仙灵骨葆对股骨头缺血坏死患者血液流变学及局部氧分压的影响

Effect of“Xianlinggubao Capsule”on the Hemorrheologic Alteration and Partly Partial Pressure of Oxygen of Avascular Necrosis of Femoral Head

目的:缺血性股骨头坏死((avascular necrosis of thefemoral head,ANFH)为骨科疑难病症,患ANFH后如不及时治疗,将呈进行性发展,许多患者将在2-3年内股骨头塌陷,最终发生骨性关节病,其发病率有增高的趋势。ANFH的发病机制目前尚不十分清楚,可能与外伤、糖皮质激素的滥用及酗酒等多种因素相关,目前临床药物治疗效果不一。目的:研究仙灵骨葆对股骨头缺血坏死患者血液流变学及局部氧分压的影响,探讨其治疗非创伤性性股骨头坏死的作用机理,为临床用药提供理论依据。材料与方法:收集我院2005年2月~2006年2月门诊予以口服仙灵骨葆治疗且获得随访的非创伤性股骨头缺血坏死患者72例。按ficat法分期,其中Ⅰ期患者29例,Ⅱ期患者38例,Ⅲ期5例,Ⅳ期患者1例。将以上患者分为三组,Ⅰ期患者为A组,Ⅱ期患者为B组,Ⅲ期及以上患者为C组,每组分别给予并给予口服仙灵骨葆胶囊3粒,tid、疗程3个月。治疗期间停用其他治疗方法。患者使用仙灵骨葆治疗前及疗程结束时,分别采取清晨空腹静脉抽血,送交实验室检测各项血液流变学指标。应用中医氧分压传感针测定治疗前后局部组织氧分压的变化。结果:口服仙灵骨葆药物治疗后,患者各项血液流变学指标均发生了变化。各项指标与治疗前相比均有显著性差异,与治疗前相比,Ⅰ期、Ⅱ期病人全血粘度及血浆粘度、胞聚集指数和刚性指数、血沉方程K值及纤维蛋白原均有所下降(P【0.05),变形指数增高(P【0.05),血球压积无显著性差异(P】0.05)。Ⅲ期及以上患者上述指标虽也有变化但均无显著性差异。(P】0.05)72例股骨头缺血坏死患者治疗前局部氧分压A组与B组无明显差异,C组局部氧分压明显低于A、B两组。而治疗后A、B组的局部氧分压较治疗前明显增高,差异有极其显著性,而C组的局部氧分压变化不明显,差异无显著性。结论:仙灵骨葆能通过改善局部微循环,增加局部氧供给,改善局部组织代谢,减少酸性代谢产物,从而起到治疗作用。

Objective:To investigate the effect of“Xianlinggubao Capsule”on the hemorrheologic alteration and partly partial pressure of oxygen of avascular necrosis of femoral head(ANFH) and approach the mechanism of treating ANFH by “Xianlinggubao Capsule”. Method:72 cases of ANFH were treated by“Xianlinggubao Capsule”from 2005, 2 to 2006, 2. According to Ficat classification, there were 29 caes of stage Ⅰof ANFH, 38 of stage Ⅱ, 5 of stage Ⅲ and 1 of stage Ⅳ. All cases were divided into 3 groups, caes of stage Ⅰof ANFH were group A, cases of stage Ⅱ were group B and others were group C. All cases were treated by “Xianlinggubao Capsule”, 3 Caps, tid, p.o. , 3 months per course. At the prior and post treatment, empty stomach blood of all cases were drawn at the early morning and the hemorrheologic alteration was detected individedly. Partly partial pressure of oxygen of ANFH was determined. Result:Post treatment, the index of the hemorrheologic alteration was altered. Blood viscosity, plasma viscosity, cell aggregation, rigidity, ESR equation K-value and Fibrinogen of stage of Ⅰ, Ⅱ were decreased (P<0.05) vs. prior treatment. Deformed finger of stage of Ⅰ, Ⅱ was increased (P<0.05). Hematocrit of stage of Ⅰ, Ⅱ was not significant difference(P>0.05). Those index of stage of Ⅲwas not significant difference(P>0.05). Partly partial pressure of oxygen of avascular necrosis of thefemoral head of Group A, B was significantly increased, and the increase was significant difference. But that of Group C was not significant alteration. Conclusion:“Xianlinggubao Capsule”treat ANFH by improving partial microcirculation, increasing local oxygen, improving local tissue metabolism and reducing acor metabolite.