补肾消蚀方治疗非创伤性股骨头缺血性坏死的临床疗效观察  

Clinical efficacy observation of Bushen ablation formula on non-traumatic osteonecrosis of femoral head

作　　者：王羽 丁彦彦 秦合伟[2] 王会丽 Wang Yu;Ding Yanyan;Qin Hewei;Wang Huili

机构地区：[1]河南驻马店市中医院,463000 [2]河南省中医院,450002

出　　处：《中国疗养医学》2022年第11期1207-1211,共5页Chinese Journal of Convalescent Medicine

基　　金：河南省中医药科学研究专项课题(TCM2019016);河南省中医药拔尖人才培养项目资助(豫卫中医函[2021]15号)。

摘　　要：目的观察补肾消蚀方对股骨头缺血性坏死患者骨代谢、骨密度、血液流变学的影响,并评价补肾消蚀方治疗股骨头缺血性坏死的临床疗效。方法本研究采用多中心随机对照试验设计将80例早期股骨头坏死患者按照随机数字表分为两组,对照组40例患者采用仙灵骨葆胶囊治疗,观察组40例患者采用补肾消蚀方治疗,连续治疗6个月后观察髓关节功能Harris评分、髋关节疼痛程度、髋关节骨密度、股骨头相关骨坏死面积、骨代谢相关指标,检测骨桥蛋白(OPN)、骨保护素(OPG)、骨钙素(OST)和Ⅰ型胶原C端肽(CTX-Ⅰ)等骨代谢相关指标,检测血液流变学指标,并根据髓关节功能Harris评分评价临床疗效。结果治疗后,观察组Harris评分较治疗前明显升高(P<0.05),升高程度明显大于对照组(P<0.05);观察组VAS评分较治疗前明显降低(P均<0.05),降低程度明显大于对照组(P均<0.05);观察组骨密度较治疗前明显升高(P<0.05),升高程度明显大于对照组(P<0.05);观察组骨坏死面积较治疗前明显减小(P<0.05),减小程度明显大于对照组(P均<0.05);观察组OPG水平较治疗前明显升高(P<0.05),升高程度明显大于对照组(P<0.05);观察组OPN、OST和CTX-Ⅰ均较治疗前明显降低(P均<0.05),降低程度明显大于对照组(P均<0.05)。治疗后,观察组患者血浆黏度、全血高切黏度、全血低切黏度、红细胞聚集指数等血液流变学指标水平较治疗前明显降低(P均<0.05),观察组血液流变学指标水平降低程度明显大于对照组(P<0.05)。观察组患者临床总有效率92.5%明显大于对照组患者临床总有效率77.5%(P<0.05)。结论采用补肾消蚀方治疗股骨头缺血性坏死,能够明显改善股骨头坏死患者髓关节功能,改善骨代谢,增加骨密度,改善血液流变学,促进骨质形成和骨蚀修复。Objective To observe the efficacy of Bushen ablation formula on bone metabolism,bone mineral density and hemorheology in patients with osteonecrosis of femoral head,and to evaluate the clinical efficacy of Bushen ablation formula in the treatment of osteonecrosis of femoral head.Methods In this study,a multicenter randomized controlled trial design was used to divide 80 patients with early osteonecrosis of femoral head into two groups according to the random number table.40 patients in the control group were treated with Xianling Gubao capsule,and 40 patients in the observation group were treated with Bushen ablation formula.After 6 months of continuous treatment,Harris score of medullary joint function,hip pain degree,hip bone mineral density,femoral head associated osteonecrosis area,bone metabolism related indexes,osteopontin(OPN),osteoprotegerin(OPG),osteocalcin(OST),typeⅠcollagen C-terminal peptide(CTX-Ⅰ)and other bone metabolism related indexes were detected.Hemorheology indexes were detected,and clinical efficacy was evaluated according to Harris score of medullary joint function.Results After treatment,the Harris score of the observation group was significantly higher than that before treatment(P<0.05),and the degree of increase was significantly higher than that of the control group(P<0.05).The VAS score of the observation group was significantly lower than that before treatment(all P<0.05),and the degree of reduction was significantly greater than that of the control group(all P<0.05).BMD in the observation group was significantly higher than that before treatment(P<0.05),and the degree of increase was significantly higher than that in the control group(P<0.05).The area of osteonecrosis in the observation group was significantly reduced compared with that before treatment(P<0.05),and the extent of reduction was significantly greater than that in the control group(P<0.05).The level of OPG in the observation group was significantly higher than that before treatment(P<0.05),and the degree of increase w

关 键 词：股骨头坏死 补肾消蚀方 骨密度 骨代谢 血液流变学 

分 类 号：R274.9[医药卫生—中西医结合]