| Objective: In order to improve the development of Chinese medicine as the goal,and better observe the curative effect of Bushen Huoxue Decoction plus reduced formula on the elderly intertrochanteric fracture of femur(liver and kidney deficiency type)after PFNA and explore its possible mechanism of action at the initial stage.At the same time,It provides a new idea for the treatment of intertrochanteric fracture of femur in the elderly by the combined operation of ancient prescription Bushen Huoxue decoction.Methods:(1)Sixty elderly patients with intertrochanteric fracture of liver and kidney deficiency who met the inclusion and exclusion criteria in the Department of Orthopedics of Affiliated Hospital of Shandong University of Chinese Medicine from October 2020 to October 2022 were included in this study,and were randomly divided into two groups according to the 1:1 ratio,namely the observation group and the control group.(2)Observation group(after PFNA internal fixation,Bushen Huoxue decoction was added to the basic treatment),control group(after PFNA internal fixation,basic treatment alone),30 cases in each group.It was ensured that the same physician treated the intertrochanteric fracture of femur with PFNA internal fixation.After the operation,the same conventional treatment was given to the two groups,such as preventing thrombosis and preventing surgical knife infection.(3)In addition,the observation group was also given Bushen Huoxue decoction for30 days on the basis of conventional treatment.(4)The postoperative VAS pain score,the degree of swelling of the affected limb,the Harris hip function score of the affected hip,the TCM syndrome score,and the clinical efficacy were observed and compared between the two groups,and the clinical efficacy was analyzed.Results:(1)The overall situation of the patients and the related aspects of the disease were compared,it can be found that the comparison of age,gender,fracture classification and complications between the two groups of patients,the disease was liver and kidney deficiency type of elderly femoral intertrochanteric fracture,the difference was not statistically significant(P > 0.05),so that the observation group and the control group can be compared.(2)VAS pain score: after comparison between the observation group and the control group at the same time,before the subjects received treatment,there was no significant difference in VAS pain score between the two groups(P = 0.519 > 0.05).After the two groups were treated,the observation group and the control group were compared,the observation group(using Bushen Huoxue decoction in addition to the basic treatment)were better than the control group(only using the basic treatment),the difference was statistically significant(P < 0.05).In addition,in the intra-group comparison,the differences between the observation group and the control group before and after treatment were statistically significant(P < 0.05),so it can be concluded that the treatment method of the observation group is better than that of the control group,and the effect in VAS score is more significant.The ability of pain relief in the observation group was better than that in the control group,which proved that the modified Bushen Huoxue decoction had a certain effect on pain relief after intertrochanteric fracture of femur.(3)The degree of swelling of the affected limb: after the comparison between the observation group and the control group at the same time,before receiving treatment,there was no statistical significance in the degree of swelling of the affected limb between the two groups(P = 0.635 > 0.05).After the two groups were treated respectively,the comparison between the observation group and the control group showed that the observation group(using Bushen Huoxue decoction in addition to basic treatment)was superior to the control group(using only basic treatment),and the difference was statistically significant(P < 0.05).In addition,in the intra-group comparison,the differences between the observation group and the control group before and after treatment were statistically significant(P < 0.05).Therefore,it can be concluded that the treatment method of the observation group is better than that of the control group,and the effect is more significant in promoting the elimination of swelling after fracture.That is,the ability of the observation group to eliminate swelling is better than that of the control group,which proves that Bushen Huoxue decoction has certain effect to eliminate swelling after the operation of intertrochanteric fracture of femur.(4)Harris hip function score of affected hips: After the comparison between the observation group and the control group at the same time,before receiving treatment,there was no statistically significant difference in Harris hip function score between the two groups(P = 0.892 > 0.05).After the two groups were treated respectively,the comparison between the observation group and the control group showed that the observation group(using Bushen Huoxue decoction in addition to basic treatment)was superior to the control group(using only basic treatment),and the difference was statistically significant(P < 0.05).In addition,in the intra-group comparison,the differences between the observation group and the control group before and after treatment were statistically significant(P < 0.05),so it can be concluded that compared with the control group,the treatment method of the observation group is better,and the effect is more significant in restoring hip function.That is,the effect of restoring hip joint function in the observation group is better than that in the control group,which proves that Bushen Huoxue decoction has certain restoring effect on hip joint function of intertrochanteric fracture of femur(5)In terms of TCM syndrome scores: after the comparison between the observation group and the control group at the same time,there was no significant difference in TCM syndrome scores between the two groups before receiving treatment(P = 0.908 > 0.05);After the two groups were treated respectively,the comparison between the observation group and the control group showed that the observation group(using Bushen Huoxue decoction in addition to basic treatment)was superior to the control group(using only basic treatment),and the difference was statistically significant(P < 0.05).In addition,in the intra-group comparison,the differences between the observation group and the control group before and after treatment were statistically significant(P < 0.05).Therefore,compared with the control group,the treatment method of the observation group was better,and the effect was more significant in relieving the symptoms of liver and kidney deficiency of patients.That is,Bushen Huoxue decoction can relieve the symptoms of liver and kidney deficiency in patients with intertrochanteric fracture of femur.(6)The comparison of clinical efficacy between the observation group and the control group showed that the observation group(using Bushen Huoxue decoction in addition to the basic treatment)was superior to the control group(using only the basic treatment)and the difference was statistically significant(P=0.002 < 0.05).Therefore,compared with the control group,the treatment method of the observation group was better and the clinical efficacy was more significant.That is,Bushen Huoxue Decoction has superior clinical effect on elderly patients with intertrochanteric fracture of femur.(7)In the course of diagnosis and treatment,there were no adverse reactions in the observation group and the control group.Conclusion: Motor-moxibustion combined with auricular point sticking and simple auricular point sticking have certain immediate analgesic effects on cold and wet type lumbago.Compared with simple auricular point sticking,motor-moxibustion combined with auricular point sticking has better immediate analgesic effect on cold and wet type lumbago than the latter in relieving pain,improving lumbago symptoms,improving cold and dampness symptoms and overall efficacy.The treatment is comfortable for patients and easy to operate,which is worthy of clinical promotion. |
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