补肾活血方治疗早期缺血性股骨头坏死患者的临床研究  

Clinical Research of Bushenhuoxue Decoction to Treat Early-stage of Ischemic Osteonecrosis of the Femoral Head

作　　者：帅波[1] 沈霖[1] 杨艳萍[1] 谢晶[1] 周丕琪[1] 徐晓娟[1] 李成刚[1] 伍满香[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院中西医结合骨科,武汉430022

出　　处：《中国中医骨伤科杂志》2013年第1期11-14,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：国家自然科学基金(项目编号:81273907)

摘　　要：目的:探讨补肾活血方对早期缺血性股骨头坏死患者骨髓水肿、疼痛VAS评分、Harris评分及体内脂联素、CRP、TNF-α和NO等相关因子水平的影响。方法:将我院门诊及住院部2010年5月-2010年10月收治的120例缺血性股骨头坏死患者(138髋)随机给予基础+加味青娥丸治疗(治疗组,n=71)及基础+钙片(对照组,n=49)治疗,随访24周,分析治疗前后两组患者骨髓水肿、疼痛VAS评分、Harris评分及体内脂联素、CRP、TNF-α和NO等相关因子水平的变化。结果:治疗前治疗组与对照组分别有62髋和43髋发生骨髓水肿,发生率分别为75.61%和76.79%(P>0.05)。治疗24周后治疗组17髋骨髓水肿消退,34髋改善,8髋无明显变化,2髋加重,对照组3髋骨髓水肿消退,11髋改善,23髋无明显变化,6髋加重,两组治疗有效率(消退+改善率)分别为82.26%和32.56%(P<0.05)。在治疗组中,治疗后VAS评分明显低于治疗前(P<0.01),而Harris评分则明显高于治疗前(P<0.01)。在对照组中VAS评分及Harris评分在治疗前后比较差异无统计学意义(P>0.05)。在治疗组中,治疗后血清脂联素水平高于治疗前(P<0.01),而CRP、TNF-α及NO含量则低于治疗前(P<0.05)。在对照组中血清脂联素、CRP、TNF-α及NO含量在治疗前后比较差异无统计学意义(P>0.05)。结论:加味青娥丸可有效的改善早期缺血性股骨头坏死患者脂联素等相关因子水平,缓解骨髓水肿及临床症状,提高患者生命质量,值得临床推广。Objective：To detect the clinical effect of QingE pill for treating early-stage of ischemic osteonecrosis of the femoral head （INFH）, and to observe the influence of bone marrow edema level, the VAS and Harris scores, the level of adi- ponectin, CRP, TNF-α, and NO. Methods：All 120 INFH patients （138 hips） outpatient and inpatient in our hospital from May 2010 to October 2010 were randomly treated with foundation method and modified QingE pill （treatment group, n= 71）, and foundation method and calcium （control group, n= 49）. The bone marrow edema level, the VAS and Harris scores, the level of adiponectin, CRP, TNF-α, and NO were statistical analysis after following up for 24 weeks. Results： There were 62 hips and 43 hips of bone marrow edema in treatment group and control group respectively before treating, and the occurrence rate of bone marrow edema was 75.61% and 76.79 % respectively （P〈0.05）. The bone marrow edema was subsided in 17 hips, improved in 34 hips, not changed in 8 hips, and heavier in 2 hips in the treatment group after 24 weeks of treatment. And in the control group, the bone marrow edema was subsided in 3 hips, improved in 11 hips, not changed in 23 hips, and heavier in 6 hips. The total effective rate （subsided ＋ improvement rate） were 82.26% and 32. 56% respectively （P〈0.05）. In the treatment group, the VAS score and CRP, TNF-αand NO levels after treatment were significantly lower than before treatment （P〈0.05）, but the Harris score and adiponectin levels were significantly higher than before treatment （P〈0.01）. In the control group, the VAS and Harris scores, the level of adiponectin, CRP, TNF-α, and NO were not different before and after treatment（P〉0.05）. Conclusion：The modified QingE pill can improve effec- tively the adiponectin level of early-stage of INFH patients, which can alleviate bone marrow edema and clinical symptoms, and improve patient＇s quality of life. So it is worthy for promotion.

关 键 词：骨髓水肿 股骨头缺血性坏死 脂联素 青娥丸 

分 类 号：R681.8[医药卫生—骨科学]