Clinical Study Of Jia Wei Bu Zhong Yi Qi Decoction On Occult Blood Loss After Artificial Femoral Head RePlacement

Objective:To observe the clinical efficacy and safety of Jia wei Bu zhong Yi qi decoction in the treatment of hidden blood loss after artificial femoral head replacement in elderly patients with intertrochanteric fracture,based on the theory that “visible blood cannot be generated quickly,and invisible qi should be fixed quickly”.The method of regulating qi and blood was used to treat hidden blood loss after artificial femoral head replacement of intertrochanteric fracture of femur,and to further explore the relationship between hidden blood loss and qi and blood of traditional Chinese medicine.Methods:A total of 66 patients with unilateral intertrochanteric fracture and artificial femoral head replacement were selected from the Department of Orthopaedics and Traumatology of Kunming Hospital of Traditional Chinese Medicine.The collected cases were divided into control group(n=33)and treatment group(n=33).The treatment group was treated with Jia wei Bu zhong Yi qi decoction on the basis of routine treatment of western medicine,and the control group was given routine treatment of western medicine.The course of treatment was from the first day of admission to the first day before operation,and from 12 hours to 1 week after operation.The laboratory efficacy index(HGB,HCT value),clinical efficacy index(occult blood loss on the 1st,2nd,3rd and 5th day after operation,total blood loss,significant and recessive blood loss,TCM syndrome score,VAS score),laboratory safety index(D-dimer)and lower extremity vascular color ultrasound safety index were observed in the control group and the treatment group after treatment.The therapeutic efficacy and safety of Jia wei Bu zhong Yi qi decoction were evaluated directly and indirectly by the above indicators.Results:1.General indicators: there was no significant difference in sex,age,height,weight,BMI indicators,operation time,affected limb and waiting time between the treatment group and the control group(P>0.05).2.Laboratory efficacy indicators(HCT,HGB): There was no significant difference in HCT and HGB between the two groups before operation.There were significant differences in HCT and HGB between the two groups on the1 st,2nd,3rd and 5th day after operation.3.Clinical efficacy indicators(hidden blood loss,total blood loss,total apparent blood loss,hidden blood loss,blood transfusion rate on the 1st,2nd,3rd and 5th days after surgery): There were significant differences in all indexes between the two groups(P<0.05).4.Clinical efficacy indicators(VAS score,TCM syndrome score,TCM syndrome efficacy): There was no statistically significant difference between the two groups before treatment in VAS score and TCM syndrome score(P>0.05);after treatment,the two groups All indicators were compared between groups,and the differences were statistically significant(P<0.05).5.Laboratory safety indicators(D-dimer,double lower extremity vascular color Doppler ultrasound): there was no lower limb thrombosis in both groups before and after treatment,and there was no significant difference in D-dimer between the two groups before treatment(P>0.05).There was significant difference in D-dimer between the two groups after treatment(P<0.05).Conclusion:1.Jia wei Bu zhong Yi qi decoction has good clinical efficacy and safety in the treatment of occult blood loss after IFF artificial femoral head replacement,which is worth popularizing.2.Jia wei Bu zhong Yi qi decoction according to the theoretical guidance of " visible blood cannot be generated quickly,and invisible qi should be fixed quickly ",further verified that replenishing qi and blood after IFF artificial femoral head replacement can effectively reduce the amount of hidden blood loss after operation,and does not increase the risk of postoperative bleeding.3.There is a large amount of blood loss after IFF artificial femoral head replacement,which is about 600-1100 ml,in which the hidden blood loss accounts for a large proportion,accounting for 66-69% of the total blood loss.The hidden blood loss is mainly concentrated in 1-3 days after operation,and postoperative blood transfusion is also mainly concentrated in 1-3 days after operation.Therefore,blood should be actively prepared during the operation,and timely blood volume should be examined and evaluated 1-3 days after operation,so that anemia can be found and corrected in time.