补肾壮骨通络汤辅助髓芯减压植骨术治疗早期非创伤性股骨头坏死临床疗效观察

目的:观察分析补肾壮骨通络汤辅助髓芯减压植骨术治疗早期非创伤性股骨头坏死临床疗效。方法:选取2015年4月～2017年6月我院收治的早期非创伤性股骨头坏死患者58例,根据随机数字表法分为两组,分别为对照组(29例)与观察组(29例)。对照组患者使用髓芯减压植骨术治疗;观察组患者在对照组治疗的基础上联合补肾壮骨通络汤进行辅助治疗。两组患者均治疗2个月,比较两组患者治疗前后的VAS、JOA及Harris评分、不良反应及临床疗效的影响情况。结果:治疗前,两组患者的VAS、JOA和Harris评分水平无明显变化,两组评分数据无统计学意义(P>0. 05);治疗后,两组患者VAS评分较前降低,JOA和Harris评分较前升高,且观察组治疗后VAS评分较对照组降低幅度大,JOA和Harris评分较对照组升高幅度显著,两组相比均有统计学意义(P<0. 05);观察组治疗后的临床有效率(93. 10%)明显高于对照组临床有效率(72. 41%)(P<0. 05);在治疗过程中,观察组患者不良反应发生率(10. 35%)与对照组(6. 90%)对比无明显差异(P>0. 05)。结论:补肾壮骨通络汤辅助髓芯减压植骨术治疗早期非创伤性股骨头坏死疗效较显著,中药汤剂可改善股骨头缺血性坏死患者Harris及JOA评分,并缓解其疼痛,更具安全性。

Clinical Curative Observation of Using Bushen Zhuanggu Tongluo Decoction Combined with Core Decompression and Bone Grafting for Early Non-traumatic Osteonecrosis of Femoral Head

Objective: To investigate the effect of Bushen Zhuanggu Tongluo Decoction combined with core decompression and bone grafting for early non-traumatic osteonecrosis of femoral head. Methods: 58 patients with early non-traumatic femoral head necrosis in our hospital from April 2015 to June 2017 were selected and divided into controlled group and observation group according to the random number table method,each with 29 cases. The controlled group received the core decompression and bone grafting,based on this,the observation group received Bushen Zhuanggu Tongluo Decoction,both 3 times a day for 2 months;The VAS,JOA and Harris scores,adverse reactions and clinical efficacy of the two groups before and after treatment were compared. Results: Before treatment,the VAS,JOA and Harris scores of the two groups had no significant difference( P >0.05);After treatment,the VAS score was decreased,and the OA and Harris scores were increased,both the decrease level and increase level were more obvious in the observation group than in the controlled group( P < 0.05);The clinical efficacy of the observation group was significantly higher than that of the controlled group( 93.10% vs 72.41%,P < 0.05);The incidence of adverse reactions between the two groups had no significant difference( 10.35% vs 6.90%,P > 0.05). Conclusion:Bushen Zhuanggu Tongluo Decoction combined with core decompression and bone grafting is an effective and safe way to ameliorate the Harris and JOA scores,relieve pain for early non-traumatic osteonecrosis of femoral head.