Experimental Study Of Treatment On Early Infected Knee Arthroplasty With Xihuangwan

Objective:1.The aim of this study was to identity the inhibitory effect in vitro on commonpathogens of periprosthetic joint infection with XiHuangWan.2.And by the treatment with XiHuangWan on knee prosthesis infection model of NewZealand rabbits, to make sure the effect on infected periprosthetic joints.Methods:1. Antimicrobial test in vitro that XiHuangWan influenced on common pathogens ofperiprosthetic joint infection.Through the method of solid medium serial dilution test, we addedthe Double diluted XiHuangWan solutions into MH agar respectively that had been heatedand dissolved, and banlaced in50℃bath.Then infunded the fully mixed agar into Sterileplates. Agar plates contained different concentrations of drug were prepared.Nextresuscitated2standard strains and15clinical strains and prepared bacterium liquid withconcentration of0.5MC.Then divided the plate into18regions respectively. By multipleinoculation apparatus inoculated the18bacterium liquids into areas specified in every plate.Then took the plates out of incubator chamber at37degrees after cultivated24hours, andobserved the growth of18bacterial strains,calculated the MIC of each bacterial.2. Experiments in vivo of treatment on early infected knee arthroplasty withXiHuangWan.Firstly, constructed New Zealand rabbits models of infection after knee replacement,then injected Staphylococcus aureus ATCC25923into the operated knee articular cavities aweek after operation to make models of PJI. A week after injection, all experimentalsubjects were Successfully infected, and were randomly divided into4groups: controlgroup, XiHuangWan group, levofloxacin group and XiHuangWan combined Levofloxacin group. Administered drugs by gastric gavage. To evaluate the efficacy of XiHuangWan onearly infected knee arthroplasty, we observed the effects of XiHuangWan on animals’general situations and blood biochemical indices.Results:1. Its bacteriostasis in vitro showed that XiHuangWan could inhibit the growth of S.aureus、S.epidermidis and E.coli in vitro. The MIC was6.4mg/ml-12.8mg/ml,3.2mg/ml-25.6mg/ml,6.4mg/ml-25.6mg/ml Respectively.2. The general situations of XiHuangWan group, levofloxacin group and combinedgroup were obviously improved than control group after treatment.And the blood biochemical indices gradually returned to normal. Moreover, the ratioof lymphocytes of XiHuangWan group and combined group was higher than levofloxacingroup after treatment, as well as the general situations. Yet there were cases of infections inXiHuangWan group and levofloxacin group through gross observation, and in each groupthrough examinating the number of bacteria of synovial fluid and tissue. Butthe number of bacteria of synovial fluid and tissue of combined group was significantlylower than that of XiHuangWan group and levofloxacin group.Conclusion:1. Experiments in vitro prove XiHuangWan could eliminate S. aureus、S.aureus andE. coli from Clinical specimens.2. Experiments in vivo showed that XiHuangWan could effectively treat the infectioncaused by S. aureus and had the similar effect of levofloxacin, it could improve therapeuticefficacy if in combination with levofloxacin.