红景天胶囊降低创伤性股骨头缺血性坏死全髋关节置换术术后疲劳综合征的临床研究

Clinical study on the treatment of fatigue syndrome after total hip arthroplasty with Hongjingtian capsule in patients with traumatic avascular necrosis of the femoral head

目的观察红景天胶囊对创伤性股骨头缺血性坏死全髋关节置换术术后疲劳综合征(POFS)的影响。方法全髋关节置换术病人术后病人114例,将114例病人按随机原则均分为对照组和观察组,每组各57例。对照组行髋关节置换术后抗炎及全程营养支持治疗,观察组在此治疗基础上加服红景天胶囊。术前、术后1周和术后2周分别记录病人股四头肌肌电图及大脑皮层诱发电位;分析静脉血氧饱和度(Sp O2)、超氧化物歧化酶(SOD)、谷胱甘肽(GSH)和脂质过氧化物(LPO),检测外周血5-羟色胺(5-HT)、神经递质肾上腺素(adrenaline,A)、去甲肾上腺素(Noradrenaline norepinephrine,NE)含量。采用简明心境量表(Brief Profile of Mood States,BPOMS)评定围术期心境状态,视觉模拟量表(visual analogue scale,VAS)评定疲劳程度,统计两组病人术后并发症及POFS发生率,比较临床疗效。结果与对照组比较,观察组术后1周和术后2周时,大脑皮层诱发电位及股四头肌肌电图电压较对照组明显下降(P<0.05);静脉血Sp O2显著提高,LPO和外周血5-HT显著下降(P<0.05);BPOMS和VAS评分、术后并发症(深静脉栓塞2例、关节脱位1例、压疮3例)及POFS发生率(19.29%)均低于对照组(P<0.05)。结论红景天胶囊可降低创伤性股骨头缺血性坏死全髋关节置换术POFS的发生。

Objective To investigate the effect of postoperative fatigue syndrome（ POFS） of total hip arthroplasty in patients with traumatic avascular necrosis of the femoral head when treated with Hongjingtian capsule. Methods A total 114 cases with total hip arthroplasty,who were enrolled from March 2015 to July 2016 in the department of orthopedics of Taihe Hospital of Shiyan city,were equally divided into the control group and the observation group. The control group was treated with anti-inflammation and nutrition support after total hip arthroplasty,and the observation group was treated with the addition of Hongjingtian capsule. One week before and after surgery,and two weeks after operation,the femoral head four muscle electromyography and evoked cortical potentials were recorded,and the venous oxygen saturation（ Sp O2） superoxide dismutase（ SOD）,glutathione（ GSH） and lipid peroxide（ LPO）,hydroxyl amine（ 5-HT） in peripheral blood and neurotransmitter epinephrine（ adrenaline,Adr）,norepinephrine（ noradrenaline,NE） content were analyzed. The peri operative mood was evaluated by Brief Profile of Mood States（ BPOMS）,and the degree of fatigue was evaluated by the visual analogue scale（ VAS）. The incidences of postoperative complications and POFS were compared. Results The cerebral cortex evoked potentials and quadriceps electromyogram voltage one week and two weeks after operation in the observation group decreased significantly compared with that in the control group（ P〈0. 05）; Sp O2% in the venous blood,significantly increased,and LPO and 5-HT in the peripheral blood significantly decreased（ P〈0. 05）; BPOMS and VAScore,postoperative complications（ 2 cases of deep venous thrombosis,1 case of joint dislocation,3 cases of pressure ulcer incidence） and POFS（ 19. 29%） were lower than that in the control group（ P〈0. 05）. Conclusion The application of Hongjingtian capsule can reduce POFS of total hip arthroplasty in patients with traumatic avascular necrosis of the femoral head.