龙龟安神汤治疗老年人髋部骨折术后谵妄临床研究

目的:观察龙龟安神汤治疗老年髋部骨折术后谵妄患者疗效。方法:选择68例老年髋部骨折术后谵妄患者,随机分为治疗组及对照组,治疗组给予龙龟安神汤联合奥氮平片治疗,对照组给予奥氮平片治疗。比较两组谵妄持续时间、谵妄评定量表-98评分(DRS-R-98)评分、中医症状分级量化评分、血清炎症因子水平、血清微小核糖核酸-205-5p(miR-205-5p)、微小核糖核酸-491-5p(miR-491-5p)相对表达量及临床疗效。结果:治疗后,治疗组总有效率88.24%高于对照组73.53%,治疗组谵妄持续时间短于对照组。治疗后,两组DRS-R-98评分、中医症状分级量化评分、炎症因子均低于治疗前,且治疗组低于对照组,差异有统计学意义(均P<0.05)。治疗后,两组血清miR-205-5p表达低于治疗前,且治疗组低于对照组,差异有统计学意义(均P<0.05)。治疗后血清miR-491-5p水平较治疗前升高,且治疗组高于对照组,差异有统计学意义(均P<0.05)。结论:龙龟安神汤治疗老年髋部骨折术后谵妄疗效较好,可缩短谵妄持续时间,并通过下调血清miR-205-5p、上调血清miR-491-5p表达抑制炎症反应。

Clinical study on Longgui Anshen decoction in treating elderly patients with delirium after hip fracture operation

Objective:To explore efficacy of Longgui Anshen decoction in the treatment of elderly patients with delirium after hip fracture surgery.Methods:68 elderly patients with delirium after hip fracture surgery were selected and randomly divided into treatment group and control group.The treatment group was treated with Longgui Anshen decoction combined with olanzapine tablets,and the control group give olanzapine tablets treatment.The duration of delirium,delirium rating scale-98(DRS-R-98)score,TCM symptom quantification score,serum inflammatory factors,serum microribonucleic acid-205-5p(miR-205-5p),microribonucleic acid-491-5p(miR-491-5p)and clinical efficacy were compared between the two groups.Results:The total effective rate of the treatment group was 88.24% higher than that of the control group 73.53%.The duration of delirium in the treatment group was significantly shorter than that of the control group.After treatment,the DRS-R-98 score,the quantitative score of TCM symptom classification and the level of inflammatory factors were significantly lower than before treatment,and the treatment group was lower than the control group,difference statistically significant(all P<0.05).After treatment,the serum miR-205-5p expression level in the two groups was lower than before treatment,and the treatment group lower than the control group,difference statistically significant(all P<0.05).After treatment,the serum miR-491-5p level was higher than before treatment,and the treatment group was higher than the control group,difference statistically significant(P<0.05).Conclusion:Longgui Anshen decoction has significant clinical effect in the treatment of delirium after hip fracture in the elderly,and the duration of delirium decreases.It can inhibit serum inflammatory factors by down-regulating expression of serum miR-205-5p and up-regulating the expression of serum miR-491-5p.