中西医结合治疗发育性髋关节炎疗效观察  

Combine Traditional Chinese Medicine and Western Medicine Treating the Developmental Coxarthritis

作　　者：王琪[1] 陈卫衡[2] 金智勇[2] 何海军[2] 谢文光[2] 刘铁钢[2] 周宇[2] 

机构地区：[1]北京中医药大学附属护国寺中医医院骨科,北京市100035 [2]中国中医科学院望京医院关节一科

出　　处：《中国全科医学》2008年第20期1878-1880,共3页Chinese General Practice

摘　　要：目的探讨一种中西医结合方法(髋关节镜+关节腔注射+中医中药等)治疗早中期发育性髋关节炎,评价其临床治疗效果,从而指导临床早中期发育性髋关节炎的治疗。方法回顾性收集发育性髋关节炎患者35例(38髋),随访内容包括治疗前、后髋关节VAS疼痛评分、Harris评分及影像学资料;根据中医证候分型将患者分为风寒湿痹组、湿热下注组和肝肾亏虚证组。治疗方法:全部病例住院期间行综合保髋疗法,方案包括髋关节镜手术,术中及术后关节腔药物注射,围术期配合中药内服外用及理疗康复锻炼等保守疗法。中药内服分别采用独活寄生汤、四妙散、六味地黄丸加减,同时配合中药熏洗、熥敷;并指导患者进行功能锻炼。疗效评定:随访期间记录患者双髋关节VAS疼痛评分、Harris评分及双髋影像学检查。结果随访35例(38髋)VAS评分治疗前后差异有统计学意义(P<0.05)。Harris评分治疗前后差异亦有统计学意义(P<0.05);3组疗效间差异无统计学意义(P>0.05),3髋影像学分期加重,余病例影像学分期稳定。结论中西医结合治疗可缓解患者疼痛、改善髋关节功能、提高生活质量,并可延缓骨关节炎发展的进程;该疗法具有创伤小、恢复快、不破坏髋关节固有结构等特点;中医各证型间疗效无差异。Objective To introduce a method of combine Traditional Chinese Medicine(TCM) and Western Medicine(WM) in treatment of developmental coxarthritis(hip arthroscope+ hip-joint cavity injection with Sodium Hyaluronate + Chinese medicines,etc.),and to evaluate its therapeutic efficacy to provide a new treatment for prometaphase of developmental coxarthritis.Methods Clinical data of 35 developmental coxarthritis patients(38 hips) were retrospectively collected.Their follow-up contents included Harris hip scores and imaging informations before and after treatment;TCM sign typing read as follows:group A with anemofrigid-damp arthralgia,group B with downward attack of damp-heat and group C with deficiency of liver-and kidney-yin.All hospitalized patients were given comprehensive hip-therapies,including hip arthroscopic surgery,hip-joint cavity drug injection during and following surgery,and some conservative treatments such as oral and external-use Chinese Medicine(CM),physical therapy and rehabilitation exercises.Oral used CM was Duhuo Jisheng Decoction(group A),Simiao San(group B),Jiajian Liuweidihuang pills(group C),meanwhile working in with CM fumigation and steaming,hot compress;patients were guided to do functional exercises.Results According to Harris hip score and X-ray examinations of 35 followed-up patients(38 hips),hip pain and claudication improved to some extent.And in accordance with VAS evaluation system for pains,the preoperative score was 4-9,averaging(6.7±1.4);the postoperative 0-5,with an average of(2.6±1.2)(P<0.05).On the basis of Harris hip-joint score evaluation system,preoperative score was(56.0±5.9),the postoperative(88.2±8.1),the rate of excellent and good results was up to 84.21%,with an significant effect(P<0.05).There was no significant difference in curative effect between all groups(P> 0.05).Imageology stagings of 3 hips deteriorated,while those of the others remained stable.Conclusion Combine TCM and WM can relieve pains,improve hip-joint functions and quality of life,and delay the proces

关 键 词：骨关节炎 髋 中西医结合 治疗结果 

分 类 号：R684.3[医药卫生—骨科学]