固本消蚀方治疗痰瘀阻络型股骨头坏死临床观察

Clinical Observation of Guben Xiaoshi Prescription for Osteonecrosis of the Femoral Head of Phlegm-Stasis Blocking Collateral Type

目的:研究固本消蚀方治疗痰瘀阻络型股骨头坏死的临床疗效。方法:选取本院骨科就诊的股骨头坏死患者,共100例。随机分为2组各50例。对照组采用双氯芬酸钠联合仙灵骨葆胶囊治疗;观察组采用固本消蚀方治疗。观察治疗前后Harris评分、疼痛视觉模拟评分量表(VAS)评分、骨密度、碱性磷酸酶(ALP)、骨钙素(BGP)和骨形态发生蛋白(BMP-2)及影像学指标等,并进行综合临床疗效评定。结果:治疗后,2组Harris评分明显升高,疼痛VAS评分明显下降,股骨颈骨密度值升高,BGP及BMP-2水平明显升高,ALP明显下降,且观察组患者改善程度优于对照组,差异均有统计学意义(P<0.05)。2组临床疗效比较,总有效率观察组96.0%,对照组76.0%,差异有统计学意义(P<0.05)。结论:应用固本消蚀方治疗痰瘀阻络型股骨头坏死,能改善痰瘀阻滞型股骨头坏死患者髋关节功能,减轻疼痛,改善股骨头坏死的生化指标及临床疗效。

Objective：To observe the clinical curative effect of Guben Xiaoshi prescription in treating Osteonecrosis of the femoral head of phlegm-stasis blocking collateral type. Methods：Selected 100 cases of patients with osteonecrosis of the femoral head of phlegm-stasis blocking collateral type who were admitted into the department of orthopaedics in our hospital,and divided them into two groups randomly,50 cases in each group. The control group received the treatment of iclofenac sodium combined with Xianling Gubao capsules, while the observation group received the treatment of Guben Xiaoshi prescription. Observed Harris scores, visual analog scale（VAS） scores, bone mineral density, alkaline phosphatase（ALP）,bone gla protein（BGP）,and bone morphogenetic protein（BMP-2） as well as imageology indexes before and after treatment,and evaluated the overall clinical curative effect. Results： After treatment, Harris scores in both groups were obviously increased, while VAS scores in both groups were evidently decreased. The density of femur and cervical vertebra were increased. The levels of BGP and BMP-2 were clearly increased, while the ALP levels were distinctly declined. The improvements of patients in the observation group were better than those in the control group. All differences were significant（P〈0.05）. The total effective rate was 96.0% in the observation group and was 76.0% in the control group,the difference being significant（P〈0.05）. Conclusion：The application of Guben Xiaoshi prescription for osteonecrosis of the femoral head of phlegm-stasis blocking collateral type can improve hip joint function of patients, release pain, and improve biochemical indexes of osteonecrosis of the femoral head and the clinical effect.