抗生素骨水泥链珠植入术结合中医辨证治疗慢性骨髓炎

Antibiotic Bone Cement Chain Bead Implantation Combined with Traditional Chinese Medicine Treatment for Chronic Osteomyelitis

目的：探讨自拟方＂骨疽消炎汤＂内服,结合清创抗生素骨水泥链珠植入术治疗慢性骨髓炎的临床疗效。方法：选取2011年1月-2013年12月我院收治的慢性骨髓炎的患者42例：其中男性23例,女性19例;年龄20~65岁,平均42岁;42例中肱骨5例,股骨16例,胫骨14例,跟骨7例;感染病程1~5年,平均2年。随机将其分成中西医结合治疗组和对照组各21例：术前3d应用敏感抗生素全身治疗,术后连用1周,而后改为口服抗生素继续治疗4周。2组均给予手术清创抗生素链珠植入术治疗,中西医结合组同时根据临床症状辨证给予中药口服治疗,对照组未给予中药内服治疗。所有病例均获随访,随访时间1~3年,计算两组的有效率、复发率及术后6周各项化验指标,分析对比两组的治疗效果。结果：治疗组21例：痊愈13例（61.9%）,显效4例（19%）,好转2例（9.5%）,无效2例（9.5%）,总有效率（90.5%）;对照组21例：痊愈9例（42.8%）,显效3例（14.2%）,好转3例（14.2%）,无效6例（28.5%）,总有效率（71.5%）。中西医结合治疗组在有效率、复发率及术后6周辅助检查结果与对照组比较差异均有统计学意义（P〈0.05）。结论：中西医结合治疗慢性骨髓炎较单纯西医治疗,可显著提高其疗效,具有治愈率高、复发率低等优点。

Objective：To evaluate the clinical efficacy of integrative medicine treatment for chronic osteomyelitis using herbal medicine prescription ＂ necrosis inflammatory soup＂ oral combined with antibiotic bone cement chain bead implantation.Methods：Selected 42 cases of patients with chronic osteomyelitis from January 2011 to December 2013 in our hospital,23 males and 19 females,aged 20~65 years,averaged 42 years.5 cases humerus,femur 16 cases,14 cases of tibia,calcaneus 7 cases,with infection duration of 1~5 years,averaged 2 years.All patients were randomly divided into combination therapy group and control group,21 cases in each group.Sensitive antibiotic was applied three days before surgery and one week postoperatively,then continue to take oral antibiotic for 4 weeks.The combination therapy group received surgical debridement treatment,antibiotic chain bead implantation and Chinese medicine treatment orally based on clinical symptoms dialectic.The surgical methods in the control group was the same as the treatment group,while internal medicine treatment is not given.All patients were followed up for 1~3 years.Calculating the efficiency,relapse rate and the laboratory indicators after six weeks of the two groups.Taking statistical analysis and compare the effects between the two groups.Results：In treatment group,recovered in 13 cases（61.9%）,effective in 4 cases（19%）,improved in 2 cases（9.5%）,invalid in 2 cases（9.5%）and the overall response rate was 90.5%.As for the control group,recovered in 9 cases（42.8%）,effective in 3 cases（14.2%）,improved in 3 cases（14.2%）,invalid in 6 cases（28.5%）,with the overall response rate 71.5%.Compared with the control group,the efficiency,relapse rate and the laboratory examinations results six weeks postoperative in the combination therapy group were significantly different（P〈0.05）.Which showed that the combination therapy group got a better efficacy than the control group in treatment of chronic osteomyelitis.Conclusion：Integrative treatment of chronic osteomyelitis can significantly improve the efficacy for its high cure rate,low recurrence rate and so on.