中药配合手术治疗塌陷前期非创伤性股骨头坏死的临床研究

Efficacy of Chinese Medicine Combined with Surgery in the Treatment of the Pre-collapse Non-traumatic Necrosis of the Femur Head

目的:观察髓芯减压打压支撑植骨术配合生骨饮Ⅱ号方治疗塌陷前期非创伤性股骨头坏死的临床疗效,进一步探讨该方法治疗塌陷前期非创伤性股骨头坏死的机理。方法:统计分析自2008年5月-2012年11月,共收治的单侧非创伤性股骨头坏死患者82例,其中治疗组42例采用髓芯减压打压支撑植骨术配合术后生骨饮Ⅱ号方口服治疗;对照组40例采用髓芯减压打压支撑植骨术治疗。观察记录治疗前和治疗后6个月、12个月股骨头塌陷程度、髋关节功能Harris评分及血清OPG三方面变化。结果:两组患者均获得满意临床效果,但治疗组优于对照组,差异有统计学意义。结论:髓芯减压打压支撑植骨术配合生骨饮Ⅱ号方综合治疗,可升高塌陷前期非创伤性股骨头坏死患者血清OPG水平,改善髋关节功能,有利于骨坏死修复,能够预防股骨头坏死塌陷。

Objective.. To observe the efficacy of core decompression and bone graft combined with Shenggu drinking Ⅱ in the treatment of pre-collapse non-traumatic necrosis of the femur head, and to investigate the mechanism. Methods：All 82 patients from May 2008 to November 2012 with unilateral non-traumatic necrosis of the femur head were randomly divided into two groups. In the treatment group （n：42）, the patients were treated with core decompression and bone graft combination with Shenggu drinking II, while 40 patients in control group only treated with core decompression and bone graft. Collapse of femoral head, Harris scoring for hips and the level of serum osteoprotegerin were collected before treatment and 6 and 12 months after treatment. Results：Patients in both groups achieved satisfied therapeutic effect. The treatment group was superior to the control group. Conclusion.. Core decompression and bone graft combination with Shenggu drinking Ⅱ can increase the level of serum osteoprotegerin, improve hip-joint function, promote osteonecrotic bone repairing and prevent effectively the femoral head from collapsing.