Clinical Study On The Effect Of Bushen Huoxue Decoction In Preventing DVT And Blood Loss After Artificial Hip Replacement For Femoral Neck Fracture In Senile Patients

Objective: The paper is to explore the effect of Bushen Huoxue(Kidney Reinforcing &Blood Circulation-Activating)Decoction applied to prevent deep vein thrombosis(DVT)and improve post-operative blood loss after artificial joint replacement for femoral neck fracture in senile patients.Method: A total of 76 eligible senile patients with femoral neck fractures,who were admitted to and treated in the Ward X of the Traumatic Orthopedics Department of the Fuzhou Second Hospital(Fujian Province,China),were enrolled and randomly divided into two groups,the group treated with combined traditional Chinese and western medicine(Bushen Huoxue Decoction and rivaroxaban combination group)and the group simply treated with western medicine(the rivaroxaban group),both of which underwent DVT prophylaxis in accordance with the guidelines.The laboratory indicators(D-dimer,and the thromboelastogram R,K,?,MA and CI values)were observed in the patient groups before the operations and on postoperative Days 1,5 and 15;based on the computational formula proposed by Gross JB,the patients' HGB and HCT values for 3 consecutive days before and after the operations were used to calculate the total and hidden blood loss volumes.The patients underwent color Doppler ultrasonography on postoperative Day 15 to check the formation of DVT.Results: A total of 64 patients finished the study protocol with complete necessary information,including 32 cases in the observation group and 32 cases in the experimental group.1.The two patient groups showed no statistically significant difference in age,gender,body mass index,blood transfusion rate,trauma-to-operation time,operation time,and patients' underlying diseases(P>0.05).2.D-Dimer Value: The difference in D-dimer values between the two groups were insignificant before the operations and on postoperative Day 1(P>0.05);however,on postoperative Days 5 and 15,the D-dimer values were lower in the combination group,and the differences were statistically significant(P<0.05).3.TEG: The two groups showed no statistically significant different in thromboelastogram R and K values before the operations and on postoperative Day 1(P>0.05),but the R and K values on the postoperative Days 5 and 15 were significantly higher in the combination group than the group simply treated with western medicine(P<0.05).There was no significant difference of MA,?,and CI values between the two groups before the operations and on postoperative Day 1(P>0.05),yet the MA,?,and CI values of the combination group were significantly lower than the other group on postoperative Days 5 and15(P<0.05).4.Hemoglobin(HGB): Both groups showed significant HGB declines after the operations(P<0.05),while the combination group had a significantly higher postoperative HGB value than the group simply treated with western medicine(P<0.05).5.Blood Loss Volumes: Both the total and the hidden blood loss volumes in the combination group were smaller than the group simply treated with western medicine,and the differences were statistically significant(P<0.05).6.Occurrence of DVT: No patients in the observation group had DVT,while,in thecontrol group,there was 1 case with right calf muscular venous thrombosis and 1 with left fibular venous thrombosis,suggesting a DVT occurrence rate of 6.25%.However,the different was no statistically significant(P>0.05).7.Evaluation of the TCM Syndrome Efficacy: Before the treatment,the two groups showed no statistically significant difference in the TCM syndrome efficacy scores(P>0.05).After the treatment,the combination group had a significantly lower score than the other group(P<0.05).8.Safety Evaluation: During the courses of treatment,no drug allergic reactions,abnormal liver and kidney functions,hemorrhage of important organs,dangerous bleeding,pulmonary embolism and related symptoms and signs,or bleeding of gums and digestive tract was found in either group.There was no statistically significant inter-group difference of postoperative skin ecchymosis(P>0.05).Conclusion: Bushen Huoxue Decoction combined with rivaroxaban might correct the high blood coagulation after artificial hip replacement in senile patients with femoral neck fracture.In such patients,the application of the Decoction can safely improve the DVT prevention and postoperative blood loss,and rectify the adverse effects of anemia.