补肾活血汤加减联合雷火灸治疗股骨头缺血性坏死30例临床观察

Observation of Bushenhuoxue decoction combined with Lei Huo Moxibustion on avascular necrosis of the femoral head

目的观察补肾活血汤加减联合雷火灸治疗股骨头缺血性坏死的临床疗效。方法将60例股骨头缺血性坏死患者随机分为2组。对照组30例采用髓芯减压术治疗,治疗组30例在对照组治疗基础上加用补肾活血汤联合雷火灸法治疗。2组均2周为1个疗程,疗程间休息2 d,6个疗程后统计临床疗效,并观察2组治疗前后主要临床症状积分、血液流变学指标及血脂情况。结果治疗组总有效率93.4%,对照组总有效率80.0%,2组比较差异有统计学意义(P<0.05),治疗组临床疗效优于对照组。2组治疗后疼痛、跛行及功能障碍症状积分均下降(P<0.05);治疗组治疗后疼痛、跛行及功能障碍症状积分及治疗前后差值均低于对照组(P<0.05)。2组治疗后全血黏度(高切、低切)、血浆黏度及红细胞比容均下降(P<0.05);治疗组治疗后全血黏度(高切、低切)、血浆黏度及红细胞比容下降优于对照组(P<0.05)。2组治疗后低密度脂蛋白、胆固醇及甘油三酯均下降(P<0.05);治疗组治疗后低密度脂蛋白、胆固醇及甘油三酯下降优于对照组(P<0.05)。结论在髓芯减压术治疗的基础上采用补肾活血汤配合雷火灸治疗股骨头缺血性坏死疗效确切。

Objective To investigate the clinical effect of Bushenhuoxue decoction combined with Lei Huo Moxibustion on avascular necrosis of the femoral head. Methods 60 patients with avascular necrosis of the femoral head were randomly divided into two groups. Patients in control group （ n = 30） were treated by core compression. 30 patients in treatment group received Bushenhuoxue decoction combined with Lei Huo Moxibustion on the basis of conventional therapy. The course was two weeks in two groups. The main clinical symptom score, hemorheology and blood lipids were observed in two groups before and after treatment. Results The total effective rate in treatment group （93.4%） was higher than that in control group （80.0%, P 〈 0.05）. Pain, lameness and dysfunction symp- tom score after treatment decreased in two groups （ P 〈 0.05 ）. Pain, lameness and dysfunction symptom score in treatment group was lower than that in control group after treatment （ P 〈 0.05 ）. Whole blood viscosity （ high and low shear）, plasma viscosity and hematocrit after treatment decreased in two groups （P 〈0.05）. The decrease of whole blood viscosity （high and low shear）, plasma viscosity and hematoerit in treatment group was superior to that in con- trol group （ P 〈 0.05 ）. LDL - C, Cholesterol and TG after treatment decreased in two groups （P 〈 0.05 ）. The de- crease of LDL - C, Cholesterol and TG in treatment group was superior to that in control group （ P 〈 0.05 ）. Conclu- sion Bushenhuoxue decoction combined with Lei Huo Moxibustion has a definite effect on avascular necrosis of the femoral head on the basis of core decompression therapy.