1005例成人股骨头坏死中医证型及发病特点的分析

nalysis of TCM Syndromes and Characteristics of 1005 Cases of Adult Necrosis of the Femoralhead

目的:探讨成人股骨头坏死患者中医证型及发病特征,为成人股骨头坏死的防治提供中医理论和方法。方法:选择2016年1月至12月在郑州中医骨伤病医院住院的股骨头缺血性坏死患者,去掉18岁以下的44例儿童股骨头肪坏死,共计1005例,其中男性811例,女性194例,对患者按照中医分型(肝肾亏虚、脾肾阳虚、痰瘀阻滞、寒湿痹阻、湿热蕴结、气滞血瘀)共6型,对患者双競分期、患者病程统计及临床中医分型统计。结果:肝肾亏虚型占35.32%,脾肾阳虚型占23.18%,痰瘀阻滞型占14.13%,寒湿痹阻型占11.44%,湿热蕴结型占11.14%,气滞血瘀型占4.78%;ARCO Ⅲ期患者最多,占39.28%,ARCOⅡ期占30.50%,ARCOIV期占28.13%,ARCOⅠ期2.08%;酒精型最多,占59.70%;病程在2年以上,均值为(29.73土34.62)月。结论:骨蚀患者病程较长,平均2年以上,就诊时以ARCOⅢ期最多,临床上以虚证居多,临床上分为肝肾亏虚、脾肾阳虚、痰瘀阻滞、寒湿痹阻、湿热蕴结、气滞血瘀6型,基本上包含了大多数证型;致病原因以痰、瘀、虚为主,与肝、脾、肾3脏密切相关,治疗上注重活血化瘀、补益肝、脾、肾。

Objective:To explore the TCM syndromes and pathogenesis of adult femoral head necrosis,and to provide the theory and methodfor the prevention and treatment of adult femora1 head necrosis.Method:From January 2016 to December 2016 in Zhengzhou Traditional Chinese Medicine Bone Trauma Hospital,a total of 1005 cases of osteonecrosis of the femoral head patients removal of 44 cases of epiphysealnecrosis of femoral head in children under 18 years of age were selected,among which 811 were males and 194 were females.According to theclassification of traditional Chinese medicine(liver and kidney deficiency,spleen and kidney yang deficiency,phlegm and blood stasis block,cold dampness obstruct ion,damp and hot accumulate knot,qi and blood stasis),a total of six type of dual hip in installment,the course of thedisease in patients with statistics and clinical Chinese medicine classification statistics were made.Results:Liver and kidney deficiencyaccounted for 35.32%,spleen and kidney yang deficiency accounted for 23.18%,sputum stasis block accounted for 14.13%,and the coldand wet resistance type accounted for 11.44%,the humid heat accumulate type accounted for 11.14%,and the qi stagnat ion blood stasisaccounted for 4.78%.The maximum number of patients in staging ARCOⅢ was 39.28%,while ARCOⅡ was 30.50%,A RCOⅣ was 28.40% and ARCOⅠ was 2.00%.Alcohol type was the most,accounting for 59.70%.The duration of the disease was over 2 years,and the mean was(29.73±34.62)months.Conclusion:Had longer duration of patients with bone erosion,an average of more than 2 years,when the doctorwith ARCOⅢ period most,clinical go up in the majority with deficiency syndrome,clinica1 can be divided into(liver and kidney deficiency,spleen and kidney Yang deficiency,phlegm and blood stasis block,cold dampness obstruct ion,damp and hot accumulate knot,qi and bloodstasis)six type,basically contains most of the card type.The cause of the cause is phlegm,stasis,deficiency,and liver and spleen kidneythree viscera is closely related,the treatment pays attention to the blood stasis,the liver,the spleen,the kidney.