桃红四物汤治疗老年髋部骨折患者股骨头置换术后早期认知功能障碍的效果

Effect of Taohong Siwu Decoction on early postoperative cognitive dysfunction after femoral head replacement in elderly patients with hip fracture

目的探讨桃红四物汤治疗老年髋部骨折患者股骨头置换后早期术后认知功能障碍(POCD)的效果。方法选取2020年6月至2022年5月浙江省湖州市第一人民医院收治的80例老年髋部骨折行股骨头置换术后早期POCD患者,采用随机数字表法将其分为对照组、观察组,每组40例。对照组给予肝素治疗1周,同时给予中药汤剂安慰剂1个月,观察组给予肝素治疗1周,同时给予桃红四物汤1个月。治疗后,比较两组临床疗效,比较两组治疗前后认知功能评分、血清学指标,观察治疗过程中不良反应发生情况。结果治疗后,两组简易精神状况检查(MMSE)评分及褪黑素(MT)、胰岛素样生长因子1(IGF-1)水平高于治疗前,美国国立卫生研究院卒中量表(NIHSS)评分、β淀粉样蛋白(Aβ)水平低于治疗前,且观察组MMSE评分及MT、IGF-1水平高于对照组,NIHSS评分、Aβ水平低于对照组,差异有统计学意义(P<0.05)。观察组临床疗效优于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论桃红四物汤治疗股骨头置换术后早期POCD效果显著,能够提高患者的认知水平,改善神经功能。

Objective To investigate the effect of Taohong Siwu Decoction on early postoperative cognitive dysfunction(POCD)after femoral head replacement in elderly patients with hip fracture.Methods Eighty elderly hip fracture patients with early POCD after femoral head replacement admitted to the First People’s Hospital of Huzhou of Zhejiang Province from June 2020 to May 2022 were selected and divided into control group and observation group by random number table method,with 40 cases in each group.The control group was given heparin treatment for one week,and the traditional Chinese medicine decoction placebo for one month;the observation group was given heparin treatment for one week,and the Taohong Siwu Decoction for one month.After treatment,the clinical efficacy of the two groups was compared,and the cognitive function scores and serological indexes of the two groups were compared before and after treatment,and the occurrence of adverse reactions during treatment was observed.Results After treatment,the score of mini mental status examination(MMSE),and levels of melatonin(MT),insulin-like growth factor 1(IGF-1)in both groups were higher than those before treatment,the scores of National Institute of Health stroke scale(NIHSS)and levels of amyloidβ(Aβ)were lower than those before treatment,and the score of MMSE and levels of MT,IGF-1 in the observation group were higher than those in the control group,scores of NIHSS and levels of Aβwere lower than those in control group,the differences were statistically significant(P<0.05).The clinical efficacy of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Taohong Siwu Decoction has a remarkable effect in the treatment of early POCD after femoral head replacement,which can improve the cognitive level and nerve function of patients.