Postoperative Clinical Observation Of The Proximal Humeral Fractures Of Neer Three Or Four Parts In Middle-aged And Elderly Patients Under The Guidance Of The Theory Of "Equal Weight Of Muscles And Bones"

Objective:Under the guidance of the theory of "equal weight of muscles and bones",we treated the address both symptoms and root causes by taking Chinese medicine internally to activating blood and dissolving stasis,by tonifying the liver and kidney,and by using Chinese medicine fumigation and washing to treated the proximal humerus fracture.Through the observation of patients’ postoperative clinical results and traditional Chinese medicine syndrome score,we have obtained the treatment effect and postoperative recovery of the theory of "equal weight of muscles and bones" for proximal humerus fracture,so as to make an accurate,objective and true evaluation of it.We hope it can be further developed in clinical practice.Methods:According to the inclusion criteria and exclusion criteria,we collected 80 patients with proximal humerus fractures who were received treatment in the orthopaedic ward of the Affiliated Hospital of Shandong University of Chinese Medicine from October 2018 to June 2020.These 80 patients were randomly divided into the experimental group and the control group by the method of random draw.They performed open reduction and locking plate internal fixation of proximal humerus fractures after completing routine preoperative physical examination and eliminating surgical contraindications.The control group did not have an experimental treatment regimen.On the basis of the control group,the experimental group was given Taohong Siwu Decoction for activating blood circulation to dissipate blood stasis within 1 month after surgery,Duhuojisheng Decoction was taken for tonifying liver and kidney from 2 to 3 months after surgery,and the shoulder joint was fumigated with external Chinese medicine 1 month after surgery.We observed the total score of traditional Chinese medicine syndrome score of deficiency of Liver and kidney deficiency syndrome,the VAS pain score at 1,3 and 7 days after surgery,the difference between the circumference of the affected side and the healthy side at 2,5 and 7 days after surgery,the healing time of fracture,and the Constant-Murley shoulder function score at 1,3,6 and 12 months after surgery.Results:The results of the experimental group and the control group showed no difference in the VAS pain score on the first day after surgery and the circumference difference between the affected side and the healthy side on the second day after surgery(P>0.05).Comparison of VAS pain scores on the 3rd and 7th days after surgery showed that the analgesic effect of the experimental group was better than that of the control group(P<0.05).Comparison of the difference between the circumference of the affected side and the healthy side in the two groups on the 5th and 7th day after surgery showed that the detumescence reduction effect of the experimental group was better than that of the control group(P<0.05).The comparison of fracture healing time between the two groups showed that Chinese medicine could effectively shorten fracture healing time in the experimental group(P<0.05).Compared with the total scores of traditional Chinese medicine syndrome scores of liver and kidney deficiency type before and after treatment,the improvement effect of the experimental group was better than that of the control group(P<0.05).The comparison of the Constant-Murley shoulder function score between the two groups at 3 and 6 months after surgery showed that the recovery of the experimental group after fumigation with Chinese medicine was better than that of the control group(P<0.05).There was no difference in the Constant-Murley shoulder function score between the two groups at the 12 th month after surgery(P>0.05),indicating that the improvement of postoperative rehabilitation activity in the two groups eventually reached the same level.Conclusion:Under the guidance of the theory of "equal emphasis on muscles and bones",we adopt the method of take of traditional Chinese medicine to treat both the symptoms and root causes,which can improve the symptoms of liver and kidney deficiency,effectively improve the pain of patients with proximal humerus fracture,accelerate the swelling of the affected limb,eliminate the mental burden of patients after surgery,and effectively promote the healing.The application of external fumigation of traditional Chinese medicine combined with postoperative rehabilitation training can improve patients’ postoperative rehabilitation and accelerate their recovery.These results show that the theory of "equal weight of bone and muscle" can effectively improve the clinical effect of postoperative proximal humerus fracture,and has certain clinical value.