摘要
目的探讨补肾生骨方联合髓芯减压治疗非创伤性股骨头坏死的临床疗效。方法选取2016年6月—2018年12月抚顺市中医院骨三科病房收诊的肾虚型非创伤性股骨头坏死住院治疗患者80例,国际骨循环研究协会(Association research circulation osseous,ARCO)分期为0~Ⅱ期,随机分为观察组和对照组,每组40例。对照组进行髓芯减压治疗,术后进行正常的恢复性锻炼,观察组在对照组的治疗基础上,于术后5 d给予补肾生骨方。术后随访12个月,记录术前及术后1、3、6、12个月的视觉疼痛模拟量表(VAS)评分及髋关节Harris评分并观察影像学表现及血浆中缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF-A)的含量。结果观察组治疗总有效率为92.50%(37/40),高于对照组82.50%(33/40)(P<0.05),观察组术后3、6、12个月VAS评分及髋关节Harris评分结果均优于对照组(P<0.05)。观察组和对照组患者术后1、3、6、1个月血浆中HIF-1α、VEGF-A的含量高于术前(P<0.05);与对照组比较,观察组患者术后1、3、6、12个月血浆中HIF-1α、VEGF-A的含量高于对照组(P<0.05)。结论髓芯减压治疗可提高患者血浆中HIF-1α、VEGF-A水平,VAS评分及髋关节Harris评分,术后给予补肾生骨方,可进一步增加患者血浆中HIF-1α、VEGF-A的含量,治疗非创伤性股骨头坏死疗效优于单纯使用髓芯减压治疗,能显著提高患者的生活质量。
Objective To explore the clinical effect of tonifying kidney and promoting production of bone recipe combined with core decompression in the treatment of nontraumatic necrosis of the femoral head.Methods From June 2016 to December 2018,80 patients with nontraumatic necrosis of the femoral head of kidney yang deficiency type were selected from orthopaedic department of our hospital.ARCO stage was 0-II.They were randomly divided into the observation group and the control group,with 40 cases in each group.The control group received core decompression treatment and normal recovery exercise after surgery.The observation group was based on the treatment of the control group,and five days after the operation were given tonifying kidney and promoting production of bone recipe,decoction with water,one dose a day,twice a day,for three months.After 12 months followed-up,VAS visual pain simulation score and Harris score of hip joint were recorded before and 1,3,6 and 12 months after operation.Results The total effective rate of observation group was 92.50%(37/40),which was higher than that of control group(82.50%,33/40)(P<0.05).The levels of HIF-1αand VEGF-A in the plasma of the observation group and the control group were significantly higher than those before operation(P<0.05),but the levels of HIF-1αand VEGF-A in the plasma of the observation group were significantly higher than those of the control group(P<0.05).Conclusion The content of HIF-1αand VEGF-A in plasma,VAS visual pain simulation score and Harris score of hip joint can be increased after the operation.The content of HIF-1αand VEGF-A in plasma can be further increased after the treatment of tonifying kidney and promoting production of bone recipe.The therapeutic effect is better than that of core decompression alone,which can significantly improve the quality of life of patients.
作者
李洪刚
LI Honggang(Orthopedic Ward,Fushun Hospital of Traditional Chinese Medicine,liaoning ning province,Funshun 113006,China)
出处
《中国中医药现代远程教育》
2021年第6期144-146,共3页
Chinese Medicine Modern Distance Education of China
关键词
中西医结合疗法
补肾生骨方
非创伤性股骨头坏死
骨痹
髓芯减压
therapy of integrated traditional Chinese and western medicine
tonifying kidney and promoting production of bone recipe
nontraumatic necrosis of the femoral head
bone bi-disease
core decompression
