带血管蒂髂骨瓣移植联合活血补肾汤治疗股骨头缺血性坏死的临床研究

Clinical study on vascularized iliac bone grafting combined with huoxue bushen decoction for treatment of femoral head avascular necrosis

目的观察带血管蒂髂骨瓣移植联合中医活血补肾汤治疗国际骨循环研究学会(ARCO)Ⅱ～Ⅲ期股骨头缺血性坏死患者的Harris评分及X线片改善情况,以验证其治疗优势。方法40例(49髋)ARCOⅡ～Ⅲ期股骨头缺血坏死患者随机分为两组,治疗组22例(28髋)采用带血管蒂髂骨瓣移植治疗,2周后服用活血补肾汤3个疗程;对照组18例(21髋)采用单纯带血管蒂髂骨瓣移植治疗。观察两组术后Harris评分及X线片改善情况。结果术后18个月治疗组Harris评分及X线片改善情况,均优于对照组。结论带血管蒂髂骨瓣移植联合活血补肾汤治疗股骨头缺血性坏死的效果明显优于单纯带血管蒂髂骨瓣移植,中药活血补肾汤在缓解患者症状和改善功能方面有明显的作用。

Objective To study the effect of vascularized iliac bone grafting combined with huoxue bushen decoction （herbs being helpful for renal function and activating blood） in treatment for Association Research Circulation Osseous （ARCO） stageⅡ-Ⅲ avaseular necrosis of the femoral head. Methods Forty patients with 49 hips being at ARCO stage Ⅱ-Ⅲ were randomly divided into two groups, treatment group（22 patients with 28, hips） were treated with huoxue bushen decoction for three course of treatment after two weeks of vascularized iliac bone grafting surgery, control group（ 18 patients with 21 hips） were operated with vaseularized iliac bone grafting, the changes of Harris hip score and X-ray film image were evaluated. Results At 18 months after treatment, the promotion of Harris hip score and X-ray film image in treatment group were ,significantly better than that in control group, Conclusions Vascularized iliac bone grafting combined with huoxuebushen decoction is more effective than vaseularized iliac bone grafting in treatment for ARCO stage Ⅱ-Ⅲ avascular necrosis of the femoral head, The bushen huoxue decoction can alleviate the symptom of femoral bead necrosis patients and promote their founction.