灯盏细辛注射液灌注疗法与自体干细胞输注疗法治疗股骨头坏死疗效的比较研究  

Comparative Study on the Therapeutic Effect of Dengzhan Xixin Injection Perfusion Therapy and Stem Cell Infusion Therapy in Treating Osteonecrosis of the Femoral Head

作　　者：汤小康[1] 倪哲吉[2] 陈欢欢[2] 童培建[2] 肖鲁伟[2] 唐成剑[1] 卢敏[1] 周长征[1] 李洪辉[1] Tang Xiaokang;Ni Zheji;Chen Huanhuan;Tong Peijian;Xiao Luwei;Tang Chengjian;Lu Min;Zhou Changzheng;Li Honghui(The First Affiliated Hospital of Hunan Chinese Medicine University,Hunan,Changsha 410007,China)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410007 [2]浙江中医药大学,浙江杭州310053

出　　处：《中国中医急症》2021年第5期798-800,812,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81574004);湖南省卫生健康委课题(202104071103,20201807);湖南省中医药科研计划项目(2021251);湖南中医药大学校级科研基金项目(ZYYDX201728);长沙市自然科学基金(kq2014225)。

摘　　要：目的观察活血化瘀中成药灯盏细辛注射液灌注疗法治疗股骨头坏死的临床疗效,探究其可能的作用机制。方法回顾性纳入介入条件下接受旋股内动脉灌注灯盏细辛注射液和旋股内动脉输注自体外周血干细胞的股骨头坏死患者共42例45髋,根据治疗方法将患者分为治疗组(27例28髋)和对照组(15例17髋)。比较两组患者治疗前后的Harris评分和MRI改变,评估灯盏细辛注射液干预股骨头坏死的临床疗效;收集两组患者治疗前后DSA血管计数及影像学检查结果等资料进行统计分析。结果治疗组患者治疗1个月后,Harris评分有明显改善,与治疗前相比差异有统计学意义(P<0.05),髋关节MRI表现有所改善,股骨头无明显进一步塌陷,病变范围有所缩小,髋关节区域DSA血管计数平均增加(2.60±0.60)条;对照组患者治疗1个月后,DSA血管计数平均增加(2.20±1.00)条。两组患者微血管均出现再生,造影显示血管分布得到改善,组间差异无统计学意义(P>0.05)。结论灯盏细辛注射液旋股内动脉灌注能有效改善股骨头坏死患者临床表现,其机制与其促进髋关节区域微小血管再通与增生有关。Objective:To observe the clinical efficacy of Chinese patent medicine Dengzhan Xixin Injection perfusion therapy for osteonecrosis of the femoral head(ONFH),and to investigate its possible mechanism.Methods:A total of 42 patients(45 hips)with ONFH were retrospectively included and analyzed under interventional conditions.They were divided into a treatment group(27 cases,28 hips)and a control group(15 cases,17 hips)according to the treatment method.The treatment group received Dengzhan Xixin Injectionperfusion therapy and peripheral blood stem cell infusion therapy.The Harris scores and MRI changes before and after treatment were compared between the two groups,and the clinical efficacy of Dengzhan Xixin Injection for treating ONFH was evaluated;data such as DSA blood vessel counts and imaging results before and after treatment were collected for statistics.Results:After 1 month of treatment,the Harris score of the treatment group was significantly improved,and the difference was statistically significant(P<0.05);the MRI performance of the hip in the treatment group was improved compared with that before treatment.There was no significant further changes in bone collapse,and the scope of the disease was reduced.After 1 month of treatment,the DSA vessel count in the hip joint area increased by an average of(2.60±0.60)in the treatment group;the DSA vessel count in the control group increased by an average of(2.20±1.00).The microvessels of the two groups were regenerated,and the angiographic results showed that the distribution of blood vessels was improved,and the difference between the groups was not statistically significant(P>0.05).Conclusion:The application of Dengzhan Xixin Injection perfusion therapy can effectively improve the clinical performance of patients with ONFH.Its mechanism is related to its promotion of recanalizationand proliferation of small blood vessels in the hip joint area.

关 键 词：股骨头坏死 活血化瘀 中成药 灯盏细辛注射液 

分 类 号：R681[医药卫生—骨科学]