Clinical Study on Modified Pingwei Powder Combined with Percutaneous Nerve Muscle Electrical Stimulation for Severe Patients with Orthopedic Trauma with ICUAcquired Weakness
Abstract: Objective: To observe the curative effect of modified Pingwei Powder combined with percutaneous nerve muscle electrical stimulation on severe patients with orthopedic trauma with intensive care unit-acquired weakness (ICU-AW). Methods:A total of 92 ICU-AW patients with severe orthopedic trauma were observed and divided into the control group and the observation group according to the random number table method,with 46 cases in each group. On the basis of routine treatment,the control group was given guidance for patients to perform rehabilitation functional exercises, and the observation group received modified Pingwei Powder combined with percutaneous nerve muscle electrical stimulation on the basis of the control group. Both groups were treated for two weeks continuously. The clinical effects and incidence of complications were compared between the two groups. The changes in Barthel Index (BI) scores,ICU stay time,mechanical ventilation days,total hospitalization days,Medical Research Council (MRC) scores, Acute Physiological and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores, and levels of tumor necrosis factor- α (TNF- α) in serum were compared between the two groups before and after treatment. Results:The total effective rates in the observation group and the control group were 95.65% and 80.43% respectively,the difference being significant (P<0.05). After treatment,the improvement in daily living activity (BI) level in the observation group was better than that in the control group (P<0.05). After treatment,the observation group had shorter ICU stay time,mechanical ventilation days,and total hospitalization days than those in the control group (P<0.05). In terms of time factors,inter group factors, and time point interaction factors,the difference in MRC scores between the two groups at different time points was significant (P<0.05). After treatment for three days and seven days,the MRC scores in the two groups were increased when compared with those before treatment (P<0.05),and the MRC score in the observation group was higher than that in the control group (P<0.05). The APACHE Ⅱ scores in the two groups were compared in terms of time factors,inter group factors,and time point interaction factors at different time points,and the difference was significant (P<0.05). After three and seven days of treatment, the APACHEⅡ scores in the two groups were reduced when compared with those before treatment (P< 0.05),and the APACHEⅡscores in the observation group were lower than those in the control group (P< 0.05). After 14 days of treatment, the TNF- α levels in the two groups were decreased when compared with those before treatment (P<0.05),and the TNF-α level in the observation group was lower than that in the control group (P<0.05). During the treatment period,the incidence of complications was 4.35% in the observation group,and 13.04% in the control group. There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: Modified Pingwei Powder combined with percutaneous nerve muscle electrical stimulation has a good therapeutic effect on severe orthopedic trauma with ICU-AW,which can improve daily living ability and limb muscle strength,shorten the disease course, inhibit serum TNF- α levels,and reduce the body's inflammatory state.