[1]冯艳琴,秦雪琴△.红景天胶囊缓解全髋关节置换术术后疲劳综合征疗效观察[J].西部中医药,2020,33(01):114.[doi:10.12174/j.issn.1004-6852.2020.01.30]
　FENG Yanqin,QIN Xueqin.Observation on Clinical Effects of Hongjingtian Capsules in Relieving Postoperative Fatigue Sydrome after Total Hip Replacement[J].Western Journal of Traditional Chinese Medicine,2020,33(01):114.[doi:10.12174/j.issn.1004-6852.2020.01.30]
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红景天胶囊缓解全髋关节置换术术后疲劳综合征疗效观察
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《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
33
期数:
2020年01期
页码:
114
栏目:
出版日期:
2020-01-15

文章信息/Info

Title:
Observation on Clinical Effects of Hongjingtian Capsules in Relieving Postoperative Fatigue Sydrome after Total Hip Replacement
文章编号:
1004-6852(2020)01-0114-05
作者:
冯艳琴，秦雪琴△
十堰市太和医院/湖北医药学院附属医院脊柱外科，湖北 十堰 442000
Author(s):
FENG Yanqin, QIN Xueqin△
Department of Spinal Surgery, Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan 442000, China
关键词:
全髋关节置换术; 股四头肌肌电图; 脑电图棘波; 5-羟色胺; 术后疲劳综合征; 红景天胶囊; 临床疗效
Keywords:
total hip arthroplasty;  quadriceps femoris EMG;  EEG spike;  5-HT;  postoperative fatigue syndrome;  Hongjingtian capsules;  clinical effects
分类号:
R255.9
DOI:
10.12174/j.issn.1004-6852.2020.01.30
文献标志码:
B
摘要:
目的：观察红景天胶囊缓解全髋关节置换术(total hip arthroplasty，THA)术后疲劳综合征(postoperative fatigue syndrome，POFS)的临床效果。方法：将股骨头缺血性坏死患者126例在实施THA术后按随机对照原则均分为对照组和观察组各63例，对照组患者THA术后行全程营养支持及抗炎预防感染，观察组在对照组治疗的基础上加服红景天胶囊以缓解POFS，两组术后均治疗3周。于THA术前、术后1周、术后3周分别记录两组患者股四头肌肌电图及脑电图棘波(electroencephalogram，EEG)振幅；测量血氧饱和度(blood oxygen saturation，SpO2)，静脉血5-羟色胺(5-hydroxy tryptamine，5-HT)及神经递质去甲肾上腺素(norepinephrine，NE)和肾上腺素(adrenaline，Adr)含量；ELISA法检测谷胱甘肽(glutathione，GSH)、脂质过氧化物(lipid peroxide，LPO)和超氧化物歧化酶(superoxide dismutase,SOD)含量；采用简明心境量表(profile of mood states，POMS)和视觉模拟量表(visual analog scale，VAS)评定两组患者围术期心境状态和疲劳程度，统计两组患者术后肛门排气时间和术后住院天数、并发症及POFS发生率。结果：治疗3周后，观察组患者EEG及股四头肌肌电图振幅分别为(80.94±7.05)μV和(91.82±11.73)μV，均低于对照组的(111.43±9.73)μV和(127.07±15.20)μV，差异均有统计学意义(P＜0.05)；观察组患者POMS和VAS评分分别为(9.19±2.54)分和(2.02±0.35)分，均低于对照组的(20.78±3.87)分和(5.12±0.41)分，差异均有统计学意义(P＜0.05)；观察组患者术后肛门排气时间、住院天数分别为(59.46±7.82）小时，(15.20±2.97)天，均短于对照组的(70.17±10.24)小时和(19.81±4.75)天，差异均有统计学意义(P＜0.05)；观察组患者肺部感染、深静脉栓塞、关节脱位和压疮分别为2、5、3、5例，分别低于对照组的0、2、1、0例，差异均有统计学意义(P＜0.05)；POFS发生率观察组为14.3%(9/63)，低于对照组的36.5%(23/63)，差异有统计学意义(P＜0.05)。治疗1、3周后，观察组患者静脉血SOD、SpO2和GSH均高于对照组，差异均有统计学意义(P＜0.05)，观察组患者5-HT和LPO均低于对照组，差异均有统计学意义(P＜0.05)。结论：红景天胶囊缓解THA患者术后POFS可能通过抑制5-HT合成与释放来调节脑血管对神经递质的敏感性，从而抑制股四头肌和EEG异常放电而降低患者“中枢性疲劳”。
Abstract:
Objective: To survey clinical effects of Hongjingtian capsules in the remission of postoperative fatigue syndrome(POFS) after total hip arthroplasty(THA). Methods: After performing THA, 126 patients with ischemic necrosis of femoral head were allocated to the control group and the observation group according to randomized controlled double-blind principle, 63 cases each group, the control group accepted whole nutritional support and anti-inflammation to prevent the infection after the operation, and the observation group took Hongjingtian capsules to relieve POFS, both groups were treated for three weeks after the surgery. To record quadriceps femoris electromyogram(EMG) and electroencephalogram(EEG) spike amplitude of the patients respectively before THA, one week and three weeks after THA; to detect the contents of SpO2, 5-HT, NE and Adr; ELISA method was used to measure the contents of GSH, LPO and SOD; POMS and VAS were adopted to assess mood states during perioperative period and fatigue degrees, to count postoperative anal exhaust time, postoperative hospitalization days, the complications and the incidence of POFS in both groups.. Results: After treating for three weeks, EEG and quadriceps femoris EMG spike amplitudes of the observation group were(80.94±7.05)μV and (91.82±11.73)μV, lower than (111.43±9.73)μV and (127.07±15.20)μV of the control group, and the difference had statistical meaning (P＜0.05); POMS and VAS of the observation group were (9.19±2.54) points and (2.02±0.35) points, lower than (20.78±3.87) points and (5.12±0.41) points of the control group, and the difference had statistical meaning(P＜0.05); postoperative anal exhaust time and hospitalization days of the observation group were (59.46±7.82)h and(15.20±2.97)d, lower than(70.17±10.24)h and(19.81±4.75)d of the control group, and the difference showed statistical meaning(P＜0.05); the number of the patients suffering pulmonary infection, deep venous thrombosis, joint dislocation and pressure sores in the observation group were two, five, three and five cases, less than zero, two, one and zero cases in the control group, and the difference had statistical meaning(P＜0.05); POFS incidence of the observation group was 14.3%(9/63), lower than 36.5%(23/63) of the control group, and the difference was significant(P＜0.05). After treating for one week and three weeks, the observation group was higher than the control group in SOD, SpO2 and GSH, and the difference showed statistical meaning(P＜0.05), the observation group was lower than the control group in 5-HT and LPO, and the difference was significant(P＜0.05). Conclusion: Hongjingtian capsules could relieve POFS of the patients after THA, because it could regulate the sensitivity of brain blood vessels to neurotransmitter through inhibiting the synthesis and release of 5-HT, and relieve central fatigue of the patients by inhibiting abnormal discharging of quadriceps femoris and EEG.

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备注/Memo

备注/Memo:
收稿日期：2018-12-20作者简介：冯艳琴(1977—)，女，主管护师。研究方向：骨科疾病的护理。△通讯作者：秦雪琴(1972—)，女，副主任护师。研究方向：病理生理学。
更新日期/Last Update: 2020-01-15