补肾活血方加减治疗早期非创伤性股骨头坏死  

Observation on Clinical Effect of Modified Bushen Huoxue Formula in Treating Early Non-traumatic Osteonecrosis of Femoral Head

作　　者：李龙飞 孟祥亚 任之强 韩崇涛[3] 徐良 阎晓霞 LI Longfei;MENG Xiangya;REN Zhiqiang;HAN Chongtao;Xu Liang;YAN Xiaoxia(School of Orthopaedics,Henan University of Chinese Medicine,Zhengzhou Henan China 450002;Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Zhengzhou Henan China 450000;The Third Affiliated Hospital to Henan University of Traditional Chinese Medicine,Zhengzhou Henan China 450008)

机构地区：[1]河南中医药大学骨伤学院,河南郑州450002 [2]河南省洛阳正骨医院(河南省骨科医院),河南郑州450000 [3]河南中医药大学第三附属医院,河南郑州450008

出　　处：《中医学报》2024年第8期1770-1775,共6页Acta Chinese Medicine

基　　金：河南省中医药科学研究专项课题项目(20-21ZY1026,2022ZY1105);河南省中医拔尖人才项目(2019ZYBJ21)。

摘　　要：目的:观察补肾活血方加减治疗早期非创伤性股骨头坏死(nontraumatic femoral head necrosis,ONFH)的临床疗效。方法:96例早期ONFH患者按照随机数字表法分为对照组及治疗组各48例。对照组给予口服仙灵骨葆胶囊、阿仑膦酸钠片,治疗组给予口服补肾活血方加减,疗程为6个月。比较两组患者治疗前后中医证候评分、髋关节Harris评分及疼痛视觉模拟量表(visual analogue scale,VAS)评分、骨代谢[骨钙素(bone gamma carboxy-glutamic acid containing proteins,BGP)、总Ⅰ型胶原氨基酸延长肽(propeptide of typeⅠprocollagen,PINP)、血清碱性磷酸酶(alkaline phosphatase,ALP)]、骨密度[股骨颈、股骨粗隆、全髋]、血液流变学[全血黏度100 L·s^(-1)、全血黏度300 L·s^(-1)、血浆黏度、红细胞聚集指数]、血脂[总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)]、不良反应发生率。结果:治疗后,治疗组有效率为91.3%,显著高于对照组的76.08%,差异有统计学意义(P<0.05);两组患者中医证候评分、VAS评分均显著降低,且治疗组显著低于同期对照组(P<0.05);两组患者Harris评分均显著升高,且治疗组显著高于同期对照组(P<0.05);治疗组血清BGP、PINP、ALP水平显著高于同期对照组(P<0.05);治疗组股骨颈、股骨粗隆、全髋骨密度显著高于同期对照组(P<0.05);治疗组全血黏度100 L·s^(-1)、全血黏度150 L·s^(-1)、全血黏度300 L·s^(-1)、血浆黏度、红细胞聚集指数水平显著低于同期对照组(P<0.05);治疗组TCH、TG、LDL-C水平显著低于同期对照组,HDL-C水平显著高于同期对照组(P<0.05);治疗组不良反应发生率为10.87%,高于对照组的6.52%,差异有统计学意义(P<0.05)。结论:补肾活血方加减治疗早期ONFH临床疗效显著,可有效改善患者临床症状,提高成骨能力,�Objective:To observe the clinical effect of Bushen Huoxue Formula in treatment of early non-traumatic osteonecrosis of the femoral head(ONFH).Methods:96 patients diagnosed with early ONFH were selected and divided into control group and treatment group with 48 patients in each group according to random number table.The control group was given oral Xianling Gubao capsule and alendronate sodium tablets,while the treatment group was given oral Modified Bushen Huoxue Decoction,and the course of treatment was 6 months.Before and after treatment,traditional Chinese medicine syndrome score,Harris hip score and Visual Analogue Scale(VAS)score were compared between the two groups.In addition,Bone metabolism[bone gamma carboxy-glutamic acid containing proteins(BGP),propeptide of type I procollagen(PINP),alkaline phosphatase(ALP)],bone mineral density[femoral neck,femoral trochanter,whole hip],hemorheology[whole blood viscosity 100 L·s^(-1),whole blood viscosity 300 L·s^(-1),plasma viscosity,red blood cell aggregation index]and blood lipid[total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)]levels,and the incidence of adverse reactions of the two groups were compared.Results:After treatment,the total effective rate of the treatment group was 91.3%,significantly higher than that of the control group(76.08%,P<0.05).TCM symptom score and VAS scores of both groups were significantly decreased,and the scores of treatment group was significantly lower than that of the control group(P<0.05).The Harris score of both groups was significantly increased,and the score of treatment group was significantly higher than that of the control group(P<0.05).The levels of serum BGP,PINP and ALP of treatment group were significantly higher than those of the control group(P<0.05).The bone density of femoral neck,femoral trochanter and whole hip of treatment group was significantly higher than that of control group(P<0.05).Whole blood viscosity of 100 L·s^(-1),whole blood

关 键 词：非创伤性股骨头坏死 补肾活血方 仙灵骨葆胶囊 阿仑膦酸钠片 

分 类 号：R274.94[医药卫生—中西医结合]