骨蚀汤加减联合塞来昔布胶囊治疗非创伤性股骨头坏死的临床疗效观察

Clinical observation of guetu decoction combined with celecoxib capsule in the treatment of non-traumatic femoral head necrosis

目的探讨骨蚀汤加减联合塞来昔布胶囊治疗非创伤性股骨头坏死的临床疗效。方法选取2015年3月—2018年3月在深圳市宝安中医院(集团)治疗的非创伤性股骨头坏死患者120例,按就诊顺序分为对照组和观察组,每组60例。对照组采用西医常规结合塞来昔布胶囊治疗,观察组在对照组基础上联合骨蚀汤加减治疗,均连续治疗6个月,随访12个月。比较两组患者的Harris评分、健康调查简表(SF-36)评分、影像学评分,关节疼痛采用视觉模拟评分法(VAS);比较两组患者的总有效率、复发率及不良反应总发生率。结果研究期间对照组患者脱落4例,观察组患者脱落2例。观察组治疗后的Harris评分、SF-36评分及影像学评分高于对照组(P<0.05);观察组治疗后关节疼痛VAS评分低于对照组(P<0.05)。观察组总有效率为94.83%,高于对照组的78.57%(P<0.05);随访12个月观察组的复发率为8.62%,低于对照组的23.21%(P<0.05)。观察组不良反应发生率为10.34%,低于对照组的32.14%(P<0.05)。结论骨蚀汤加减联合塞来昔布胶囊治疗非创伤性股骨头坏死临床疗效更优,复发率更低,更有利于减轻服药后带来的不良反应,值得临床推广应用。

objective To investigate the clinical effect of guetu decoction combined with celecoxib capsule on non-invasive necrosis of femoral head.Methods A total of 120 patients with non-traumatic femoral head necrosis were divided into the control group(n=60)and the observation group(n=60).Patients in the control group were treated with conventional western medicine combined with celecoxib capsule;patients in the observation group were treated with guetang plus or minus treatment for 6 consecutive months on the basis of treatment in the control group,followed up for 12 months.The clinical efficacy,Harris scale,health survey summary(SF-36),and imaging scores of the two groups were compared and analyzed before and after treatment.Score of pure hip pain,the effective rate,recurrence rate,and safety were compared between the two groups.Results During the study,4 patients in the control group and 2 patients in the observation group were abscission.The total effective rate of observation group was 94.83%,which was higher than 78.57%of control group(P<0.05).The recurrence rate of the observation group was 8.62%,which was lower than that of the control group(23.21%)after 12 months followup(P<0.05).The Harri scale,SF-36 scale,and hip imaging scores of the observation group were higher than those of the control group(P<0.05).The joint pain score in the observation group was lower than that in the control group(P<0.05).The incidence of adverse reactions in observation group was 10.34%,which was lower than 32.14%in control group(P<0.05).Conclusion Guetu decoction combined with celecoxib capsule for the treatment of nontraumatic femoral head necrosis has better clinical efficacy,lower recurrence rate,and is more conducive to reduce the adverse reactions after taking the medicine,which is worthy of clinical promotion and application.