Effectiveness of Chinese Herbal Medicine in Postoperative Fatigue Syndrome Following Total Joint Arthroplasty or Hip Fracture Surgery: Evidence from Randomized Controlled Trials

Jinlong Zhao; Guanghui Zhou; Zhongsheng Wang; Guihong Liang; Xingde Wei; Bangxin Sha; Weiyi Yang; Jun Liu; Hongyun Chen

doi:10.2174/0113862073258802231107060433

Effectiveness of Chinese Herbal Medicine in Postoperative Fatigue Syndrome Following Total Joint Arthroplasty or Hip Fracture Surgery: Evidence from Randomized Controlled Trials

Comb Chem High Throughput Screen. 2023 Nov 29. doi: 10.2174/0113862073258802231107060433. Online ahead of print.

Authors

Jinlong Zhao¹, Guanghui Zhou¹, Zhongsheng Wang², Guihong Liang³, Xingde Wei¹, Bangxin Sha⁴, Weiyi Yang², Jun Liu^{5

6

6}, Hongyun Chen²

Affiliations

¹ The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
² Medical College of Acupuncture-Moxibustion and Rehabilitation of Guangzhou University of Chinese Medicine, Guangzhou, China.
³ The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China.
⁴ The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
⁵ The Research Team on Bone and Joint Degeneration and Injury of Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, China.
⁶ Guangdong Second Traditional Chinese Medicine Hospital (Guangdong Province Enginering Technology Research Institute of Traditional Chinese Medicine), Guangzhou 510095, China.

PMID: 38031783
DOI: 10.2174/0113862073258802231107060433

Abstract

Background: There is no high-quality, evidence-based protocol for the treatment of postoperative fatigue syndrome (POFS) after total joint arthroplasty (TJA) or fracture surgery with Chinese herbal medicine (CHM).

Purpose: The purpose of this study was to explore the efficacy of CHM in the treatment of POFS after TJA or hip fracture surgery (HFS).

Methods: We searched six databases to obtain randomized controlled trials (RCTs) of CHM for the treatment of POFS after TJA or HFS. The retrieval time limit was from the establishment of each database to August, 2022. According to the Cochrane Handbook for Systematic Reviews version 5.1, we used RevMan 5.3 to evaluate the quality of the studies. Stata 14.0 software was used to merge and analyze the data. The weighted mean difference (WMD) was the effect estimate for statistical analysis. We also performed subgroup analyses according to different types of surgeries.

Results: A total of 11 RCTs were included in this study, comprising 430 cases in the CHM group and 432 cases in the control group (CG). The meta-analysis results showed that there was no significant difference in the Brief Profile of Mood States (BPOMS) score (WMD=0.08, 95% confidence interval (CI): -0.29 to 0.45, P=0.688), Christensen Fatigue scale (CHFS) score (WMD = 0.15, 95% CI: -0.09 to 0.39, P=0.214) or Identity-Consequence Fatigue Scale (ICFS) score (WMD=-0.40, 95% CI: -1.84 to 1.05, P=0.589) between the CHM group and the CG on the first postoperative day. The use of CHM significantly reduced the BPOMS score (WMD=-0.85 and WMD=-3.01, respectively), CHFS score (WMD=-1.01 and WMD= -1.45, respectively), and ICFS score (WMD=-3.51 and WMD=-5.26) on postoperative days 3 and 7. Compared with the CG, the CHM group had significantly increased serum transferrin and IgG levels on postoperative days 3 and 7. The subgroup analysis results suggested that the application of CHM in HFS patients improved fatigue symptoms on postoperative days 3 and 7, while the application of CHM to treat POFS in TJA patients had great inconsistency in the evaluation of different indicators.

Conclusion: The application of CHM improved the fatigue status of POFS patients after TJA or HFS and increased the levels of transferrin and IgG in serum, which is conducive to promoting the postoperative rehabilitation process of patients. The subgroup analysis results showed that the application of CHM to intervene in POFS in HFS patients had obvious benefits.

Keywords: Chinese Herbal Medicine; Effectiveness; Hip Fracture SurgerEffectiveness; Postoperative Fatigue Syndrome; Total Joint Arthroplasty.