冲击波联合骨蚀胶囊治疗早期激素性股骨头坏死69例

69 Cases Observation on the Effect of Extracorporeal Shock Wave Combined with Gushi Capsule on Steroid-Induced Avaseular Neeresis of Femoral Head in the Early Stage

目的:探讨冲击波(Extracorporeal Shock Wave,ESW)联合骨蚀胶囊治疗早期激素性股骨头坏死(Steroid-Induced Avaseular Neeresis of Femoral Head,SANFH)的临床疗效,血清Toll样受体-4(Toll Like Receptor-4,TLR4)和核转录因子Kappa B(Nuclear Transcription Factor-κB,NF-κB)的表达。方法:选取2017年3月至2019年3月就诊的早期(ARCO分期Ⅰ、Ⅱ、Ⅲa期)激素性股骨头坏死患者69例,给予冲击波联合骨蚀胶囊治疗。比较患者治疗前后的临床疗效(包括疼痛、关节活动度、骨质改善情况等)的变化差异以及患者血清TLR4和NF-κB含量水平的变化。结果:3组患者在接受治疗后Harris评分中疼痛积分、功能积分和关节活动度均明显高于治疗前(P<0.05),给予冲击波联合骨蚀胶囊治疗干预后患者血清TLR4和NF-κB明显下降,差异均有统计学意义(P<0.05)。结论:冲击波联合骨蚀胶囊对早期的SANFH患者有较好的临床效果,其治疗中发挥的作用可能与其调节TLR4和NF-κB的表达有关。

Objective:To observe the clinical efficacy of extracorporeal shock wave(ESW)combined with Gushi capsule in the treatment of steroid-induced avaseular neeresis of femoral head(SANFH)in the early stage and the expression of toll like receptor-4(TLR4),nuclear transcription factor-κB(NF-κB).Methods:69 patients with SANFH(stageⅠ,ⅡandⅢ)were selected and treated with ESW combined with Gushi capsule from March 2017 to March 2019.The changes of clinical efficacy(including pain,joint activity,bone improvement,etc.)and the levels of TLR4 and NF-κB in serum were compared before and after treatment.Methods:The pain score,function score and joint activity score of patients in the early stage were significantly higher(P<0.05),TLR4 and NF-κB were significantly decreased(P<0.05).Conclusion:ESW combined with Gushi capsule has good clinical efficacy for the early stage of SANFH,and its role in treatment may be related to the regulation of TLR4 and NF-κB expression.