Effect Of Mongolian Medicine Erdun Wurile On Postoperative Sleep Quality Of Elderly Patients

Objective In this experiment,the Mongolian medicine Erdun wurile was applied to the elderly patients undergoing elective thoracic surgery.By monitoring the postoperative sleep quality,melatonin（MT）,γ-aminobutyric acid（GABA）,tumor necrosis factor-α（TNF-α）levels and postoperative recovery,the influence of Erdun wurile on the postoperative sleep quality of the elderly patients was observed.Methods Totally 60 elderly patients（≥65 years old）who underwent elective thoracic surgery in our hospital from March 2021 to December 2021 were randomly divided into control group（D）and experimental group（S）,with 30 patients in each group.Patients in group S took 15Erdun wurile tablets orally after getting up in the morning from 3 days before operation to 3days after operation;Patients in group D were treated with placebo at the same time.Both groups were given general anesthesia in the same way,intercostal nerve block was performed during operation,and PCIA analgesia pump with the same specification was used for analgesia management after operation.5ml venous blood was collected from cubital vein of all patients on the preoperative day 3 before taking medicine（T₀）and postoperative days 1（T₁）,4（T₂）.After centrifugation,the upper plasma was collected,and the levels of melatonin（MT）,γ-aminobutyric acid（GABA）and tumor necrosis factor-α（TNF-α）in plasma were measured by ELISA.Pittsburgh Sleep Quality Index Scale（PSQI）was used to evaluate the sleep quality of patients before taking medicine 3 days before operation（T₀）and 1 month after operation（T₃）.Richards-Campbell Sleep Scale（RCSQ）was used to evaluate the night sleep quality of patients before taking medicine 3 days before operation（T₀）and 1 day after operation（T₁）.The postoperative recovery quality scale（Qo R-40）was used to evaluate the recovery quality of patients before taking medicine 3 days before operation（T₀）and the first day after operation（T₁）.Results 1.General situation:There was no statistical difference in gender,age,body mass index（BMI）,anesthesia time and operation time,the score of PSQI,the score of RCSQ,the score of Qo R-40,the level of MT,the level of GABA and the level of TNF-αbetween the two groups（P>0.05）.2.Comparison of postoperative results:（1）Compared with T₀,the score of PSQI in group D was higher at T₃,the difference was statistically significant（P<0.05）,but there was no statistical difference in the score of PSQI in group S at T₃（P>0.05）;Compared with patients in group D,the score of PSQI in group S was lower at T₃the difference was statistically significant（P<0.05）.（2）Compared with T₀,the score of RCSQ in group D was lower at T₁,the difference was statistically significant（P<0.05）,but there was no statistical difference in the score of RCSQ in group S at T₁（P>0.05）;Compared with patients in group D,the score of RCSQ in group S was higher at T₁,the difference was statistically significant（P<0.05）.（3）Compared with T₀,the MT level of patients in group D decreased at T₁and T₂,the difference was statistically significant（P<0.05）,the MT level of patients in group S decreased at T₁,the difference was statistically significant（P<0.05）,and there was no statistical difference in MT level of patients in group S at T₂（P>0.05）;Compared with T₁in the group,the level of MT in both groups increased at T₂,the difference was statistically significant（P<0.05）;Compared with patients in group D,the scores of patients in group S were higher at T₁and T₂,the difference was statistically significant（P<0.05）.（4）Compared with T₀,the level of GABA in group D decreased at T₁and T₂,the difference was statistically significant（P<0.05）,but there was no statistical difference in the level of GABA in group S at T₁and T₂（P>0.05）;Compared with T₁in the group,the level of GABA in group D increased at T₂,the difference was statistically significant（P<0.05）,but there was no statistical difference in the level of GABA in group S at T₂（P>0.05）;Compared with patients in group D,GABA level in patients in group S increased at T₁and T₂,the difference was statistically significant（P<0.05）.（5）Compared with T₀,the level of TNF-αin patients in group D increased at T₁and T₂,the difference was statistically significant（P<0.05）,the level of TNF-αin group S had no statistical difference at T₁and T₂（P>0.05）;Compared with T₁in the group,the level of TNF-αin group D increased at T₂,the difference was statistically significant（P<0.05）,while the level of TNF-αin group S had no statistical difference at T₂（P>0.05）;Compared with patients in group D,the levels of TNF-αin patients in group S decreased at T₁and T₂,the difference was statistically significant（P<0.05）.（6）Compared with T₀,the score of emotional state,physical comfort,self-care ability,pain and total in group D decreased at T₁,the difference was statistically significant（P<0.05）,but there was no statistical difference in the score of psychological support（P>0.05）,the score of self-care ability,pain and total in group S decreased at T₁,the difference was statistically significant（P<0.05）,but there was no statistical difference in emotional state,physical comfort and psychological support score（P>0.05）;Compared with the patients in group D,the score of emotional state,physical comfort,self-care ability and total patients in group S increased at T₁,the difference was statistically significant（P<0.05）.Conclusion 1.Perioperative administration of Mongolian medicine Erdun wurile is helpful to improve the level of plasma MT and GABA and reduce the level of TNF-α.2.Perioperative administration of Mongolian medicine Erdun wurile is helpful to improve the postoperative sleep quality of patients and promote their rapid recovery.