川骨片治疗早期非创伤性股骨头缺血坏死24例的临床观察
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摘要
目的观察川骨片治疗非创伤性股骨头缺血性坏死的临床效果。方法回顾2017年7月-2018年7月,24例(36髋)股骨头缺血坏死患者(FicatI期-II期)采用口服川骨片治疗的临床疗效。其中酒精性10例(13髋),激素性11例(20髋),特发性3例(3髋)。结果随访时间6-12月,根据Harris评分,优8髋(22.2%),良18髋(50%),中7髋(19.4%),差3髋(8.3%),总有效率91.6%。复查X线表现好转2例,无变化23例,进展11例。结论单纯采用川骨片治疗非创伤性股骨头缺血坏死可以延缓病情进展,并改善临床症状。
Objective To observe the clinical effect of the treatment of non-traumatic necrosis of femoral head by taking Chuangu Tablet. Methods A retrospective study of the clinical data from 24 cases(36 hips) of necrosis of femoral head(stage Ficat I-II) in July2017-2018 July treated by taking Chuangu Tablet.Among them,Among them, 10 cases were alcoholic(13 hips), 11 cases were steroid(20 hips), and 3 cases have no reason. Results Follow up time was 6-12 months, according to Harris score, excellent 8 hips(22.2%), good18 hips(50%), middle 7 hips(19.4%), poor 3 hips(8.3%), and total effective rate 91.6%.X-ray examination showed improvement in 2 cases, no change in 23 cases, and deterioration in 11 cases. Conclusions The use of Chuangu tablet in the treatment of non-traumatic necrosis of the femoral head can delay the progression of the disease and improve the clinical symptoms.
Objective To observe the clinical effect of the treatment of non-traumatic necrosis of femoral head by taking Chuangu Tablet. Methods A retrospective study of the clinical data from 24 cases(36 hips) of necrosis of femoral head(stage Ficat I-II) in July2017-2018 July treated by taking Chuangu Tablet.Among them,Among them, 10 cases were alcoholic(13 hips), 11 cases were steroid(20 hips), and 3 cases have no reason. Results Follow up time was 6-12 months, according to Harris score, excellent 8 hips(22.2%), good18 hips(50%), middle 7 hips(19.4%), poor 3 hips(8.3%), and total effective rate 91.6%.X-ray examination showed improvement in 2 cases, no change in 23 cases, and deterioration in 11 cases. Conclusions The use of Chuangu tablet in the treatment of non-traumatic necrosis of the femoral head can delay the progression of the disease and improve the clinical symptoms.
引文
[1]任维龙,许波,李刚.中医药治疗早期股骨头缺血性坏死疗效的Meta分析[J].中华中医药学刊,2016(10):2454-2458.
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[6]Wang G,Zhang CQ,Sun Y,et al.Changes in femoral head blood supply and vascular endothelial growth factor in rabbits with steroid-induced osteonecrosis[J].J Int Med Res,2010,38(3):1060-1069.
[7]Zeng X,Zhan K,Zhang L,et al.The impact of high total cholesterol and high low-density lipoprotein on avascular necrosis of the femoral head in lowenergy femoral neck fractures[J].J Orthop Surg Res,2017,12(1):30.
[8]Mukisi M,Bashoun K,Burny F.Sickle-cell hip necrosis and intraosseous pressure[J].Orthop Traumatol Surg Res,2009,95(2):134-138.
[9]Jilka RL,Noble B,Weinstein RS.Osteocyte apoptosis[J].Bone,2013,54(2):264-271.
[10]Zheng L,Wang W,Ni J,et al.The association of e NOS gene polymorphism with avascular necrosis of femoral head[J].Plo S one,2014,9(2):e87583.
[11]Tian L,Wen Q,Dang X,et al.Immune response associated with Tolllike receptor 4 signaling pathway leads to steroid-induced femoral head osteonecrosis[J].BMC Musculoskeletal Disorders,2014,15(1):18.
[12]刘伯龄,赵文海.股骨头无菌性坏死的辨证施治[J].中国骨伤,1991,4(1):1.
[13]丁小刚,覃勇,鄂建设,等.骨碎补总黄酮对老年性骨质疏松症患者血清骨钙素水平及骨密度影响[J].中国骨质疏松杂志,2013,19(5):519-521.
[14]Niu Y B,Li Y H,Kong X H,et al.The beneficial effect of Radix Dipsac total saponins on bone metabolism in vitro and in vivo and the possible mechanisms of action[J].Osteoporos Int,2012,23(11):2649-60.
[15]卞琴,黄建华,杨铸,等.三种补肾中药有效成分对皮质酮致骨质疏松大鼠骨髓间充质干细胞基因表达谱的作用[J].中西医结合学报,2011,9(2):179-185.
[2]Harris WH.Traumatic arthritis of the hip after dislocation and acetabular fractures:Treatment by mold arthroplasty.An end-resultstudy using a new method of result evaluatio[J].J Bone Joint Surg(Am),1969,51(4):737-755.
[3]Amanatullah DF,Strauss EJ,Di Cesare PE.Current management options for osteonecrosis of the femoral head:part 1,diagnosis and nonoperative management[J].Am J Orthop(Belle MeadNJ),2011,40(9):186-192.
[4]Mont M,Cherian J,Sierra R,et al.Nontraumatic Osteonecrosis of the Femoral Head:Where Do We Stand Today?A Ten-Year Update[J].J Bone Joint Surg Am,2015,97(19):1604-1627.
[5]Guerado E,Caso E.The physiopathology of avascular necrosis of the femora head:an update[J].Injury,2016,47(Suppl 6):16-26.
[6]Wang G,Zhang CQ,Sun Y,et al.Changes in femoral head blood supply and vascular endothelial growth factor in rabbits with steroid-induced osteonecrosis[J].J Int Med Res,2010,38(3):1060-1069.
[7]Zeng X,Zhan K,Zhang L,et al.The impact of high total cholesterol and high low-density lipoprotein on avascular necrosis of the femoral head in lowenergy femoral neck fractures[J].J Orthop Surg Res,2017,12(1):30.
[8]Mukisi M,Bashoun K,Burny F.Sickle-cell hip necrosis and intraosseous pressure[J].Orthop Traumatol Surg Res,2009,95(2):134-138.
[9]Jilka RL,Noble B,Weinstein RS.Osteocyte apoptosis[J].Bone,2013,54(2):264-271.
[10]Zheng L,Wang W,Ni J,et al.The association of e NOS gene polymorphism with avascular necrosis of femoral head[J].Plo S one,2014,9(2):e87583.
[11]Tian L,Wen Q,Dang X,et al.Immune response associated with Tolllike receptor 4 signaling pathway leads to steroid-induced femoral head osteonecrosis[J].BMC Musculoskeletal Disorders,2014,15(1):18.
[12]刘伯龄,赵文海.股骨头无菌性坏死的辨证施治[J].中国骨伤,1991,4(1):1.
[13]丁小刚,覃勇,鄂建设,等.骨碎补总黄酮对老年性骨质疏松症患者血清骨钙素水平及骨密度影响[J].中国骨质疏松杂志,2013,19(5):519-521.
[14]Niu Y B,Li Y H,Kong X H,et al.The beneficial effect of Radix Dipsac total saponins on bone metabolism in vitro and in vivo and the possible mechanisms of action[J].Osteoporos Int,2012,23(11):2649-60.
[15]卞琴,黄建华,杨铸,等.三种补肾中药有效成分对皮质酮致骨质疏松大鼠骨髓间充质干细胞基因表达谱的作用[J].中西医结合学报,2011,9(2):179-185.