健脾补肾方预防股骨头坏死塌陷的临床观察  

Clinical observation of Jianpi Bushen formula to prevent collapse of osteonecrosis of femoral head

作　　者：于潼[1] 谢利民[1] 王文岳[1] 徐颖鹏[1] 李玉彬[1] 张振南[1] 韩良[1] 李林溪[1] 

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《中国中药杂志》2013年第11期1827-1831,共5页China Journal of Chinese Materia Medica

摘　　要：为观察健脾补肾方预防痰瘀阻络型股骨头坏死塌陷的临床疗效,由中国中医科学院广安门医院骨科门诊收集50例(73髋)塌陷前股骨头坏死病例(ARCOⅠ,Ⅱ,Ⅲa),对符合纳入标准的病例予健脾补肾方口服,并对其进行随访,以ARCO标准作为影像学分级标准,Harris评分评价髋关节的功能。经过平均4.2年(3～5.4年)的随访,73髋中塌陷12髋、未塌陷61髋(未塌陷率83.56%),ARCOⅠ期7髋均未发生塌陷(未塌陷率100%),ARCOⅡ期49髋塌陷9髋、未塌陷40髋(未塌陷率81.63%),ARCOⅢa期17髋塌陷3髋、未塌陷14髋(未塌陷率82.35%)。Kaplan-Meier生存分析显示平均股骨头未塌陷生存时间为5年(4.8～5.2年),随访时间为3年时股骨头未塌陷率为92.5%,4年股骨头未塌陷率为74%,且趋于稳定趋势。Harris评分治疗前为71.93±11.25,治疗后为81.63±12.16,配对t检验示差异有统计学意义。结果提示健脾补肾方能延迟或预防痰瘀阻络型股骨头坏死的塌陷,显著改善髋关节功能,为股骨头坏死治疗的有效方法。To observe the clinical effect of Jianpi Bushen formula to prevent the collapse of osteonecrosis of femoral head（ONFH） of type phlegm and blood stasis obstructing the collaterals. 50 cases（including 73 hips） of non-collapse ONFH（ARCOⅠ,Ⅱ,Ⅲa） were selected from the out-patient department of orthopedic in Guang＇anmen Hospital attached to China Academy of Chinese Medical Science. All the cases fit for diagnostic criteria were given Jianpi Bushen formula and followed up. Staging criteria was ARCO classification. Harris score evaluated the hip function. The mean follow-up time was 4.2 years（3-5.4 years）. After a mean of 4.2 years （3-5.4 years） followed-up, 12 hips collapse occurred while 61 hips not （the non-collapse rate was 83.56%）. Collapse did not occurred among the all 7 hips at stage ARCOⅠ（the non-collapse rate was 100%）. Among the 49 hips at stage ARCOⅡ, 9 hips collapse occurred while 40 hips not （the non-collapse rate was 81.63%）. Among the 17 hips at stage ARCOⅢa, 3 hips collapse occurred while 14 hips not （the non-collapse rate was 82.35%）.Kaplan-Meier analysis showed the average survival time of non-collapse was 5 years（4.8-5.2 years）. The 3 year survival rate of non-collapse was 92.5%.The 4 year survival rate was 74% and the condition tended to be stability trend. The Harris score was 71.93±11.25 before treatment and 81.63±12.16 after treatment, significantly different. These results suggest that： Jianpi Bushen formula is an effective method for treating ONFH of type phlegm and blood stasis obstructing the collaterals. It can delay or prevent the collapse of femoral head and significantly improve the hip function.

关 键 词：股骨头坏死 中医治疗 预防塌陷 临床疗效 

分 类 号：R274.9[医药卫生—中西医结合]