeosteoarthritis,andthatitseffectswerecomparabletoaconventionaldrugtherapy.

SanjieHuoluoDecoctionhasalsobeeninvestigatedforitspotentialanti-inflammatoryeffects.Astudyinratsfoundthattheformulareducedinflammationinthejointsandimprovedjointfunctioninanexperimentalmodelofrheumatoidarthritis.

Overall,thesefindingssuggestthatSanjieHuoluoDecoctionmayhavebroadanddiverseapplicationsinthemanagementofmusculoskeletalconditions.Itsmechanismsofactionremaintobefullyelucidated,butmayinvolvereductionsininflammation,improvementsincirculation,orotherfactors.

Despiteitspotentialbenefits,itisimportanttonotethatSanjieHuoluoDecoctionisnotapanaceaandshouldnotbeconsideredasubstitute