通络生骨方治疗激素性股骨头坏死的回顾性临床研究

摘要

目的：观察通络生骨方治疗激素性股骨头坏死筋脉凝滞证的临床疗效。方法：回顾性分析2010年2月至2013年6月收治住院的随访24个月以上的ARCO分期Ⅱ-Ⅲ期的108例激素性股骨头坏死患者，将行通络生骨方治疗者设为治疗组(54例)，行健骨生方治疗者设为对照组(54例)，依据Harris评分法，对治疗后患者的疼痛程度、关节功能、关节畸形、关节活动度依次评分，并计算其总分；观察X线片并记录其股骨头坏死的修复等级及治疗期间药物不良反应发生情况。结果：治疗组Harris评分的优良率与对照组接近，差异无统计学意义(P＞0.05)；治疗组在改善关节活动度、关节畸形，缓解疼痛及Harris总评分方面优于对照组(P＜0.05)；影像学资料表明，治疗组死骨总吸收率、死骨明显吸收率、新骨总形成率、新骨明显形成率均高于对照组(81.48%、64.81%；51.85%、35.19%；83.33%、61.11%；51.85%、31.48%，P＜0.05)；2组患者在治疗期间药物不良事件发生率较低，且能自行缓解。结论：通络生骨方治疗ARCOⅡ-Ⅲ期激素性股骨头坏死安全有效，可考虑在早中期激素性股骨头坏死患者中推广。%Objective: To observe clinical effects ofTongLuoShengGuprescription in treating steroid-induced necrosis of femoral head(SONFH) of tendon and vein stagnation pattern. Methods: All 108 patients, who were fol-lowed up more than 24 months, hospitalized from February, 2010 to June, 2013 were retrospectively analyzed from stage Ⅱto Ⅲof ARCO. The patients who receivedTongLuoShengGuprescription were selected as the test group (54 cases), the ones who acceptedJianGuShengprescription were established as the control group (54 cases), accord-ing to Harris scales, the pain degrees, joint function, joint deformity, joint activity of the patients were scored after treating, and total scores were calculated; the incidences of adverse reactions during therapeutic period and rehabili-tation degrees of femoral head necrosis were recorded after observing X-ray. Results: The test group was close to the control group in the excellent rate of Harris scales, and there was no statistical difference(P>0.05); the test group was superior to the control group in improving joint activity, joint deformity, relieving the pain and total Harris scales (P<0.05). Imaging data demonstrated that the test group was higher than the control group in total absorption rate of necrotic bone, notable absorption rate of necrotic bones, total formation rate of new bone, notable formation rate of new one (81.48%, 64.81%; 51.85%, 35.19%; 83.33%, 61.11%; 51.85%, 31.48%,P<0.05); the incidence of adverse reactions in both groups were lower during therapeutic period, and the patients could be relieved by themselves. Conclusion:TongLuoShengGuprescription is effective and safe in treating SONFH from stage Ⅱto Ⅲof ARCO, which could be applied to the patients with SONFH at early and moderate stages.