新中医2026，Vol.58Issue(9)：20-27,8.DOI:10.13457/j.cnki.jncm.2026.09.004
四神煎加减联合平衡针对全膝关节置换术后患者的影响
Effects of Modified Sishen Decoction Combined with Balance Acupuncture on Patients After Total Knee Arthroplasty
摘要
Abstract
Objective:To observe the effects of modified Sishen Decoction combined with balance acupuncture on pain,stress response,serum levels of β-defensin-3(HBd-3),and soluble vascular cell adhesion molecule-1(sVCAM-1)in patients after total knee arthroplasty(TKA).Methods:A total of 108 patients with knee osteoarthritis treated in the Department of Orthopedics,Chinese Medicine Hospital of Puyang,from February 2023 to January 2025 were selected and randomly divided into the control group and the study group using the random number table method,with 54 cases in each group.In the control group,3 cases were lost to follow-up,leaving 51 cases included;in the study group,3 cases were lost to follow-up and 2 cases voluntarily withdrew,totaling 5 cases excluded,leaving 49 cases included.Both groups underwent TKA and received conventional postoperative treatment.The control group additionally received balance acupuncture,while the study group received modified Sishen Decoction combined with balance acupuncture.Clinical effects were evaluated.Serum levels of adrenomedullin(AM),calcitonin gene-related peptide(CGRP),anandamide(AEA),sVCAM-1,bradykinin(BK),high-sensitivity C-reactive protein(hs-CRP),plasma adrenocorticotropic hormone(ACTH),cortisol(COR),HBd-3 protein,plasma D-dimer,and fibrinogen were measured on postoperative day 1 and at 4 weeks after surgery.At 4 weeks after surgery,the 6-Point Behavioral Rating Scale(BRS-6)was used for pain assessment,and the circumference differences of the affected versus the healthy side at the thigh(15 cm above the upper edge of the patella)and calf(10 cm below the lower edge of the patella)were measured.A 6-month follow-up was conducted to record the incidence of prosthesis loosening,synovitis,and chronic pain in both groups.Results:The total effective rate in the study group was 95.92%(47/49),higher than that of 80.39%(41/51)in the control group(P＜0.05).At 4 weeks after surgery,levels of hs-CRP,HBd-3,ACTH,COR,sVCAM-1,D-dimer,fibrinogen,CGRP,AM,and BK were decreased when compared with those on postoperative day 1 in both groups(P＜0.05),and the levels in the study group were lower than those in the control group(P＜0.05).At 4 weeks after surgery,AEA levels were increased when compared with those on postoperative day 1 in both groups(P＜0.05),and the AEA level in the study group was higher than that in the control group(P＜0.05).After treatment,the BRS-6 score and circumference differences of the thigh and calf in the study group were lower than those in the control group(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).The 6-month follow-up after surgery showed that the incidence of prosthesis loosening,synovitis,and chronic pain in the study group was lower than that in the control group,the difference being significant(P＜0.05).Conclusion:Modified Sishen Decoction combined with balance acupuncture in the treatment of patients after TKA can regulate the levels of pain-promoting and pain-inhibiting mediators,reduce stress and inflammatory responses,improve coagulation function,alleviate pain and edema of the affected limb,prevent long-term complications,and enhance clinical effect.关键词
膝骨关节炎/全膝关节置换术后/四神煎/平衡针/疼痛介质/应激反应/β-防御素-3/可溶性血管细胞间黏附分子-1Key words
Knee osteoarthritis/After total knee arthroplasty/Sishen Decoction/Balance acupuncture/Pain mediators/Stress response/β-defensin-3/Soluble vascular cell adhesion molecule-1分类
医药卫生引用本文复制引用
李晓良,梁婷,葛占洲,何瑞娟,杨晓莉..四神煎加减联合平衡针对全膝关节置换术后患者的影响[J].新中医,2026,58(9):20-27,8.基金项目
河南省第三批中医药青苗人才项目(豫卫中医药科教[2024]4号) （豫卫中医药科教[2024]4号）
