双合汤联合微创保髋术治疗围塌陷期非创伤性股骨头坏死临床研究  

Clinical Study on Shuanghe Decoction Combined with Minimally Invasive Hip-preserving Surgery in the Treatment of Non-traumatic Osteonecrosis of the Femoral Head in Peri-Collapse Stage

作　　者：刘华 蔡志刚 陈梅 沈计荣[2] 夏天卫 魏爱淳 LIU Hua;CAI Zhigang;CHEN Mei;SHEN Jirong;XIA Tianwei;WEI Aichun(Haian Hospital of Traditional Chinese Medicine,Haian 226600,China;Jiangsu Provincial Hospital of Traditional Chinese Medicine,Nanjing 210029,China)

机构地区：[1]海安市中医院,江苏海安226600 [2]江苏省中医院,江苏南京210029

出　　处：《中国中医药信息杂志》2023年第2期135-140,共6页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：江苏省第五期“333高层次人才培养工程”科研资助项目(BRA2020201)。

摘　　要：目的观察双合汤联合微创保髋术治疗围塌陷期非创伤性股骨头坏死(NONFH)的临床疗效。方法采用随机数字表法将92例NONFH患者分为对照组45例和观察组47例。对照组采用微创保髋术治疗,观察组在对照组基础上予双合汤,每日1剂,每日2次,口服,3个月为1个疗程,连续治疗2个疗程。评价2组临床疗效,观察2组治疗前及术后6、12个月Harris评分、MRI坏死指数、骨密度(Ward's三角、股骨颈、股骨粗隆)、血脂指标(胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇)及生化标记物(饥饿素、软骨寡肽蛋白及硬化蛋白),监测观察组肝、肾功能。结果观察组总优良率为80.85%(38/47),对照组为64.44%(29/45),观察组明显优于对照组(P<0.05)。与本组治疗前比较,2组术后6、12个月Harris评分、MRI坏死指数、骨密度、血脂指标、生化标记物明显改善(P<0.05);2组术后6、12个月比较,观察组上述各项指标均明显优于同时点对照组(P<0.05)。观察组治疗后肝、肾功能与治疗前比较差异无统计学意义(P>0.05)。结论双合汤联合微创保髋术治疗围塌陷期NONFH临床疗效显著,可促进坏死骨修复,提高骨密度,改善脂质代谢紊乱与生化标记物水平。Objective To observe the efficacy of Shuanghe Decoction combined with minimally invasive hip-preserving surgery in the treatment of non-traumatic osteonecrosis of the femoral head(NONFH)in the peri-collapse stage.Methods Totally 92 NONFH patients were divided into control group(45 cases)and observation group(47 cases)according to random number table method.The control group was treated with minimally invasive hip-preserving surgery alone.The observation group was given Shuanghe Decoction combined with minimally invasive hip-preserving surgery,one dosage per day,twice a day,orally.Three months was one treatment course,for consecutive two courses.The clinical efficacy of both groups was evaluated.Harris score,necrosis index of MRI,bone mineral density,blood fat indexes(TC,TG,HDL-C and LDL-C)and biochemical markers(Ghrelin,COMP and sclerostin)levels before surgery,6 and 12 months after surgery in both groups were recorded.The liver and kidney function of the observation group was monitored.Results The total survival rate in the observation group was 80.85%(38/47),and the control group was 64.44%(29/45).The clinical efficacy of the observation group was significantly better than that of the control group(P<0.05).Compared with before treatment,the Harris score,necrosis index of MRI,bone mineral density,blood fat index and biochemical markers levels in the two groups were significantly improved at 6 and 12 months after surgery(P<0.05).At 6 and 12 months after surgery,the above indexes were significantly better than those in the control group at the same time(P<0.05).There was no significant difference in liver and kidney function between the observation group after treatment and before treatment(P>0.05).Conclusion The treatment for NONFH in peri-collapse stage with Shuanghe Decoction combined with minimally invasive hip-preserving surgery has a definite clinical efficacy,which can promote the repair of necrotic bone and increase bone mineral density and improve the disorder of lipid metabolism and the level of biochemi

关 键 词：非创伤性股骨头坏死 双合汤 保髋术 围塌陷期 临床研究 

分 类 号：R272.968[医药卫生—中医儿科学]