补肾活血通络祛湿汤辅助钻孔减压治疗早期股骨头坏死临床研究  

Clinical study of Bushen Huoxue Tongluo Qushi Decoction assisted drilling decompression in the treatment of early femoral head necrosis

作　　者：郭国峰 GUO Guofeng(Department of Orthopedics and Traumatology,Integrated Traditional Chinese and Western Medicine Hospital,Xiangcheng Health School,Xiangcheng 466200,China)

机构地区：[1]项城市卫校中西医结合医院骨伤科,河南项城466200

出　　处：《沈阳医学院学报》2023年第3期256-260,共5页Journal of Shenyang Medical College

摘　　要：目的:探讨补肾活血通络祛湿汤辅助钻孔减压治疗早期股骨头坏死(FHS)的效果。方法:选择我院104例早期FHS患者为研究对象,按照随机数字表法分成对照组、治疗组,各52例。对照组接受钻孔减压治疗,治疗组在对照组基础上予以补肾活血通络祛湿汤辅助治疗。对比2组总有效率、治疗前后Harris髋关节功能评分(HHS)、视觉模拟评分(VAS)、中医证候积分、血液流变学(全血低切黏度、全血高切黏度)、血管内皮功能[细胞黏附分子-1(ICAM-1)、血管内皮生长因子(VEGF)]、骨代谢[Ⅰ型胶原交联C端肽(sCTX)、骨钙素(sOC)、胰岛素生长因子-1(IGF-1)]水平。结果:治疗2个月后,治疗组总有效率高于对照组(P<0.05);治疗组VAS评分较对照组低,HHS评分较对照组高(P<0.01);治疗组髋部隐痛、腰膝酸软、面色潮红、心烦失眠中医证候积分较对照组低(P<0.01);治疗组全血低切黏度、全血高切黏度较对照组低(P<0.01);治疗组血清ICAM-1、VEGF、sCTX水平较对照组低,血清sOC、IGF-1水平较对照组高(P<0.01)。结论:补肾活血通络祛湿汤辅助钻孔减压治疗早期FHS患者可进一步提升疗效,有效提高髋关节功能,缓解疼痛,改善局部微循环,促进病情恢复,同时能进一步提高机体血管内皮功能,促进骨生长及骨质形成。Objective:To explore the effect of Bushen Huoxue Tongluo Qushi Decoction assisted drilling decompression in the treatment of early femur head necrosis(FHS).Methods:A total of 104 patients with early FHS in our hospital were selected and randomly divided into the control group and the treatment group according to random number table method,with 52 cases in each group.The control group was treated with drilling decompression,and the treatment group was treated with Bushen Huoxue Tongluo Qushi Decoction on the basis of the control group.The total effective rate,Harris hip function score(HHS),VAS score,traditional Chinese medicine syndrome score,hemorheology(whole blood low tangential viscosity,whole blood high tangential viscosity),vascular endothelial function[cell adhesion molecule-1(ICAM-1),vascular endothelial growth factor(VEGF)],bone metabolism[collagen type I crosslinked C-terminal peptide(sCTX),osteocalcin(sOC),insulin growth factor-1(IGF-1)]of the 2 groups were compared.Results:After 2 months of treatment,the total effective rate of the treatment group was higher than that of the control group(P<0.05).VAS score of the treatment group was lower and HHS score was higher than that of the control group(P<0.01).The scores of traditional Chinese medicine syndrome of dull hip pain,waist and knee tenderness,flushed face,upset and insomnia in the treatment group were lower than those in the control group(P<0.01).Whole blood low tangential viscosity and whole blood high tangential viscosity in the treatment group were lower than those in the control group(P<0.01).Serum ICAM-1,VEGF and sCTX levels in the treatment group were lower,and the serum sOC and IGF-1 levels were higher than those in the control group(P<0.01).Conclusion:Bushen Huoxue Tongluo Qushi Decoction assisted drilling decompression in the treatment of early FHS patients can further improve the curative effect,effectively improve hip joint function,relieve pain,improve local microcirculation,promote the recovery of the disease,and further improve the vasc

关 键 词：股骨头坏死 钻孔减压 中药口服 血管内皮功能 

分 类 号：R274.9[医药卫生—中西医结合]