灯盏花素注射液结合髓心减压与坦棒植入治疗早期股骨头坏死的对比研究

Comparative Study on Breviscapine Injection Combined Core Decompression with Tantalum Implant for Treating Early Osteonecrosis of the Femeral Head

目的：探讨灯盏花素注射液结合髓心减压与坦棒植入对早期股骨头坏死临床疗效及灯盏花素注射液治疗早期股骨头坏死的机制。方法：45例（53髋）早期股骨头坏死患者随机分为观察组（23例、29髋）和对照组（22例、24髋）,并给予髓心减压术。观察组术后当天给予灯盏花素注射液静脉滴注,20 mg/d,连续2周;对照组在髓心减压后植入坦棒,术后不予灯盏花素注射液,其余治疗两组完全相同。分别在治疗前、术后第1、6、15天,观察血液流变学指标变化;在治疗前、治疗后3~6个月,采用Harris评分系统评估髋关节功能,摄X线片评估骨坏死情况。结果：所有患者治疗后Harris评分较治疗前显著提高（P〈0.05）,两组对比无显著差异。观察组患者全血比黏度、血浆黏度、红细胞压积、红细胞聚集指数、红细胞变形指数均降低,与治疗前比较有显著性差异（P〈0.05）;对照组各项指标与治疗前比较无显著差异（P〉0.05）。结论 ：灯盏花素注射液结合髓心减压可以显著减轻髋关节疼痛、改善功能,促进骨修复,延缓骨坏死发展。

Objective： To study the clinical result of Breviscapine injection combined core decompression comparative with tantalum implant for treating early osteonecrosis of the femeral head, and analysis the mechanism. Methods： 44 Patients with early osteonecrosis of the femeral head were divided into observation group （23 cases,29 hips） and control group （22 cases,24 hips） randomly. All cases were received core decompression. The observation group was received Breviscapine injection （20 mg/d） at theoperative day and the following two weeks, the control group was received tantalum implant without Breviscapine injection. The basle treatment were completely identical in two groups. The hemorh eology indexes and blood lipid level of patients were examined at 0, lst,6th, 15th day post-treatment and the Harris score were examined on pre-treatment,3rd month post-treatment respectively. Results： The Harris score of post-treatment was significantly increased comparing with pre-treatment （P〈0.05）, but it was no significant difference between two groups （P〉0.05）. The whole blood contrast viscosity, plasma viscosity, hematocrit, erythrocyte sedimentation rat of the observation group were respectively decreased and there were significantly decreased between post-treatment and pre-treatment （P〈 0.05）. Those of the control group was no significant difference between post- and pre-treatment （P〉O.05）. Conclusion： Breviscapine injection combined core decompression can significantly relieve pain, improvement function of joint, to promote bone repairing, and delay the progress of oste0necrosis.