Effect of Danggui Buxue Decoction combined with sequential tranexamic acid anticoagulation on elderly patients undergoing total knee arthroplasty
WANG Jiang-jing
QI Jia
ZHANG Li-na
SUN Jing-cun
Abstract：Objective To investigate the effects of Danggui Buxue Decoction combined with sequential anticoagu-lation of tranexamic acid on recovery outcomes in elderly patients undergoing total knee arthroplasty(TKA).Methods A total of 104 elderly patients with knee osteoarthritis(KOA)scheduled for TKA between January 2021 and December 2022 were enrolled and randomly assigned to two groups(n=52 each).The observation group received Danggui Buxue Decoction plus sequential tranexamic acid anticoagulation,while the control group received tranexamic acid anticoagulation alone.Postoperative blood loss parameters,hemoglobin(Hb),red blood cell count(RBC),coagulation indices[pro-thrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D)],as well as knee joint range of motion(ROM)and Hospital for Special Surgery(HSS)knee scores at 1,3,and 6 months postopera-tively were compared.Postoperative complications were recorded.Results The observation group had significantly lower total blood loss,postoperative drainage,and hidden blood loss compared with the control group(P＜0.05),while intrao-perative blood loss was comparable(P＞0.05).Hb and RBC levels decreased at postoperative day 1 and day 7 in both groups,reaching the lowest point,then recovered by day 14;levels in the observation group returned to baseline(P＞0.05),and were significantly higher than those in the control group at all time points(P＜0.05).Coagulation indices showed postoperative changes with PT and APTT shortened and FIB and D-D elevated on day 1(P＜0.05),then gradu-ally normalized by day 14.Compared with the control group,the observation group had longer PT and APTT and lower FIB and D-D on day 1 and day 7(P＜0.05).Both ROM and HSS scores improved progressively at 1,3,and 6 months after surgery,with the observation group showing significantly greater improvements than the control group(P＜0.05).The in-cidence of postoperative complications was 9.62％in the observation group and 23.08％in the control group,with no sig-nificant difference(P＞0.05).Conclusion The combination of Danggui Buxue Decoction with sequential anticoagula-tion of tranexamic acid in elderly TKA patients effectively reduces hidden blood loss,mitigates the impact of surgery on co-agulation function,and improves postoperative knee joint function.
Keywords：Angelica Buxue Decoctiontranexamic acidthe elderlytotal knee replacementoccult blood losscoagulation function
Publication Date：2025-09-15
Online Publishing Date：2025-11-06(First online date of this platform, not the publication date of the document)
Pages：6( 1357-1362 )