中药联合髋关节注射自体BMSCs治疗中晚期ANFH的临床观察

Treatment of ANFH in middle-advanced stage with traditional Chinese medicine combined with hip joint injection of autologous BMSCs

目的观察中药联合髋关节注射自体骨髓间充质干细胞(BMSCs)治疗股骨头缺血性坏死(ANFH)的临床疗效。方法选择60例中晚期ANFH患者(FicatⅢ～Ⅳ期),其中研究组30例(44髋),给予髋关节注射自体BMSCs悬液10 ml,BMSCs数量约为2×(107～108)个;对照组30例(45髋)患者,给予髋关节注射玻璃酸钠注射剂25 mg/髋。治疗1次为1个疗程。同时两组患者均根据中医辨证分型服用宁亚功主任自拟方药。治疗6个月后观察患者双髋关节X片及髋关节评分变化。结果治疗后,研究组有效率为86.36%高于对照组的75.55%(P<0.05);髋关节评分研究组的(56.614±15.072)分高于对照组的(46.000±10.039)分(P<0.01)。结论中药联合髋关节注射自体BMSCs治疗中晚期ANFH,能够促进坏死区骨修复,缓解症状,改善髋关节功能。

Objective To observe clinical curative effects of traditional Chinese medicine combined with hip joint injection of autologous bone marrow mesenchymal stem cells（BMSCs）on avascular necrosis of femoral head（ANFH）.Methods Sixty patients with ANFH in middle-advanced stage（FicatⅢ-Ⅳ stage）were divided into two groups.There were 30 cases（44 hips）in the research group which received hip joint injection of 10 ml suspension of autologous BMSCs.The number of BMSCs was 2×107 to 2×108.The other 30 patients（45 hips）were divided into the control group which received the hip joint injection of sodium hyaluronate 25 mg/hip.One injection was a course of treatment in both groups.At the same time,both groups also took the self-prescribed traditional Chinese medicine according to the differentiation of symptoms and signs for classification of syndrome.Changes in patients’ X-ray films of bilateral hips and hip joint scores were observed 6 months after the treatment.Results After the treatment,the effective rate of the research group（86.36%）was higher than that of the control group（75.55%）（P〈0.05）.And the hip joint scores of the research group（56.614±15.072）was higher than that of the control group（46.000±10.039）（P〈0.01）.Conclusion Traditional Chinese medicine combined with hip joint injection of autologous BMSCs can promote bone repair in the necrotic area and relieve symptoms in the patients with ANFH in middle-advanced stage.It can also improve the hip joint function.