桃红四物汤加减治疗对气滞血瘀型股骨头坏死骨修复及血液流变学的影响

目的:观察桃红四物汤加减治疗对气滞血瘀型股骨头坏死的临床疗效,并分析其机制。方法:选取2015年1月至2017年1月在南京军区福州总院附属第一医院骨科门诊、住院部就诊的气滞血瘀型股骨头坏死患者102例,按就诊顺序将患者分为观察组与对照组,每组51例。2组均行基础治疗,对照组加以体外冲击波治疗,观察组在对照组基础上加以汤剂桃红四物汤加减口服,共治疗8周。分别在治疗前及治疗后对2组的临床疗效、髋关节Harris评分及骨密度进行评定,同时检测血清骨钙素及血液流变学指标的变化,并进行统计分析。结果:8周治疗后,观察组总有效率(92.15%)优于对照组(82.35%)(P0.05);观察组治疗后髋关节Harris评分、骨密度及血清骨钙素均较治疗前明显提高,且优于对照组(P0.05);2组血液流变学各项指标均较治疗前明显降低,且观察组优于对照组(P0.05)。结论:桃红四物汤可以有效减轻Ⅰ、Ⅱ期气滞血瘀型股骨头坏死患者的临床症状,改善局部血凝状态,有利于骨坏死的恢复。

Study on Taohong Siwu Decoction in the Treatment in Osteonecrosis of the Femoral Head Based on Bone Repair and Hemorheology

To observe the clinical effects of modified Taohong Siwu Decoction in the treatment of femoral head necrosis of qi stagnation and blood stasis type, and analyze its mechanism. Methods:A total of 102 patients in the outpatient department of orthopedics, and hospitalization department in our hospital from January 2015 to January 2017 were randomly selected and divided into treatment group and control group according to the order of treatment, with 51 cases in each group. The two groups were treated with basic treatment, while the control group was treated with extracorporeal shock wave therapy. The treatment group was treated with modified Taohong Siwu Decoction, and the treatment last for 8 weeks. Before and after treatment, the clinical efficacy, hip Harris score and bone mineral density were evaluated, and the changes of serum osteocalcin and hemorheology were detected and analyzed. Results:After 8 weeks of treatment, the clinical efficacy of the treatment group and the control group were compared. The total efficiency of the treatment group (92.15%) was better than the control group (82.35%) (P<0.05); after treatment, Harris hip score, bone density and serum osteocalcin were significantly improved in treatment group compared with before treatment, which was better than the control group (P<0.05); the hemorheology indexes of two groups were significantly lower than that before treatment, and the treatment group was better than the control group (P<0.05). Conclusion:Taohong Siwu Decoction can effectively alleviate the clinical symptoms of patients with femoral head necrosis of qi stagnation and blood stasis type, and improve the local blood coagulation state, which is conducive to the recovery of osteonecrosis, and it is worthy of clinical application.