| Objective: This topic intends to observe the clinical effect of Bushen Huoxue Decoction combined with open reduction and locking plate internal fixation in the treatment of osteoporotic proximal humeral fracture,so as to judge the effectiveness and superiority of this method and provide reference for the clinical treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and western medicine.Methods: From June 2021 to December 2022 in Ruikang Hospital affiliated to guangxi university of chinese medicine,40 patients with osteoporotic proximal humeral fracture were treated with open reduction and locking plate internal fixation.The TCM syndrome differentiation was kidney deficiency and blood stasis.Patients were divided into control group and treatment group according to the treatment willingness,with 20 cases in each group.The control group was given oral alfacalcidol soft capsules and intramuscular injection of calcitonin for anti-osteoporosis treatment after operation.The treatment group was given Bushen Huoxue Decoction on the basis of the control group.The changes of TCM symptom score,TCM symptom curative effect,visual analogue scales(VAS),calcium and phosphorus product values,bone alkaline phosphatase(BALP),osteoprotegerin(OPG),nuclear factor-kb receptor activating factor(RANK),receptor activator of NF-κB ligand(RANKL)and bone mineral density were observed in the two groups before and after treatment.The data were statistically analyzed by SPSS26.0 software,and P<0.05 was set as a statistically significant standard to evaluate the clinical efficacy of Bushen Huoxue Decoction combined with open reduction and locking plate internal fixation in the treatment of osteoporotic proximal humeral fractures.Results: There was no significant difference in baseline data(sex,age,distribution of affected limbs and fracture classification)between the two groups(P>0.05),which was comparable.There was no statistically significant difference in the scores of TCM symptoms before operation between the two groups(P>0.05),but the scores of TCM symptoms in the treatment group were lower than those in the control group on the 3rd month after operation,with statistical significance(P<0.05).Compared with the curative effect of TCM symptoms after treatment in the two groups,in the control group,1 case was cured,1 case was significantly effective and 12 cases were effective,with a total effective rate of 70%.In the treatment group,2 cases were cured,8 cases were significantly effective and 9 cases were effective,with a total effective rate of95%.The treatment group was significantly better than the control group,and the difference was statistically significant(P<0.05).The overall analysis of VAS score showed that there were significant differences in comparison between groups and time points(P<0.05),but there was no significant difference in interaction(P>0.05).On the 14 th day after operation,the calcium and phosphorus product values of patients in both groups were higher than those on the 1st day after operation,and the difference was statistically significant(P<0.05).The level of calcium and phosphous product values in the treatment group was higher than that in the control group on the 14 th day after operation,and the difference was statistically significant(P<0.05).The BALP of patients in both groups on the 14 th day after operation was higher than on the 1st day,and the difference was statistically significant(P<0.05).However,there was no significant difference in BALP between the two groups on the 14 th day after operation(P>0.05).On the 14 th day after operation,the OPG level in both groups was higher than that the 1st day after operation,and the levels of RANK and RANKL were lower than the 1st day,with statistical significance(P<0.05).The level of OPG increased and the level of RANK and RANKL decreased in the treatment group on the 14 th day after operation,which were significantly higher than that in the control group(P<0.05).The overall analysis of bone mineral density showed that there were significant differences between groups and time points(P<0.05),but there was no significant difference in interaction(P>0.05).Conclusion: Bushen Huoxue Decoction has positive therapeutic significance in relieving patients’ pain,accelerating patients’ postoperative recovery,improving osteoporosis symptoms and promoting fracture healing after operation.Bushen Huoxue Decoction is safe and reliable,with no obvious adverse reactions,and can be popularized in clinic. |
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