Clinical Efficacy Analysis Of Huoxuebugu Decoction In The Treatment Of Elderly Patients With Neer Ⅲ And Ⅳ Proximal Humeral Fractures After Operation

Objective:The clinical effect of modified Huoxuebugu decoction in the treatment of Neer III and Ⅳ proximal humeral fractures in the elderly was analyzed to provide the basis for the clinical application of integrated traditional Chinese and western medicine in the treatment of Neer III and Ⅳ proximal humeral fractures in the elderly.Methods :The elderly patients with Neer III and Ⅳ proximal humeral fractures who met the inclusion criteria from October 2019 to June 2020 in Department of Orthopedics and Trauma,Yongchuan Hospital of Traditional Chinese Medicine,Chongqing Medical University were collected.The patients were randomly divided into two groups according to the random number table method.The control group was treated with internal fixation and locking system operation,and the patients were treated with anti-infection,detumescence and analgesia after operation.On the basis of the scheme of the control group,the experimental group was treated with Huoxue Bugu Decoction from the same day after operation for four weeks.The subjective pain(from 0 to 10 points,from painless to severe pain)of the two groups were evaluated by pain digital grading method at 3days,1 week,4 weeks and 6 months after operation.In addition,the recovery of shoulder joint function was evaluated by shoulder Neer scoring system at 1 week,4 weeks and 6 months after operation according to the stability of the affected shoulder joint and the range of active and passive activities.The main observation indexes were subjective pain and objective shoulder function at each time point after operation.The secondary indexes included postoperative hospital stay,fracture healing time and postoperative complications.Results :A total of 80 patients were included in this study,including 40 cases in the control group(Neer III 24 cases,Ⅳ 16cases)and 40 cases in the experimental group(Neer III 26 cases,Ⅳ14 cases).There was no significant difference in the baseline characteristics between the two groups.The NRS scores of the experimental group were significantly lower than those of the control group at 3 days,1 week,4 weeks and 6 months after operation(P <0.05).Similarly,the Neer scores of patients in the experimental group at 1,4 and 6 months after operation were significantly higher than those in the control group(P < 0.05).It is worth noting that the postoperative hospital stay and fracture healing time in the experimental group were significantly lower than those in the control group(P < 0.05).Finally,2 patients in the experimental group were complicated with shoulder joint adhesion,while 7 patients in the control group were complicated with shoulder joint adhesion(P <0.05).Another patient was complicated with wound epidermal infection and 1 patient was complicated with delayed fracture healing.Conclusions:In view of Neer type III and Ⅳ proximal humeral fractures in the elderly,oral administration of Huoxuebugu decoction combined with postoperative basic treatment can effectively relieve postoperative pain,improve shoulder joint function,reduce the incidence of postoperative complications,shorten postoperative hospital stay and fracture healing time.