加味第一竹沥汤联合打压支撑植骨术对早中期股骨头坏死寒湿痹阻证患者的临床疗效

Clinical effects of Supplemented No.1 Zhuli Decoction combined with core decompression and internal support bone grafting on patients with early and middle stage osteonecrosis of femoral head due to Cold-dampness Obstruction

目的考察加味第一竹沥汤联合打压支撑植骨术对早中期股骨头坏死寒湿痹阻证患者的临床疗效。方法86例患者随机分为对照组和观察组,每组43例,对照组给予打压支撑植骨术,观察组在对照组基础上加用加味第一竹沥汤。检测临床疗效、Harris评分、髋关节影像学评分、中医证候评分、骨代谢指标(BALP、BMP2、BGP)、血脂指标(ApoA、ApoB、TG)、并发症发生率变化。结果观察组总有效率高于对照组(P<0.05)。术后6、12、24周,观察组Harris评分、髋关节影像学评分高于对照组(P<0.05),中医证候评分更低(P<0.05);术后24周,观察组骨代谢指标高于对照组(P<0.05),血脂指标更低(P<0.05)。2组并发症发生率比较,差异无统计学意义(P>0.05)。结论加味第一竹沥汤联合打压支撑植骨术可改善早中期股骨头坏死寒湿痹阻证患者临床症状,促进骨基质钙化,提高骨痂质量,加速成骨细胞分化。

AIM To investigate the clinical effects of Supplemented No.1 Zhuli Decoction combined with core decompression and internal support bone grafting on patients with early and middle stage osteonecrosis of femoral head due to Cold-dampness Obstruction.METHODS Eighty-six patients were randomly assigned into control group(43 cases)for intervention of core decompression and internal support bone grafting,and observation group(43 cases)for intervention of both Supplemented No.1 Zhuli Decoction and core decompression and internal support bone grafting.The changes in clinical efficacy,Harris score,hip joint imaging score,TCM symptom score,bone metabolism indices(BALP,BMP2,BGP),blood lipid indices(ApoA,ApoB,TG)and incidence of complications were detected.RESULTS The observation group demonstrated higher total effective rate than the control group(P<0.05).At postoperative 6,12 and 24 weeks,the observation group displayed higher Harris score and hip joint imaging score than the control group(P<0.05),along with lower TCM symptom score(P<0.05).At postoperative 24 weeks,the observation group exhibited higher bone metabolism indices than the control group(P<0.05),along with lower blood lipid indices(P<0.05).No statistical significance in incidence of complications was found between the two groups(P>0.05).CONCLUSION For the patients with early and middle stage os-teonecrosis of femoral head,Supplemented No.1 Zhuli Decoction combined with core decompression and internal support bone grafting can improve clinical symptoms,promote the calcification of bone matrix,enhance the quality of bony callus,and accelerate the differentiation of osteoblasts.