中西医结合治疗早期激素性股骨头坏死的临床研究

The clinical research of combined treatment of traditional Chinese medicine and western medicine on early-stage steroid-induced femoral head osteonecrosis

目的探讨中西医结合治疗早期激素性股骨头坏死的疗效及安全性。方法对86例159髋采用中西医结合保守治疗早期激素性股骨头缺血性坏死患者和30例56髋采用中药治疗患者的临床资料进行回顾性研究。结果治疗42个月后复查,应用国际骨循环学会(ARCO)分期、分型系统评价,中西医结合治疗组有进展者56髋,进展率为35.22%;中医治疗组有进展者42髋,进展率为75.00%;应用Harris髋关节功能评分系统评价,中西医结合治疗组有进展者20髋,进展率为12.58%;中医治疗组有进展者34髋,进展率为60.71%;两组进展率的比较有显著性差异(P<0.05)。结论中西医结合保守治疗早期激素性股骨头缺血性坏死,对股骨头坏死起到促进修复、阻止疾病进展速度的作用,疗效满意,治疗方案安全可靠。

Objective To investigate the effect and safety about the combined treatment of traditional Chinese medicine（TCM） and western medicine on early-stage steroid-induced femoral head osteonecrosis. Methods A retrospestive study was carried out. It included 86 patients with 159 hip-joint early-stage femoral head ischemic osteonecrosis treated by combination of TCM and western medicine, and 30 patients with 56 hip-joint early-stage femoral head ischemic osteonecrosis treated by herbal medicine, Results Assessed by ARCO, the follow-up examination after 42-month treatment showed that in 86 patients group, 56 hip-joints had improved with an improvement rate of 35.22% and in 30 patients group, 42 hip-joints had improved with an improvement rate of 75.00%. It had significant difference between the two groups （P〈0.05）. Assessed by Harris Hip Score, 20 hip-joints in 86 patients group improved with an improvement rate of 12.58% and 34 hip-joints in 30 patients group inproved with an improvement rate of 60.71%. It also had significant difference betweeen the two groups （P〈0.05）. Conclusions Conservative combined treatment of TCM and western medicine on early-stage steroid-induced femoral head osteonecrosis can promote the restoration of femoral head and pre- vent further worsening of the illness. It is .effective, safe and reliable.