密集型针刺配合药物治疗股骨头缺血性坏死的疗效观察

目的观察密集型针刺配合口服股骨头坏死愈胶囊治疗股骨头缺血性坏死的临床疗效及其对髋关节功能和血管内皮细胞生长因子(VEGF)、骨形态发生蛋白(BMP-2)的影响。方法将82例股骨头缺血性坏死患者随机分为治疗组和对照组,每组41例。治疗组采用密集型针刺配合口服股骨头坏死愈胶囊治疗,对照组采用单纯口服股骨头坏死愈胶囊治疗。观察两组治疗前后髋关节功能(Harris评分)及VEGF、BMP-2的变化情况,并比较两组临床疗效及复发情况。结果治疗组优良率为90.2%,对照组为68.3%,两组比较差异具有统计学意义(P<0.05)。两组治疗1个疗程后及治疗后Harris评分和血清VEGF、BMP-2水平与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗1个疗程后及治疗后Harris评分和血清VEGF、BMP-2水平与对照组比较,差异均具有统计学意义(P<0.05)。治疗组治疗后3个月、6个月复发率分别为6.4%和8.5%,对照组分别为12.5%和25.0%。两组治疗后6个月复发率比较,差异具有统计学意义(P<0.05)。结论密集型针刺配合口服股骨头坏死愈胶囊治疗股骨头缺血性坏死疗效确切,可有效改善患者髋关节功能,促进血清VEGF、BMP-2合成,且复发率较低。

Observations on the Efficacy of Intensive Acupuncture plus Medication for Avascular Necrosis of Femoral Head

Objective To investigate the clinical efficacy of intensive acupuncture plus Gugutouhuaisiyu Capsule for avascular necrosis of femoral head and its effect on hip joint function,vascular endothelial growth factor(VEGF)and bone morphogenetic protein(BMP-2).Method Eighty-two patients with avascular necrosis of femoral head were randomized to treatment and control groups,41 cases in each group.The treatment group received intensive acupuncture plus oral administration of Gugutouhuaisiyu Capsule and the control group,oral administration of Gugutouhuaisiyu Capsule alone.Hip joint function(Harris score),VEGF and BMP-2 were observed in the two groups before and after treatment.The clinical therapeutic effects and recurrences were compared between the two groups.Result The excellent and good rate was 90.2%in the treatment group and 68.3%in the control group with a statistically significant difference between the two groups(P<0.05).The Harris score and serum VEGF and BMP-2 levels had statistically significant differences in the two groups after one course of treatment and at the end of treatment compared with before(P<0.05).There were statistically significant differences in the Harris score and serum VEGF and BMP-2 levels between the treatment and control groups after one course of treatment and at the end of treatment(P<0.05).The recurrence rate was 6.4%at three months and 8.5%at six months after treatment in the treatment group and 12.5%at three months and 25.0%at six months after treatment in the control group.There was a statistically significant difference in the recurrence rate between the two groups at six months after treatment(P<0.05).Conclusion Intensive acupuncture plus Gugutouhuaisiyu Capsule has a definite therapeutic effect on avascular necrosis of femoral head.It can effectively improve hip joint function and promote the synthesis of serum VEGF and BMP-2 with a lower recurrence rate.