活血化瘀通络方治疗早期激素性股骨头坏死的临床研究  

Clinical study on the treatment of early steroid induced avascular necrosis of femoral head with Huoxuehuayutongluo decoction

作　　者：纪志华[1] 贾丙申[1] 周立义[1] 付昆[1] 孟志斌[1] 于鹏[1] 

机构地区：[1]海南医学院第一附属医院,海口570102

出　　处：《中药药理与临床》2017年第4期178-181,共4页Pharmacology and Clinics of Chinese Materia Medica

摘　　要：目的:研究活血化瘀通络方治疗早期激素性股骨头坏死的临床价值。方法:选取2015年3月至2017年4月我院收治的早期激素性股骨头坏死患者90例为研究对象,采用随机数表法分为观察组、对照组各45例,均于内固定术后2周内进行旋股内、外侧动脉介入术,术后对照组行常规治疗,观察组加服活血化瘀通络方,比较两组治疗有效率及治疗前后血清骨形成蛋白2(BMP2)、骨钙素(BGP)、转化生长因子-β1(TGF-β1)、内皮素(ET)水平,分析两组血浆黏度(ηp)、红细胞压积(HCT)、红细胞沉降率(ESR)等血液流变学指标,采用视觉模拟评分法(VAS)、Harris髋关节功能评分表评价两组疼痛度、关节功能,同时记录不良反应。结果:观察组治疗有效率88.89%,明显高于对照组71.11%;观察组治疗后血清BMP2(23.10±1.54)μg/L、BGP(38.20±1.11)pg/ml、TGF-β1(31.29±1.35)pg/ml均明显高于对照组,而ET水平(50.28±1.10)pg/ml明显低于对照组;治疗后观察组血ηp(1.02±0.21)mP a·s、HCT(25.10±1.24)%、ESR(12.19±0.14)mm/h明显低于对照组;治疗后观察组VAS评分(1.23±0.14)分明显低于对照组,Harris评分(89.45±1.13)分明显高于对照组;两组不良反应发生率11.11%、8.89%比较无显著差异。结论:活血化瘀通络方可有效治疗早期激素性股骨头坏死,改善其骨代谢及血液流变学指标,降低疼痛度,促进机体关节功能恢复,同时安全性好,值得在临床推广应用。Objective： To study the clinical value of traditional Chinese medicine（ TCM） for promoting blood circulation to remove blood stasis and dredging collaterals in the treatment of early steroid-induced avascular necrosis of femoral head（ SANFH）. Methods： 90 cases of patients with early SANFH treated in our hospital from March 2015 to April 2017 were selected as subjects. They were divided into the observation group and the control group by the random number table method,with 45 cases in each group. All patients underwent medial and lateral femoral circumflex artery intervention within 2 weeks after internal fixation. After operation,patients in the control group were given the routine treatment,while they in the observation group were additionally treated with Huoxuehuayutongluo decoction. The effective rate of treatment,levels of serum bone morphogenetic protein 2（ BMP2）,bone gla protein（ BGP）,transforming growth factor β1（ TGF-β1） and endothelin（ ET） were compared between two groups. The hemorheological indexes such as plasma viscosity（ ηp）,hematocrit（ HCT） and erythrocyte sedimentation rate（ ESR） in two groups were analyzed. The pain degree and joint function were evaluated with the visual analogue scale（ VAS） and harris hip score,and adverse reactions were recorded. Results： The total effective rate of treatment in the observation group was higher than that in the control group（ 88. 89% vs 71. 11%）（ P〈0. 05）. After treatment,levels of serum BMP2,BGP and TGF-β1 in the observation group were significantly higher than those in the control group,while the level of ET was lower than that in the control group（ P〈0. 05）. After treatment,ηp,HCT and ESR were lower in the observation group than the control group（ P〈0. 05）. After treatment,the VAS score in the observation group was lower than that in the control group,while Harris score was higher than that in the control group（ P〈0. 05）. There was no significant difference between two groups in

关 键 词：活血化瘀通络方 激素性股骨头坏死 临床研究 

分 类 号：R274.9[医药卫生—中西医结合]