Study On The Quality Of Life Of Senile Intertrochanteric Fracture Treated With Bushen Huoxue Decoction Plus Minus Combined With Intertrochanteric Femoral Head Replacement

Objective:To observe the clinical effect of Bushen Huoxue Decoction plus minus combined with intertrochanteric femoral head replacement in the treatment of senile patients with intertrochanteric fracture,and to explore the effective methods to improve the quality of life after operation for senile patients with intertrochanteric fracture.Methods:Patients who were diagnosed as unstable intertrochanteric fracture and were suitable for artificial femoral head replacement in the orthopedic department of Zhoukou Hospital of Traditional Chinese Medicine from December 2019 to September2020 were selected as the research subjects.Sixty-six patients were selected strictly according to the inclusion and exclusion criteria and signed the"informed consent"before treatment.According to the random number table method,they were randomly divided into the observation group(Bushen Huoxue Decoction plus minus combined with intertrochanteric femoral head replacement)and the control group(intertrochanteric femoral head replacement only),with 33 cases in each group.The SF-36 scale,Harris score,VAS score and the incidence of postoperative complications between the two groups before and 1,3 and 6 months after surgery were observed and recorded,and the differences between the two groups were analyzed.Results:A total of 66 cases were collected in this study,all of which were inpatients from the orthopedic department of Zhoukou Hospital of Traditional Chinese Medicine.A total of 5 cases were withdrawn during the follow-up period,and 2 patients in the observation group were excluded because they did not adhere to oral medication as required.In the control group,2 patients voluntarily withdrew the informed consent,and 1 patient was excluded because he could not be contacted.Before surgery,the two groups of patients were compared in gender,age,body mass index,fracture type,hip site and other aspects,and the statistical P value was>0.05,the results were not statistically significant,the difference was not significant.The independent sample t test was used to compare the SF-36 scale,Harris score and VAS score between the two groups before treatment,and the statistical P value of>0.05 was obtained,with no statistical significance and no significant difference.Two groups of patients with preoperative and postoperative 1 month,3 month and 6 month SF-36 scale,Harris hip score and VAS score comparison,using repetitive measure analysis of variance,respectively,from the point of time effect,P values<0.05,suggesting that as the change of time all the research object of SF-36 scale,Harris hip score and VAS score will be changed significantly.In terms of time-group effect,P values were all<0.05,indicating that SF-36 scale,Harris hip joint score and VAS score had different trends with time in different groups.The independent sample t test was used to compare the SF-36 scale between the two groups at 1 month,3 months and 6 months after surgery,an d the statistical P values were all<0.05.The results were statistically significant and significantly different,indicating that the postoperative quality of life in the observation group was better than that in the control group.The independent sample t test was used to compare the Harris hip score between the two groups at 1 month,3 months and 6months after surgery,and the statistical P values were all<0.05,which were statistically significant and significantly different,indicating that the hip function of the observation group was better than that of the control group after surgery.The independent sample t test was used to compare the VAS scores between the two groups at 1 month,3 months and 6 months after surgery,and the statistical P values were all<0.05,which were statistically significant and significantly different,indicating that the relief of postoperative pain in the observation group was significantly better than that in the control group.During the final follow-up,the excellent and good rates of hip joint function between the two groups were compared by rank counting and Rank-sum test.The excellent and good rates of hip joint function in the two groups were:80.65%in the observation group and 53.33%in the control group;Z=-2.314,P=0.021<0.05,the results were statistically significant.At the last follow-up,there was 1 case of pneumonia in the observation group,and a total of 1 patient developed complications.In the control group,there were 2 cases of pneumonia,2 cases of urinary tract infection,1 case of pressure sores,and 1 case of deep vein thrombosis.A total of 6 patients developed complications.Non-grade counting Chi-square test was used to compare the incidence of complications in the two groups during the fi nal follow-up.The incidence of complications in the two groups was 3.23%in the observation group and 20.00%in the control group;χ~2=4.233,P=0.040<0.05,the results were statistically significant,there was a significant difference.Conclusiou:For the elderly intertrochanteric femoral fracture,intertrochanteric femoral head replacement can make the fracture achieve immediate stability,patients can get out of bed early to take the initiative to carry out appropriate functional exercise,and give full play to the patient’s autonomous disease resistance ability.At the same time,the addition and subtraction of Bushen Huoxue Decoction is used to promote blood circulation and remove blood stasis,regulate qi and relieve pain in the early stage,and strengthen tendon and bone in the middle and late stage.It can effectively reduce postoperative pain,significantly improve hip function,reduce the incidence of postoperative complications and improve the quality of life of patients,which is worthy of clinical promotion.