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

Abstract

aims: The purpose of this study was to explore the efficacy of CHM in the treatment of POFS after TJA or hip fracture surgery (HFS). background: There is no high-level evidence-based basis for the treatment of postoperative fatigue syndrome (POFS) after total joint arthroplasty (TJA) or fracture surgery with Chinese herbal medicine (CHM). objective: The purpose of this study was to explore the efficacy of CHM in the treatment of POFS after TJA or hip fracture surgery (HFS). method: We searched six databases to obtain randomized controlled trials (RCTs) of CHM in 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 Review version 5.1, we applied RevMan 5.3 to evaluate the quality of the literature. Stata 14.0 software was used to merge and analyse the measured data. The weighted mean difference (WMD) was the effect quantity for statistics. We also performed subgroup analyses according to different types of surgery. result: 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% 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) and 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 application 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 contents 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 content 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. other: NA