骨宁丸联合头颈部开窗打压植骨治疗股骨头坏死临床疗效观察

Clinical efficacy of Guningwan cooperated with bone grafting through a window at the femoral head neck junction surgery in the treatment of osteonecrosis of the femoral head

目的观察骨宁丸联合股骨头颈部开窗病灶清除打压植骨术治疗早中期股骨头坏死(ONFH)的临床疗效。方法选取早中期ONFH患者42例(63髋)为观察对象,并采用随机数字表法将其分为研究组(21例34髋)和对照组(21例29髋)。对照组采用股骨头颈部开窗病灶清除打压植骨术治疗,研究组在此基础上术后第1天即给予骨宁丸口服,持续治疗6个月。对两组治疗前后的Harris评分及VAS评分进行统计分析,结合影像学检查,评价髋关节功能改变情况及临床治疗有效率。结果两组患者治疗前髋关节Harris评分及VAS评分比较,差异无统计学意义(P>0.05)。两组治疗后与治疗前比较,髋关节Harris评分及VAS评分均显著提高,研究组治疗后上述评分较对照组明显升高,差异均有统计学意义(P<0.05)。结论骨宁丸联合股骨头颈部开窗病灶清除打压植骨术能有效防治早中期ONFH,缓解疼痛,改善髋关节功能,提高关节活动度,临床疗效满意,值得推广应用。

Objective To observe the clinical effect of Guningwan cooperated with bone grafting through a window at the femoral head neck junction surgery in the treatment of early and middle osteonecrosis of the femoral head.Methods Forty two cases of patients(63 hips) with early and middle osteonecrosis of the femoral head treated in the hospital were selected as research objects,and they were randomly divided into study group(23 cases,34 hips) and control group(23 cases,29 hips) by random number table method.The control group was given bone grafting through a window at the femoral head neck junction surgery simply,based on that,the study group was given Guningwan on the first day after surgery,treating for 6 months continuously.The Harris score and VAS score of the two groups before and after treatment were statistically analyzed,combined with imaging examination;the changes of hip joint function and effective rate of clinical treatment were evaluated.Results There were no statistically significant differences of Harris score and VAS score between the two groups before treatment(P>0.05).Compared with before treatment,Harris score and VAS score in the two groups after treatment were obviously increased,and these scores in the study group after treatment were all significantly higher than those in the control group,the differences were all statistically significant(P<0.05).Conclusion Guningwan cooperated with bone grafting through a window at the femoral head neck junction surgery can prevent and treat the early and middle osteonecrosis of the femoral head effectively,relieve pain,improve the hip joint function,increase the joint range of motion,receive good clinical efficacy,and it is worthy for popularization and application.