益气安神汤治疗老年股骨颈骨折患者行关节置换术后谵妄的临床观察  

Clinical observation of Yiqi Anshen Decoction in treating postoperative delirium in elderly patients with femoral neck fractures undergoing joint replacement surgery

作　　者：张鹏[1] 陈果 毕梦娜[1] ZHANG Peng;CHEN Guo;BI Mengna(Sichuan Orthopedic Hospital,Chengdu 610041,China)

机构地区：[1]四川省骨科医院,四川成都610041

出　　处：《四川中医》2025年第4期109-112,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：四川省中医管理局科学技术研究专项课题:老年髋部骨折患者中医特色风险评估系统的临床研究(编号:2021MS064)。

摘　　要：目的:评估自拟益气安神汤治疗老年股骨颈骨折关节置换术后谵妄的临床效果。方法:选取四川省骨科医院自2020年10月~2023年10月期间,收治60岁以上的因股骨颈骨折采取关节置换,并且术后出现谵妄的病例82例,随机分为治疗组(n=41)和对照组(n=41)。常规西药治疗为对照组,治疗组在西药治疗的基础上口服自拟益气安神汤治疗,治疗7日。对两组患者的临床疗效和治疗期间不良反应发生情况进行比较。比较两组谵妄CAM-CR评分、谵妄持续时长、睡眠时间、血常规以及炎性因子(CRP、SR、IL-6)实验室检查水平,不良反应发生率。结果:治疗组临床的有效率明显高于对照组。治疗到第3、7天治疗组的CAM-CR评分低于对照组,差异有统计学意义(P<0.05);同时,治疗组比对照组效果更明显。治疗期间,治疗组和对照组总不良反应发生率无明显差异(P>0.05)。结论:用益气安神汤治疗老年股骨颈骨折关节置换术后谵妄疗效明确,并能够有效延长患者睡眠时长,减少贫血发生,改善术后炎性反应。Objective:Analyzing the clinical efficacy of self-formulated Yiqi Anshen Decoction in treating postoperative delirium in elderly patients with femoral neck fractures after joint replacement surgery.Methods:We selected 82cases of delirium occurring in elderly patients with femoral neck fractures who underwent joint replacement surgery and were admitted to Sichuan Orthopedic Hospital from October 2020to October 2023.These cases were randomly divided into a treatment group(n=41)and a control group(n=41).The control group received conventional Western medicine treatment,while the treatment group received oral self formulated Yiqi Anshen Decoction on the basis of the control group for 7days.Compare the clinical efficacy and incidence of adverse reactions during treatment between two groups of patients.Compare the incidence of adverse reactions between two groups of delirium CAM-CR scores,duration of delirium,sleep time,blood routine,and laboratory tests for inflammatory factors(CRP,SR,IL-6).Results:The total clinical effective rate of the treatment group was higher than that of the control group.On the 3rd and 7th day of treatment,the CAM-CR score in the observation group was lower than that in the control group(P>0.05).The laboratory data of the treatment group was better than that of the control group.There was no significant difference in the total incidence of adverse reactions between the treatment group and the control group during the treatment period according to statistical analysis(P>0.05).Yiqi Anshen Tang has a clear therapeutic effect on delirium after joint replacement surgery for elderly femoral neck fractures,and can effectively increase patientssleep duration,reduce anemia incidence,and improve postoperative inflammatory reactions.

关 键 词：股骨颈骨折 关节置换术 谵妄 

分 类 号：R274.1[医药卫生—中医骨伤科学]