目的:观察"三因制宜"理念的中医辨证护理在全髋关节置换术患者中的应用效果.方法:将88例全髋关节置换术(total hip arthroplasty,THA)患者按随机数字表法分为对照组和三因组各44例.对照组给予西医常规护理,三因组在对照组的基础上给予"三因制宜"理念的中医辨证护理.观察两组患者术前及术后6天视觉模拟量表(visual analogue scale,VAS)和汉密尔顿焦虑量表(hamilton anxiety scale,HAMA)评分、术后7天炎症指标[白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necro-sis factor α,TNF-α)]、术后5个月Harris髋关节评分、并发症及护理满意度.结果:术后6天两组患者VAS和HAMA评分均低于术前(P＜0.05),三因组低于对照组(P＜0.05);术后7天两组患者血清IL-6、TNF-α水平均高于术前(P＜0.05),三因组低于对照组(P＜0.05);术后5个月,三因组患者Harris髋关节疼痛评分低于对照组(P＜0.05),活动度、功能评分均高于对照组(P＜0.05),畸形评分与对照组比较差异无统计学意义(P＞0.05);三因组患者并发症总发生率为2.27%(1/44),低于对照组的13.64%(6/44)(P＜0.05);三因组患者总满意度为95.45%(42/44),高于对照组的79.55%(35/44)(P＜0.05).结论:基于"三因制宜"理念的中医辨证护理可有效缓解THA患者疼痛,抑制炎症反应、改善髋关节功能,降低术后并发症,提高护理满意度.
Application Effect of TCM Syndrome Differentiation and Nursing in Total Hip Arthroplasty Patients Based on"Treatment Individualized to Patient,Season and Locality"
Objective:To observe the application effect of TCM syndrome differentiation and nursing based on the concept of"treatment individualized to patient,season and locality"in patients with total hip arthroplasty(THA).Methods:All 88 THA patients were divided into 44 cases each in the control group and the three factors group according to the random number table method.The control group was given Western medicine routine care,and the three factors group was given TCM syndrome differentiation nursing based on"treatment individualized to patient,season and locality"the control group accepted.To observe visual analogue scale(VAS)and Hamilton anxiety scale(HAMA)scores of the patients in the two groups before surgery and six days after surgery,and the inflammation indexes[interleukin-6(IL-6),tumor necrosis factor alpha(TNA-α)]on the 7th day after surgery,as well as Harris hip scores five months after the operation,the complications,and nursing satisfaction.Results:VAS and HAMA scores of patients in both groups six days after the operation were lower than these before the surgery(P＜0.05),VAS and HAMA scores of the three factors group were lower than these of the control group(P＜0.05);the levels of IL-6 and TNF-α of the two groups seven days after the surgery were higher than these before the operation(P＜0.05),the levels of IL-6 and TNF-α of the three factors group were lower than these of the control group(P＜0.05);five months after the operation,VAS scores of Harris hip of the three factors group were lower than these of the control group(P＜0.05),range of motion(ROM),functional scores higher than these of the control group(P＜0.05),while the difference had no statistical meaning when it was compared with the control group in malformation scores(P＞0.05);the total complication rate of the three factors group was 2.27%(1/44),lower than 13.64%(6/44)of the control group(P＜0.05);the total satisfaction of the three factors group was 95.45%(42/44),higher than 79.55%(35/44)of the control group(P＜0.05).Conclusion:TCM syndrome differentiation nursing based on"treatment individualized to patient,season and locality"can effectively relieve pain,inhibit inflammatory response,improve hip function,reduce postoperative complications,and improve nursing satisfaction in patients with THA.
total hip arthroplastytreatment individualized to patient,season and localityTCM syndrome differentiation nursingeffect analysis
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