Clinical Study On Prevention Of DVT In Senile Patients With Intertrochanteric Femoral Fracture After Operation By Using Shixiao Powder And Taohongsiwu Decoction Combined With Rivaroxaban

Objective To explore Shixiao powder and Taohongsiwu Decoction combined with Rivaroxaban effect on blood hypercoagulability after intertrochanteric fracture surgery in elderly patients and its clinical value in preventing deep vein thrombosis of lower limbs.Methods Select the elderly patients with femoral intertrochanteric fracture admitted to the Department of Traumatic Orthopaedics,Fouzhou Hospital of Integrated Chinese and Western Medicine,Fujian Province,in which 100 patients who met the requirements were randomly divided into two groups: Chinese medicine combined with western medicine group(hixiao powder and Taohongsiwu Decoction combined with Rivaroxaban group)and western medicine group(Rivaroxaban group).The blood indexes(D-dimer,Fib,APTT,TT,thromboelastogram(R,MA,Angle,CI)of the two groups were observed before and on the first,seventh and fourteenth day after operation.VAS pain scores and TCM syndrome points changes.The deep vein color Doppler ultrasonography of both lower limbs was performed on the fourteenth day after operation to determine whether DVT occurred.Results 1.There was no significant difference in gender,age,time from admission to operation after injury,operation time,BMI and basic illnessbetween the two groups(P > 0.05)2.D-dimer and Fib : there was no statistical significance in D-dimer and Fib between the two groups before and on the first day after operation(P > 0.05);the D-dimer and Fib of Chinese medicine combined with western medicine group on the seventh and fourteenth day after operation were lower than those of Western medicine group,and the difference was statistically significant(P < 0.05).3.Thromboelastogram:R: there was no statistical significance in the R of the two groups before and on the first day after operation(P > 0.05);the Chinese medicine combined with western medicine group was significantly higher than that of western medicine group on the seventh and fourteenth day after operation(P < 0.05).MA,Angle and CI :there was no statistical significance in MA,Angle and CI between the two groups before and on the first day after operation(P > 0.05).The MA,Angle and CI of Chinese medicine combined with western medicine group on the seventh and fourteenth day after operation were lower than those of western medicine group,and the difference was statistically significant(P < 0.05).4.PT and APTT: there was no statistical significance in PT between the two groups before and on the first day after operation(P > 0.05);The PT of Chinese medicine combined with western medicine group was significantly higher than that of western medicine group on the 7th and 14 th day after operation.There was no statistical significance in APTT between the two groups(P > 0.05).5.VAS pain score: there was no significant difference in VAS pain score between the two groups on the first day after operation(P > 0.05);on the seventh day and the fourteenth day after operation,the VAS pain score of the Chinese medicine combined with western medicine group was lower than that of the western medicine group,the difference was statistically significant(P < 0.05).6.Thrombosis: There were 3 patients in the Chinese medicine combined with western medicine group,all of them were calf intermuscular vein thrombosis,the incidence of thrombosis was 6.6%.There were 6 patients in the western medicine group,2 was posterior tibial vein thrombosis,4 was calf intermuscular vein thrombosis,the incidence of thrombosis was 13.3%.There was no statistical significance between the two groups(P > 0.05).7.TCM syndrome points and efficacy:there was no significant difference in TCM syndrome points between the two groups on the before treatment(P > 0.05);on the after treatment,the TCM syndrome points of the Chinese medicine combined with western medicine group was lower than that of the western medicine group,the difference was statistically significant(P < 0.05).The TCM syndrome efficacy of the Chinese medicine combined with western medicine group was better improvement than that of the western medicine group,the difference was statistically significant(P < 0.05).8.Safety monitoring: No pulmonary embolism and corresponding clinical symptoms occurred in both groups.No drug allergy was found in the two groups,and no bleeding in gingiva and digestive tract was found during the treatment.No major organ bleeding or fatal bleeding occurred after operation.There was no difference in bleeding and the nature of exudate after operation.There was no statistical significance in skin ecchymosis after operation(P > 0.05);Conclusion Shixiao powder and Taohongsiwu Decoction combined with Rivaroxaban can effectively reduce the blood hypercoagulability of elderly patients with femoral intertrochanteric fracture after operation,thus effectively reduce the risk of DVT after operation,it has a certain effect on improving postoperative painwhich and TCM syndrome efficacy,it is worthy of clinical promotion.