关键词: 中药, 腰椎椎体间融合, 术后发热, 炎症, 白细胞介素, 干扰素γ, 肿瘤坏死因子, 信号通路

Abstract: BACKGROUND: Postoperative fever is one of the common clinical symptoms after posterior lumbar interbody fusion. There is no clear etiology or pathogenesis. The postoperative body temperature of patients is easy to repeat, the course of the disease is long, and the therapeutic effect of western medicine is poor, which affects the postoperative recovery of patients. 
OBJECTIVE: To review the relationship between inflammatory signaling pathways and postoperative fever and the mechanism of Chinese medicine in preventing and treating fever after posterior lumbar interbody fusion, and to explore new therapeutic drugs for postoperative fever.
METHODS: The CNKI Chinese Journal full-text database, WanFang database, and PubMed database were searched for articles published from June 2006 to December 2023. Chinese search terms were “Chinese medicine, postoperative fever, inflammation, interleukin-1, interleukin-6, interleukin-8, interferon gamma, tumor necrosis factor, prostaglandin E2, p38 mitogen-activated protein kinase, nuclear factor-κB, Toll-like receptor, Janus kinases/signal transduction and transcriptional activator, Notch signaling pathway.” English search terms were “medicinal herb, postoperative fever, inflammation, interleukin-1, interleukin-6, interleukin-8, γ-interferon, tumor necrosis factor, prostaglandin E2, p38 mitogen-activated protein kinase, nuclear factor-κB, toll-like receptor, janus kinases/signal transducer and activator of transcription, notch signaling pathway.” Articles with irrelevant research content and poor quality were excluded, and 100 articles were included and summarized.
RESULTS AND CONCLUSION: (1) The operation induced the release of inflammatory factors, and the pro-inflammatory factors acted on the thermoregulatory center in the anterior hypothalamus to promote fever. (2) The absorption of bleeding and oozing fluid in the incision after surgery, and the phagocytosis of the egg white decomposition products of the necrotic cells, produce endogenous pyrogen (interleukin, tumor necrosis factor, interferon, etc.), leading to fever. (3) Cytokines pass through inflammatory signals, play an inflammatory role, and promote fever. (4) Chinese herbs or Chinese herbal compounds can regulate inflammatory signaling pathways and play an anti-inflammatory and antipyretic role in preventing and treating postoperative fever. Due to the lack of the mechanism of action of traditional Chinese medicine, it is necessary to further study and clarify the signaling pathways related to the prevention and treatment of postoperative fever by traditional Chinese medicine, and use modern technology to link cellular and molecular technology with the pharmacological mechanism of traditional Chinese medicine, so as to guide clinicians to use medicine and promote postoperative recovery of patients. (5) Chinese medicine combined with Western medicine in the treatment of postoperative fever is a future research hotspot. We should give full play to the advantages of Chinese medicine, and clarify the target mechanism of action of different syndrome types of Chinese medicine monomer or active ingredient extracts and Chinese medicine decoction. 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: traditional Chinese medicine, lumbar interbody fusion, postoperative fever, inflammation,  , interleukin, interferon-γ, tumor necrosis factor, signaling pathway