abstracted & translated by
Bob Flaws, Dipl. Ac. & C.H., Lic. Ac., FNAAOM, FRCHM
Keywords: Chinese medicine, Chinese herbal medicine, artificial knee surgery, postoperative swelling
In issue #4, 2003 of Jiang Xi Zhong Yi Yao (Jiangxi Chinese Medicine & Medicinals), Zhang Xin-hua published an article titled, "A Small Discussion on the Treatment of 36 Cases of Artificial Knee Postoperative Swelling & Distention," which appeared on page 23 of that journal. A summary of that article is given below.
Among the 36 patients enrolled in this study, 19 were male and 17 were female, 50-84 years of age. Twelve were cadres, 14 were workers, and 10 were peasants. Seventeen cases had a history of external injury, 10 had circulatory ischemia, and nine had rheumatoid arthritis. All 36 patients had undergone artificial knee replacement surgery and all experienced postoperative lower extremity which was worse when standing and walking. The time after surgery was variable among these patients, some longer and some shorter.
Yi Qi Li Shui Tang (Boost the Qi & Disinhibit Water Decoction) consisted of: Radix Codonopsitis Pilosulae (Dang Shen), 10g, Rhizoma Atractylodis Macrocephalae (Bai Zhu), 10g, Radix Astragali Membranacei (Huang Qi), 30g, Rhizoma Cimicifugae (Sheng Ma), 5g, Pericarpium Citri Reticulatae (Chen Pi), 10g, Radix Angelicae Sinensis (Dang Gui), 10g, Radix Ligustici Wallichii (Chuan Xiong), 6g, Caulis Akebiae (Mu Tong), 6g, Liu Yi San (Six to One Powder), 15g, Herba Lycopodii (Shen Jin Cao), 15g, and Radix Cyathulae (Chuan Niu Xi), 10g. If there was yang vacuity, 10 grams of Radix Lateralis Praeparatus Aconiti Carmichaeli (Fu Zi) were added. If pain was severe, 10 grams each of Rhizoma Corydalis Yanhusuo (Yan Hu Suo) and Radix Auklandiae Lappae (Mu Xiang) were added. One packet was boiled in water and administered per day, with seven days equaling one course of treatment.
Cure was defined as complete disappearance of swelling and distention with strength and agility when walking and standing. Improvement was defined as complete disappearance of swelling and distention. However, the course of treatment was relatively long. Based on these criteria, 29 cases were judged cured, and seven were judged improved.
It is the Chinese author’s experience that patients with this disorder are old with bodily weakness. In addition, enduring disease has damaged the qi and surgery has made this qi vacuity even more severe. Thus the water qi’s movement and transformation lacks power. Instead, it gathers to become swelling and distention. If one simply were to use the water-disinhibiting or quickening the blood method, this would easily damage the original qi and edema would not disperse but might even become more severe. In any case, the condition would endure and not heal. Within the above formula, Dang Shen, Bai Zhu, and Huang Qi fortify the spleen and supplement the qi. Sheng Ma upbears the clear and downbears the turbid. Then the water-disinhibiting medicinals, Mu Tong and Liu Yi San are added to as assistants in order to free the flow of the network vessels and guide the other medicinals to the appropriate channels. Therefore, their combined effect is to promote the movement of qi to clear water. This is based on the statement of fact, "If the qi moves, water fluids move. If the qi stops, water fluids collect and transform into evil dampness."
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