A study on effect of Shenfu injection on early postoperative cognitive function and brain derived neurotrophic factor in patients with burns / 中国中西医结合急救杂志

ABSTRACT

Objective To investigate the effects of Shenfu injection on early post-operative cognitive dysfunction (POCD) and brain derived neurotrophic factor (BDNF) in patients with burns. Methods Fifty-six patients with burns and ready to receive surgical treatment of scars admitted to Affiliated Hospital of Southwest Medical University from July 2015 to January 2017 were enrolled, and they were divided into a control group and a Shenfu group by random number table, 28 cases in each group. The regimen of anesthesia induction before operation and anesthesia maintenance in the operation in two groups was the same, and the patients in Shenfu group received intravenous drip of Shenfu injection 40 mL at 0.5 hour before surgery. The Mini-mental State Examination Scale (MMSE) was used to evaluate the cognitive function after surgery, and MMSE score reduction of > 2 scores was recognized as cognitive impairment after operation;patient's pain degree was evaluated by using visual analogue scale (VAS); the levels of serum BDNF were detected by the enzyme-linked immunosorbent assay (ELISA) at 0.5 hour before operation, immediately after operation, and 12 hours, 1 day, 3 days after operation. Results The MMSE scores were significantly decreased in the two groups after surgery, but decreasing degree of the MMSE scores in Shenfu group were significantly slower than those of the control group (1 day after surgery was 22.8±2.9 vs. 20.5±3.2, 3 days after surgery was 25.6±3.1 vs. 23.2±3.0, both P < 0.05). The incidence of POCD in the Shenfu group was significantly lower than that of the control group [7.1% (2/28) vs. 42.9% (12/28), P < 0.05]. The VAS scores were significantly higher in the two groups after surgery, but there was no significant difference between the two groups at each time point (all P > 0.05). The serum BDNF levels were significantly increased in two groups at immediate post-operation and 12 hours after surgery compared with those 1 day before operation, in addition, the BDNF level in Shenfu group was obviously higher than that in the control group (mg/L: 13.5±4.2 vs. 9.9±3.3, 11.4±3.5 vs. 9.1±3.2, both P < 0.05), the serum BDNF levels in two groups returned to their preoperative levels on 1 day and 3 days after surgery (all P > 0.05). Conclusion The Shenfu injection can reduce the incidence of early POCD in patients with large area burns and its mechanism may be related to the increase of BNDF expression.