Clinical Study Of Yanghuo Zhuanggu Decoction Combined With Zoledronic Acid Injection In The Treatment Of Spleen And Kidney Deficiency Type Femoral Intertrochanteric Fragility Fractures After PFNA Internal Fixation

Objective: to clarify the clinical efficacy of Yanghuo Zhuanggu decoction combined with zoledronic acid in patients with osteoporosis after internal PFNA fixation.Comparison of three treatment methods: Yanghuo Zhuanggu decoction,Zoledronic acid and Yanghuo Zhuanggu decoction combined with zoledronic acid for improving hip motion,relieving hip pain,improving TCM symptoms,fracture healing and bone mineral density after PFNA operation.To provide clinical basis for the rehabilitation of brittle fracture after operation.Methods: The patients with senile intertrochanteric brittle fracture of femur were selected from December 2019 to March 2020 in Osteoporosis department of Chinese Medicine Hospital of Gansu province,and according to the "Primary Osteoporosis Clinical Practice Guide of TCM" related content of TCM syndrome determination,Syndrome belongs to "spleen and kidney deficiency type" osteoporosis patients,In 90 cases,The group was divided into Chinese medicine group(n=30),western medicine group(n=30)and combined drug group(n=30).Traditional Chinese medicine group using PFNA internal fixation and Yanghuo Zhuanggu decoction after routine operation and anti-osteoporosis treatment;Western medicine group use PFNA internal fixation aid zoledronic acid injection after routine operation and anti-osteoporosis treatment;PFNA internal fixation and zoledronic acid injection,The medication period is 1 month.Data were collected to observe the bone density values(BMD)before and 6 months after the treatment of 3 treatments,Comparison of pain scores(VAS)before and after treatment,the hip system score(Harris);Comparison of three groups before and after treatment of TCM syndrome integral changes;After treatment,the healing time of fracture was observed and compared.During clinical treatment,Chinese medicine group lost 1 person because of the patient long stay in other places cannot follow up,Western medicine group lost 1 person,The combined medication group did not automatically withdraw from 1 person on time,The actual number is 87,SPSS21.0 statistical software is used to analyze the results.Results:1.basic situation: there was no significant difference in the preoperative basic situation(age,sex,etc.)between the three groups(P>0.05).42.fracture healing time: the healing time of traditional Chinese medicine group was significantly lower than that of western medicine group by X line comparison(P <0.05).Compared with the combination group,the western medicine group,the combination group,the healing time was better than the western medicine group,the difference was statistically significant(P<0.05).3.BMD value: compared with the BMD value before treatment,the BMD value of 3groups at each observation time point after treatment was improved to varying degrees.Six months after treatment,the BMD value of traditional Chinese medicine group was lower than that of western medicine group,and the increase of western medicine group was more significant(P <0.05).The BMD value of western medicine group was slightly higher than that of western medicine group(P >0.05).4.VAS score :3 groups of patients before and after contrast treatment,the VAS score was reduced.The difference between the two groups was statistically significant(P<0.05).After 4weeks of treatment,the difference between the two groups was statistically significant(P<0.05).After 2 weeks and 4 weeks of treatment,the difference between Chinese medicine group and western medicine group was statistically significant(P<0.05),and the effect of traditional Chinese medicine group was better than that of western medicine group.5.Harris score: the Harris score of patients before and after treatment was improved to varying degrees,the difference was statistically significant(P<0.05).Compared with the hip function of the patients in 1 month after operation,the scores of the patients in the traditional Chinese medicine group and the combined drug group were higher than those in the western medicine group(P<0.05).After 3 months and 12 months follow-up Chinese medicine group score was lower than western medicine group,the difference was statistically significant(P<0.05).The Harris score of follow-up patients in 3 months and 12 months after treatment was slightly higher than that in western medicine group(P <0.05).6.TCM syndrome score: the symptoms of TCM group and combined medication group were improved before and after treatment,and the difference between the two groups was not statistically significant(P>0.05).Compared with traditional Chinese medicine group,the symptoms of western medicine group were not improved(P <0.05).Conclusions:Yanghuo Zhuanggu decoction combined with zoledronic acid can effectively relieve postoperative pain,improve bone mineral density,shorten fracture healing time,ensure the function of hip joint in early postoperative period.It is beneficial to early rehabilitation exercise and effective intervention of cold and weak waist and leg caused by deficiency of spleen and kidney.