Abstract： Objective： To observe the curative effects of Fu's subcutaneous needling combined with Xinshang Duanxu Decoction on postoperative coagulation function， swelling degree， and stress status in elderly patients with hip fractures. Methods：A total of 90 senile patients with hip fractures who planned to undergo surgical treatment were divided into the prescription group and the combination group according to the random number table method， with 47 and 46 cases in each group. There were 2 cases dropped out from the prescription group and 1 case from the combination group；finally，there were 45 cases in each group. The prescription group was treated with Xinshang Duanxu Decoction， and the combination group was treated with Fu's subcutaneous needling combined with Xinshang Duanxu Decoction. Clinical effects were compared between the two groups. Changes in TCM syndrome scores，swelling degree，the scores of Delirium Rating Scale-Revised-98 (DRS-R-98)， plasma activated partial thromboplastin time (APTT)， plasma fibrinogen， plasma prothrombin time (PT)， malondialdehyde (MDA)， aldosterone (ALD)， cortisol (Cor)，tumor necrosis factor-α (TNF-α)，interleukin-8 (IL-8)，and the expression levels of Microrna-491-5p (miR-491-5p) were compared between the two groups before and after surgery. Results：The total clinical effective rate was 97.78% in the combination group and 82.22% in the prescription group，the difference being significant (P＜0.05). On the tenth day after surgery，each score of TCM syndrome in the two groups was decreased when compared with that before surgery (P＜0.05)， and each score in the combination group was lower than that in the prescription group (P＜0.05). There was significant difference in the degree of swelling between two groups at different time points in terms of time factors，intergroup factors，and time point interaction factors (P＜0.05). On the first day after surgery，there was no significant difference in the degree of swelling between two groups (P＞0.05)； on the third day after surgery， the degree of swelling in the two groups was increased when compared with that on the first day after surgery (P＜0.05)； on the fifth and tenth days after surgery， the degree of swelling in the two groups was decreased when compared with that on the first and third days after surgery (P＜0.05)；on the tenth day after surgery，the degree of swelling in the two groups was decreased when compared with that on the fifth day after surgery， and the degree of swelling in the combination group was lower than that in the prescription group (P＜0.05). On the tenth day after surgery，the DRS-R-98 scores in the two groups were decreased when compared with those on the first day after surgery (P＜0.05)，and the DRS-R-98 score in the combination group was lower than that in the prescription group (P＜0.05). On the tenth day after surgery， the levels of APTT， fibrinogen， and PT in the two groups were decreased when compared with those on the first day after surgery (P＜0.05)， and the above three levels in the combination group were lower than those in the prescription group (P＜0.05). On the tenth day after surgery，the levels of MDA，ALD，and Cor in the two groups were decreased when compared with those on the first day after surgery (P＜0.05)，and the above three levels in the combination group were lower than those in the prescription group (P＜0.05). On the tenth day after surgery，the levels of TNF- α and IL-8 in the two groups were decreased when compared with those on the first day after surgery (P＜0.05)，and miR-491-5p were increased (P＜0.05)；the levels of TNF-α and IL-8 in the combination group were lower than those in the prescription group (P＜0.05)，and the level of miR-491-5p in the combination group was lower than that in the prescription group (P＜0.05). Conclusion： Fu's subcutaneous needling combined with Xinshang Duanxu Decoction for elderly patients after surgery for hip fractures can inhibit inflammation in the body， reduce stress reactions， improve coagulation function， postoperative delirium， swelling degree and clinical symptoms of patients， and enhance clinical effects.