桃红四物汤加味联合PFNA内固定治疗老年股骨粗隆间骨折临床观察

目的 观察养血活血、健脾补肾中药内服配合股骨近端防旋髓内钉（proximal femoral nail antirotation，PFNA）内固定术治疗老年股骨粗隆间骨折的临床疗效。方法 将56例股骨粗隆间骨折行手术治疗的老年患者随机分为观察组和对照组，每组28例。观察组采用加味桃红四物汤内服联合PFNA内固定术治疗，对照组仅行PFNA内固定术。采用Harris评分评价髋关节功能，观察并比较两组患者术后肿胀消退时间、骨折愈合时间和总并发症发生率。结果 术后30、60 d，两组患者髋关节Harris评分逐渐升高，差异均有统计学意义（P＜0.05），且观察组髋关节Harris评分显著高于对照组（P＜0.05）。观察组患者骨折愈合时间和患肢肿胀消退时间较对照组明显缩短(P<0.05)，总并发症发生率显著降低（P<0.05）。结论 加味桃红四物汤内服配合PFNA内固定术可改善老年股骨粗隆间骨折患者髋关节功能，促进骨折愈合，减轻患肢肿胀，减少并发症发生率。

Clinical Effect of Jiawei Taohong Siwu Decoction Combined with Proximal Femoral Nail Anti-rotation Internal Fixation in Treatment of Elderly Femoral Intertrochanteric Fractures

Objective To investigate the clinical effect of oral administration of blood-nourishing, blood-activating, spleen-strengthening, and kidney-tonifying traditional Chinese medicine combined with proximal femoral nail anti-rotation (PFNA) internal fixation in the treatment of elderly femoral intertrochanteric fractures. Methods A total of 56 elderly patients who underwent surgical treatment of femoral intertrochanteric fractures were randomly divided into observation group and control group, with 28 patients in each group. The patients in the observation group were treated with oral administration of Jiawei Taohong Siwu Decoction combined with PFNA internal fixation, and those in the control group were treated with PFNA internal fixation alone. Harris score was used to evaluate hip function, and the two groups were compared in terms of regression time of swelling, time to fracture healing, and incidence rate of complications after surgery. Results Both groups had a gradual increase in Harris score of hip joint on days 30 and 60 after surgery (P<0.05), and the observation group had a significantly higher Harris score than the control group (P<0.05). Compared with the control group, the observation group had significantly shorter time to fracture healing and regression time of swelling in the affected limb (P<0.05) and a significantly lower incidence rate of complications (P<0.05). Conclusion In elderly patients with femoral intertrochanteric fractures, Jiawei Taohong Siwu Decoction combined with PFNA internal fixation can improve hip function, promote fracture healing, alleviate swelling of the affected limb, and reduce the incidence rate of complications.