股骨头坏死愈胶囊联合多孔钽棒治疗早期股骨头坏死临床观察
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摘要
目的:探讨股骨头坏死愈胶囊联合多孔钽棒治疗早期股骨头坏死的临床疗效。方法:将ARCO分期Ⅰ期和Ⅱ期的股骨头坏死患者54例(60髋),按住院号随机分为治疗组27例(29髋)和对照组27例(31髋)。治疗组采用多孔钽棒植入术后口服股骨头坏死愈胶囊治疗,对照组仅采用多孔钽棒植入术治疗。术后对所有患者进行随访观察,评价2组患者的髋关节Harris功能评分、临床疗效及骨修复情况。结果:治疗后,2组患者髋关节Harris功能评分均较治疗前有明显提高,差异有统计学意义(P<0.05);治疗组髋关节Harris功能评分优于对照组,差异有统计学意义(P<0.05)。治疗组优10髋,良15髋,可3髋,差1髋,总有效率为96.55%;对照组优5髋,良10髋,可9髋,差7髋,总有效率为77.42%。2组比较,差异有统计学意义(P<0.05)。治疗组的骨修复情况优于对照组。结论:股骨头坏死愈胶囊联合多孔钽棒治疗早期股骨头坏死,能有效改善患者的患髋功能,缓解关节疼痛,提高患者生活质量,其近期疗效显著。
Objective:To investigate the clinical efficacy of Gugutou Huaisiyu Jiaonang(股骨头坏死愈胶囊)combined with porous tantalum rod insertion in the treatment of osteonecrosis of the femoral head.Methods:Fifty four patients(60 hips)with osteonecrosis of the femoral head at ARCO stage I and stage Ⅱ were randomly divided into a treatment group(27 cases with 29 hips)and a control group(27 cases with 31 hips).The patients in the treatment group were treated with porous tantalum rod insertion combined with Gugutou Huaisiyu Jiaonang,and those in the control group were only treated with porous tantalum rod insertion.After operation,all patients were followed up to evaluate their Harris scores,clinical efficacy and bone recovery.Results:After the treatment,Harris scores of the two groups were significantly increased compared with those before treatment,the difference being statistically significant(P < 0.05).Harris scores of the treatment group were better than those of the control group,and the difference was statistically significant(P < 0.05).For the recovery,in the treatment group,10 hips were best,15 hips were better,3 hips were OK,1 hip was not good,and the total effective rate was 96.55%;while in the control group,5 hips were best,10 hips were better,9 hips were OK,7 hips were not good,and the total effective rate was 77.42%.The difference between the two groups was statistically significant(P < 0.05).The bone recovery in the treatment group was better than the control group.Conclusion:Gugutou Huaisiyu Jiaonang combined withporous tantalum rod insertion in the treatment of osteonecrosis of the femoral head can effectively improve the activity of hip function,relieve joint pain,and improve the quality of life of patients.The curative effect for early osteonecrosis of the femoral head is obvious.
Objective:To investigate the clinical efficacy of Gugutou Huaisiyu Jiaonang(股骨头坏死愈胶囊)combined with porous tantalum rod insertion in the treatment of osteonecrosis of the femoral head.Methods:Fifty four patients(60 hips)with osteonecrosis of the femoral head at ARCO stage I and stage Ⅱ were randomly divided into a treatment group(27 cases with 29 hips)and a control group(27 cases with 31 hips).The patients in the treatment group were treated with porous tantalum rod insertion combined with Gugutou Huaisiyu Jiaonang,and those in the control group were only treated with porous tantalum rod insertion.After operation,all patients were followed up to evaluate their Harris scores,clinical efficacy and bone recovery.Results:After the treatment,Harris scores of the two groups were significantly increased compared with those before treatment,the difference being statistically significant(P < 0.05).Harris scores of the treatment group were better than those of the control group,and the difference was statistically significant(P < 0.05).For the recovery,in the treatment group,10 hips were best,15 hips were better,3 hips were OK,1 hip was not good,and the total effective rate was 96.55%;while in the control group,5 hips were best,10 hips were better,9 hips were OK,7 hips were not good,and the total effective rate was 77.42%.The difference between the two groups was statistically significant(P < 0.05).The bone recovery in the treatment group was better than the control group.Conclusion:Gugutou Huaisiyu Jiaonang combined withporous tantalum rod insertion in the treatment of osteonecrosis of the femoral head can effectively improve the activity of hip function,relieve joint pain,and improve the quality of life of patients.The curative effect for early osteonecrosis of the femoral head is obvious.
引文
[1]Zalavras CG,Lieberman JR.Osteonecrosis of the femoral head:evaluation and treatment[J].J Am AcadOrthop Surg,2014,22(7):455-464.
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[4]中华医学会骨科学分会关节外科学组.股骨头坏死临床诊疗规范(2015版)[J].中华关节外科杂志(电子版),2015,9(1):97-100.
