OBJECTIVE To investigate the clinical efficacy of Jianpi Yishen Tongluo Decoction in the postoperative treatment of middle-aged and elderly patients with rotator cuff injury complicated with sarcopenia.

METHODS A total of 80 elderly patients with sarcopenia who were scheduled to undergo arthroscopic rotator cuff repair at Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine from October 2022 to January 2024 were selected and randomly divided into the treatment group and the control group with 40 cases in each group according to the random number table method. Two cases in the control group dropped out, with 40 cases completed in the treatment group and 38 cases in the control group finally. Both groups received arthroscopic rotator cuff repair, routine postoperative nursing and basic rehabilitation guidance. The control group was additionally given oral celecoxib capsules, while the treatment group was additionally given oral Jianpi Yishen Tongluo Decoction. The Constant-Murley Shoulder Function Score (Constant-Murley score), Skeletal Muscle Mass Index (SMI), Visual Analogue Scale (VAS) score for pain and Activity of Daily Living (ADL) score of the two groups were compared before surgery, at 6 and 12 weeks after surgery. Additionally, Traditional Chinese Medicine syndrome scores, the incidence of postoperative complications, patient satisfaction, clinical efficacy, and serum levels of inflammatory factors interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were compared between the groups.

RESULTS At 6 and 12 weeks after surgery, the Constant-Murley scores and SMI of both groups were significantly higher than those before surgery (P<0.01), and the above indicators in the treatment group were significantly higher than those in the control group at the same time points (P<0.01). At 6 and 12 weeks after surgery, the VAS score of the treatment group was significantly lower than that of the control group (P<0.01), and the ADL score was significantly higher than that of the control group (P<0.01). At 12 weeks after surgery, the serum levels of IL-6 and TNF-α in the treatment group were significantly lower than those in the control group (P<0.01), and the total traditional Chinese medicine syndrome scores and each individual symptom scores in the treatment group were significantly lower than those in the control group (P<0.01). The incidence of postoperative complications in the treatment group was 5.0%, which was significantly lower than 21.1% in the control group (P<0.05). The patient satisfaction rate in the treatment group was 95.0%, which was significantly higher than 76.3% of the control group (P<0.05). The total clinical effective rate of the treatment group was 92.5%, which was significantly higher than 73.7% of the control group (P<0.05). No serious adverse reactions occurred in both groups during the treatment.

CONCLUSION Jianpi Yishen Tongluo Decoction can effectively improve the sarcopenia state of middle-aged and elderly patients with rotator cuff injury complicated with sarcopenia after surgery, alleviate pain and inflammatory response, significantly improve Traditional Chinese Medicine syndromes, shoulder joint function and activity of daily living, reduce the incidence of complications and improve patient satisfaction. Its curative effect is superior to the celecoxib regimen, with good safety.