| 加味逍遥散在预防老年髋部骨折患者术后谵妄的临床研究 |
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投稿时间：2019-04-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 陈建良 |
CHEN Jian-liang |
绍兴市上虞中医医院, 浙江 绍兴 312300 |
Shangyu Hospital of Traditional Chinese Medicine of Shaoxing, Shaoxing 312300, Zhejiang, China |
chjil8168@163.com |
| 万蕾 |
WAN Lei |
绍兴市上虞中医医院, 浙江 绍兴 312300 |
Shangyu Hospital of Traditional Chinese Medicine of Shaoxing, Shaoxing 312300, Zhejiang, China |
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| 朱少兵 |
ZHU Shao-bing |
绍兴市上虞中医医院, 浙江 绍兴 312300 |
Shangyu Hospital of Traditional Chinese Medicine of Shaoxing, Shaoxing 312300, Zhejiang, China |
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| 许勇 |
XU Yong |
绍兴市上虞中医医院, 浙江 绍兴 312300 |
Shangyu Hospital of Traditional Chinese Medicine of Shaoxing, Shaoxing 312300, Zhejiang, China |
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| 郑晓东 |
ZHENG Xiao-dong |
绍兴市上虞中医医院, 浙江 绍兴 312300 |
Shangyu Hospital of Traditional Chinese Medicine of Shaoxing, Shaoxing 312300, Zhejiang, China |
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| 期刊信息：《中国骨伤》2019年，第32卷，第9期，第833-836页 |
| DOI：10.3969/j.issn.1003-0034.2019.09.012 |
| 基金项目:浙江省中医药科技计划项目（编号：2016ZA195） |
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| 中文摘要:目的：研究疏肝解郁健脾补血降低高龄髋部骨折患者谵妄发生的疗效。方法：将2014年12月至2018年6月收治的180例髋部骨折的老年患者按照入院顺序分为治疗组及安慰剂组：治疗组患者90例，服用加味逍遥散，其中男32例，女58例；年龄（72.12±4.92）岁；股骨转子骨折67例，股骨颈骨折23例；35例行动力髋螺钉固定，31例行髓内固定，24例行人工髋关节置换。安慰剂组患者90例，服用安慰剂，其中男37例，女53例；年龄（72.91±5.43）岁；股骨转子骨折69例，股骨颈骨折21例；其中37例动力髋螺钉固定，30例髓内固定，23例人工髋关节置换。观察比较两组患者年龄、性别、损伤部位、术中出血量、术后引流量、手术时间、麻醉时间、术后疼痛评分、术后血红蛋白、术后C-反应蛋白、谵妄严重程度评分及谵妄发生。结果：所有患者随访至谵妄恢复正常，治疗组中术后谵妄12例（13.33%）；安慰剂组术后谵妄39例（43.33%），治疗组明显优于安慰剂组；两组监测指标对比：术后疼痛评分（P=0.002）、术后血红蛋白（P=0.012），术后C-反应蛋白（P=0.042），两组比较差异有统计学意义。结论：加味逍遥散通过其疏肝解郁、健脾补血之效，达到降低术后疼痛、炎症刺激及补充血容量的目的，能够明显降低术后谵妄的发生率。 |
| 【关键词】加味逍遥散 髋部骨折 老年人 谵妄 |
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| Clinical study of Jiawei Xiaoyao Powder(加味逍遥散,JWXYP) on preventing delirium in elderly patients with hip fracture after operation |
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ABSTRACT
Objective:To study the effect of soothing liver,relieving depression,invigorating spleen and reinforcing blood on reducing delirium in elderly patients with hip fracture.
Methods:From December 2014 to June 2018,180 elderly patients with hip fracture admitted were divided into treatment group and placebo group according to the order of admission:90 patients in treatment group were treated with Jiawei Xiaoyao Powder(加味逍遥散,JWXYP),including 32 males and 58 females,with an average age of(72.12±4.92),involving 67 cases of femoral trochanter fractures and 23 cases of femoral neck fractures; 35 cases underwent dynamic hip screw fixation,31 cases underwent intramedullary fixation and 24 cases underwent artificial hip replacement. In the placebo group,90 patients were treated with placebo,including 37 males and 53 females,with an average age of(72.91±5.43) years old,involving 69 cases of femoral trochanteric fractures and 21 cases of femoral neck fractures,including 37 cases underwent dynamic hip screw fixation,30 cases underwent intramedullary fixation and 23 cases underwent artificial hip replacement. The age,sex,injury site,intraoperative bleeding volume,postoperative drainage,operation time,anesthesia time,post-operative pain score,post-operative hemoglobin,post-operative CRP,delirium severity(DRS) score and delirium occurrence were observed and compared between the two groups.
Results:All patients were followed up until delirium returned to normal,postoperative delirium was found in 12 cases (13.33%) in the treatment group and in 39 cases(43.33%) in the placebo group,the treatment group was significantly better than the placebo group. The monitoring indexes of the two groups were compared:post-operative pain score(P=0.002),post-operative hemoglobin(P=0.012),post-operative CRP(P=0.042).
Conclusion:JWXYP can relieve liver depression,invigorate spleen and invigorate blood circulation,reduce pain,inflammatory stimulation and supplement blood volume after operation,and significantly reduce the incidence of delirium after operation. |
| KEY WORDS Jiawei Xiaoyao Powder (加味逍遥散,JWXYP) Hip fractures Aged Delirium |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈建良,万蕾,朱少兵,许勇,郑晓东.加味逍遥散在预防老年髋部骨折患者术后谵妄的临床研究[J].中国骨伤,2019,32(9):833~836 |
| 英文格式: | CHEN Jian-liang,WAN Lei,ZHU Shao-bing,XU Yong,ZHENG Xiao-dong.Clinical study of Jiawei Xiaoyao Powder(加味逍遥散,JWXYP) on preventing delirium in elderly patients with hip fracture after operation[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(9):833~836 |
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