Objective：To discuss the effect of Yishen Huoxue Xugu tang on the stress level and bone metabolism markers in patients with senile proximal femoral fractures after internal fixation with proximal femoral nail antirotation(PFNA).Methods：Divided 94 cases of patients with senile proximal femoral fractures into the control group and the observation group randomly，47 cases in each group.Both groups received preoperative routine nursing after hospitalization；the control group underwent internal fixation with PFNA，while the observation group additionally received the oral administration of Yishen Huoxue Xugu tang.Detected and compared the contents of malondialdehyde(MDA)，superoxide dismutase(SOD)，catalase(CAT)， cortisol(COR)， epinephrine(E)， amino-terminal propeptide of type I procollagen(PINP)， cross-linked carboxyterminal telopeptide of type I collagen(CTX)and osteocalcin(OC)in serum of patients in both groups，and observed the recovery condition， Harris scores， postoperative complications and therapeutic effect in Chinese and English medicine.Results：The excellence rate and the cure rate in the observation group were higher than those in the control group(P＜0.05).The time of postoperative off-bed activities，the time of fracture healing and the time of full weight bearing in the observation group were respectively shorter than those in the control group(P ＜ 0.05).After treatment，the contents of serum MDA，E，COR and CTX in both groups were decreased，and the contents of SOD，CAT，PINP and OC were increased；the contents of serum MDA，E，COR and CTX in the observation group were lower than those in the control group，and the contents of SOD，CAT，PINP and OC were higher than those in the control group，differences being significant(P＜0.05).One and three months after treatment，Harris scores in the observation group were significantly higher than those in the control group(P ＜0.05).The incidence of complications in the observation group was lower than that in the control group(P＜0.05).Conclusion：The application of Yishen Huoxue Xugu tang has significant therapeutic effect in treating patients with senile proximal femoral fractures after internal fixation with PFNA.It can reduce stress response，improve bone metabolism，help fracture healing，promote the recovery of hip joint function and decrease postoperative complications，which is worthy of clinical application and promotion.