Abstract: OBJECTIVE   To observe the efficacy and safety of Buqi Huoxue Tongluo decoction combined with low-molecular-weight heparin on pre-thrombotic state of hip fracture elderly patients with qi deficiency and blood stasis.METHODS   A total of 60 hip fracture elderly inpatient with qi deficiency and blood stasis in our department from August 2018 to August 2019 were randomly divided into the control group, treatment group 1 (T1), and treatment group 2 (T2), 20 cases each group. The control group was given conventional dose of low-molecular-weight heparin, T1 was given Buqi Huoxue Tongluo decoction combined with conventional dose of low-molecular-weight heparin, while T2 was given Buqi Huoxue Tongluo decoction combined with small dose of low-molecular-weight heparin. The pre-thrombotic status indexes of D-dimer (D-D), fibrinogen degradation product (FDP), von Willebrand factor (vWF), serum antithrombin Ⅲ(AT-Ⅲ) were measured in the three groups before and after treatment. The changes in the traditional Chinese medicine (TCM) syndrome scores were observed. In addition, we also recorded the operation time, bleeding volume, blood transfusion volume and whether thrombosis was formed and some other data.RESULTS   After treatment, the improvement condition of FDP, vWF and AT-Ⅲ in treatment group 1 was better than those in the control group (P < 0.05), and the improvement condition of AT-Ⅲ in treatment group 2 was better than that in the control group (P < 0.05), but the difference between the two treatment groups was not statistically significant (P>0.05). The improvement condition of TCM syndrome score in the treatment groups was better than that in the control group (P < 0.05, P < 0.01), but the difference of syndrome score between the two treatment groups was not statistically significant (P>0.05). The amount of bleeding and blood transfusion in the treatment group was less than that in the control group (P < 0.05, P < 0.01). The difference was not statistically significant when comparing the thrombosis in the three groups (P>0.05).CONCLUSION   Buqi Huoxue Tongluo decoction combined with low molecular heparin can effectively improve the pre-thrombotic state, prevent deep vein thrombosis in hip fracture elderly patients with qi deficiency and blood stasis and reduce the dosage of low molecular heparin and the risk of bleeding, therefore the treatment is safe, effective, and worthy of clinical promotion.