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[6]王帅,张宏军.股骨头坏死愈胶囊联合打压植骨术治疗早期非创伤性股骨头坏死50例[J].风湿病与关节炎,2014,3(6):27-29.
[7]魏立友,李新民,杨清,等.补肾活血方配合推拿治疗股骨头坏死及对髋关节功能的影响[J].陕西中医,2010,31(9):1171-1173.
[8]章乐成,尹宗生.骨髓间充质干细胞及其载体在股骨头坏死治疗中的研究与进展[J].中国组织工程研究,2014,18(3):440-445.
[9]张治宇,蔡郑东,王立强,等.骨小梁金属AVN重建棒在早期股骨头坏死中的应用:2年45髋临床观察[J].中国组织工程研究,2010,14(39):7295-7298.
[10]包伟东,孙永强,刘国杰.股骨头坏死的保头治疗进展[J].风湿病与关节炎,2016,5(9):72-76.
[11]佟刚,赵鉴非,戴军,等.多孔重建钽棒内固定治疗早期股骨头坏死疗效观察与分析[J].中国骨与关节损伤杂志,2012,27(10):882-884.
[12]汪亮,刘耀升,刘蜀彬,等.多孔钽棒植入治疗早中期股骨头坏死的生存率分析和预后因素评估[J].中国骨与关节外科,2015,8(5):396-402.
[13]郑国藩,谢亮文,陈宗雄.植入多孔钽棒治疗股骨头坏死的研究进展[J].实用医学杂志,2015,31(2):171-172.
[14]乔登朝,李志强,王少华.活络骨康丸联合辛伐他汀治疗非创伤性股骨头坏死临床观察[J].风湿病与关节炎,2016,5(10):20-22.
[15]谭旭仪,刘又文,高书图,等.股骨头坏死愈胶囊对股骨头坏死患者血液流变学的影响[J].中成药,2014,36(10):2227-2228.
[16]刘又文,王玉辉,贾宇东,等.股骨头坏死愈胶囊对兔激素性股骨头坏死血清骨钙素与降钙素的影响[J].世界中西医结合杂志,2014,9(3):248-250.
[2]田青松,周游,李新志.早期股骨头坏死的诊疗进展[J].实用医学杂志,2014,30(18):2869-2871.
[3]沈祥,韦标方.保髋治疗股骨头坏死的研究进展[J].风湿病与关节炎,2014,3(6):68-73.
[4]中华医学会骨科学分会关节外科学组.股骨头坏死临床诊疗规范(2015版)[J].中华关节外科杂志(电子版),2015,9(1):97-100.
[5]李子荣.股骨头骨坏死的ARCO分期[J].中华外科杂志,1996,34(3):186-187.
[6]王帅,张宏军.股骨头坏死愈胶囊联合打压植骨术治疗早期非创伤性股骨头坏死50例[J].风湿病与关节炎,2014,3(6):27-29.
[7]魏立友,李新民,杨清,等.补肾活血方配合推拿治疗股骨头坏死及对髋关节功能的影响[J].陕西中医,2010,31(9):1171-1173.
[8]章乐成,尹宗生.骨髓间充质干细胞及其载体在股骨头坏死治疗中的研究与进展[J].中国组织工程研究,2014,18(3):440-445.
[9]张治宇,蔡郑东,王立强,等.骨小梁金属AVN重建棒在早期股骨头坏死中的应用:2年45髋临床观察[J].中国组织工程研究,2010,14(39):7295-7298.
[10]包伟东,孙永强,刘国杰.股骨头坏死的保头治疗进展[J].风湿病与关节炎,2016,5(9):72-76.
[11]佟刚,赵鉴非,戴军,等.多孔重建钽棒内固定治疗早期股骨头坏死疗效观察与分析[J].中国骨与关节损伤杂志,2012,27(10):882-884.
[12]汪亮,刘耀升,刘蜀彬,等.多孔钽棒植入治疗早中期股骨头坏死的生存率分析和预后因素评估[J].中国骨与关节外科,2015,8(5):396-402.
[13]郑国藩,谢亮文,陈宗雄.植入多孔钽棒治疗股骨头坏死的研究进展[J].实用医学杂志,2015,31(2):171-172.
[14]乔登朝,李志强,王少华.活络骨康丸联合辛伐他汀治疗非创伤性股骨头坏死临床观察[J].风湿病与关节炎,2016,5(10):20-22.
[15]谭旭仪,刘又文,高书图,等.股骨头坏死愈胶囊对股骨头坏死患者血液流变学的影响[J].中成药,2014,36(10):2227-2228.
[16]刘又文,王玉辉,贾宇东,等.股骨头坏死愈胶囊对兔激素性股骨头坏死血清骨钙素与降钙素的影响[J].世界中西医结合杂志,2014,9(3):248-250.