A Multi-factor Study Of Modified Fuyuan Huoxue Decoction Combined With Intertan In The Treatment Of Intertrochanteric Fractures In The Elderly

Objective: Retrospective analysis of Modified Fuyuanhuoxue Decoction combined with Intertan on early clinical efficacy in the treatment of intertrochanteric fractures in the elderly and explore the effects of Modified Fuyuanhuoxue Decoction on multiple factors in recessive blood loss and coagulation function.Methods: Randomly selected 60 patients who received unilateral Intertan surgery in the Department of Orthopedics,Affiliated Hospital of Shandong University of Traditional Chinese Medicine(Shandong Provincial Hospital of Traditional Chinese Medicine)from September 2016 to September 2018,in total 60 cases.Recorded basic information such as height and weight of patients after admission,defined fracture diagnosis and determined the surgical indications.After obtaining informed consent,the patients were divided into Chinese medicine group and control group.The Chinese medicine group was given to drinking Modified Fuyuanhuoxue Decoction and subcutaneous injecting low molecular weight heparin on the second day after admission.The control group was only given to subcutaneous injecting low molecular weight heparin on the second day after admission.Both groups were treated with anti-infection,nutritional support and rehabilitation after surgery.Didn’t use other drugs which affect coagulation except above two drugs.Improve relevant auxiliary inspection after admission,Actively treated other basic diseases of the elderly.After removing surgical contraindications,operated intertrochanteric fracture closed reduction internal fixation with Intertan.Recorded the first day after admission,the first day after surgery and one day before discharge about Prothrombin Time(PT),Activated Partial Thrombin Time(APTT),Plasma Fibrinogen(FIB),Thrombin Time(TT),D-dimer(D-DI)in coagulation four and Hemoglobin(HGB),Hematocrit(Hct)in blood routine.Statistical analysis of the data obtained by using SPSS 24.0 software.Results: Sixty patients have been followed up,The hemoglobin(HGB)of the Chinese medicine group before discharge was 100.37±17.34 g/L,The hemoglobin(HGB)of the control group was 96.13±9.98 g/L.There was statistically difference comparing the two groups(t=1.159,P=0.028<0.05);The hematocrit(Hct)of the Chinese medicine group before discharge was 33.06±4.91%,The hematocrit(Hct)of the control group was 30.73±4.68%.There was no significant difference comparing the two groups(t=1.882,P=0.547>0.05);The amount of recessive blood loss in the Chinese medicine group before discharge was-220±350.45 ml,The amount of recessive blood loss in the control group was 354.74±548.327 ml.There was statistically difference comparing the two groups(t=-4.837,P=0.039<0.05).The Prothrombin Time(PT)of the Chinese medicine group before discharge was 17.46±1.04 s,The Prothrombin Time(PT)of the control group was 13.47±1.43 s.There was statistically difference comparing the two groups(t=2.034,P=0.028<0.05).The Activated Partial Thrombin Time(APTT)of the Chinese medicine group before discharge was 40.67±9.78 s,The Activated Partial Thrombin Time(APTT)of the control group was 37.23±3.5 s.There was statistically difference comparing the two groups(t=1.815,P=0.049<0.05).The plasma fibrinogen(FIB)of the Chinese medicine group before discharge was 3.21±0.6 g/L,The plasma fibrinogen(FIB)in the control group was 4.37±0.85 g/L.There was statistically difference comparing the two groups(t=-6.139,P=0.02<0.05).The thrombin time(TT)of the Chinese medicine group before discharge was 17.69±1.54 s,The thrombin time(TT)of the control group was 16.57±1 s.There was statistically difference comparing the two groups(t=3.349,P=0.026<0.05).The D-dimer(D-DI)of the Chinese medicine group before discharge was 2.81±3.8 ug/ml,The D-dimer of the control group(D-DI)was 2.18±1.3 ug/ml.There was statistically difference comparing the two groups(t=0.856,P=0.039<0.05).Two groups of patients had no intraoperative and postoperative thromboembolism,vascular or nerve damage during hospitalization follow-up.The scalpel is healed in the first stage.No postoperative complications happened such as infection or loose internal fixation.Conclusion: It can both prevent deep vein thrombosis that patients take Modified Fuyuanhuoxue Decoction combined with low molecular weight heparin and take low molecular weight heparin alone.However,patients taking Modified Fuyuanhuoxue Decoction are better than patients taking low molecular weight heparin alone in improving recessive blood loss,prolonging thrombin activation time,inhibiting plasma fibrinogen formation and reducing D-dimer content.