中药配合微创手术治疗股骨头坏死的临床研究

The clinical study on avascular necrosis of femoral head treated with traditional Chinese medicine combination with minimally invasive surgery

目的：观察运用中药内服外敷配合局部微创手术治疗股骨头缺血性坏死的临床疗效。方法采用随机对照设计方法，经髋关节 X 线拍片及 MRI 检查筛选具有股骨头坏死患者，根据 Ficat 分期选取1~2期患者，随机分为治疗组与对照组，以患者进入研究的时间先后顺序为编号进行分组，每组纳入26例，两组共52例。设置对照组仅进行股骨头髓芯钻孔减压（Ficat1期）或股骨头颈部小切口开窗减压植骨术（Ficat2期），中药内服外敷配合局部微创手术治疗为治疗组。观察两者疗效，并对其疗效进行量化统计分析并比较。结果26例治疗组经过综合治疗并三个月随访后，优11例，良10例，可3例，差2例。有效率92.31%；对照组经过单纯手术治疗并随访三个月后，优4例，良7例，可8例，差7例。有效率73.08%。结论中药内服外敷配合局部微创手术治疗股骨头缺血性坏死具有良好的临床疗效。

Objective：To investigate the clinical effects of the traditional Chinese medicine（ad usum internum and topical apply）combination with local minimally invasive surgery on avascular necrosis of femoral head. Methods：52 pa-tients who had been diagnosed with avascular necrosis of femoral head through X - ray and MRI were selected for the pres-ent study. These patients which belong to Ⅰ - Ⅱstage on the basis of Ficat Staging,were randomly separated to treatment group and control group,and each group included 26 patients. In control group,the 26 patients were treated with pith drill-ing decompression（FicatⅠ）or decompression bone graft through slotting in femoral neck（Ficat Ⅱ）. However,in treat-ment group,the 26 patients were treated with traditional Chinese medicine（ad usum internum and topical apply）combina-tion with local minimally invasive surgery. The clinical effects of the two therapeutic methods were statistical analyzed and contrasted. Results：In the treatment group,after the fellow - up times of three months,11 patients were excellent,10 pa-tients were good,3 patients were general,2 patients were poor,and the effective rate was 92. 31% . In contrast,in the control group,after the fellow - up times of three months,4 patients were excellent,7 patients were good,8 patients were general,7 patients were poor,and the effective rate was 73. 08 % . Conclusion：The therapeutic method of traditional Chi-nese medicine combination with minimally invasive surgery could be extensively applied to treat avascular necrosis of femo-ral head.