补肾活血汤加减联合髓芯减压术治疗ARCOⅠ期和Ⅱ期股骨头坏死的临床观察

Clinical Observation on Treatment of ARCO StageⅠandⅡFemoral Head Necrosis with Modified Bushen Huoxue Decoction and Core Decompression

目的:研究补肾活血汤加减联合髓芯减压术治疗ARCOⅠ期和Ⅱ期股骨头坏死的临床效果。方法:对在2018年11月-2019年11月本院收治的66例股骨头坏死国际分期(ARCO分期)Ⅰ期和Ⅱ期的股骨头坏死患者实施研究。随机分为两组,对照组33例行单纯髓芯减压术,治疗组33例行髓芯减压术+补肾活血汤加减治疗,并分别于手术前、手术后6个月、手术后1年对比两组患者髋关节Harris评分,手术前、手术后1年对两组MRI股骨头带状信号、骨髓水肿评价。结果:两组术前的Harris评分、MRI评价比较,差异无统计学意义(P>0.05),但在术后6个月、1年髋关节评分及术后1年MRI评价上,治疗组均优于对照组,差异有统计学意义(P<0.05)。结论:补肾活血汤加减联合髓芯加压术治疗早期股骨头坏死可促使髋关节功能不断改善,值得临床推广。

Objective:To study the clinical effect of modified Bushen Huoxue Decoction combined with core decompression in the treatment of ARCO stageⅠandⅡfemoral head necrosis.Method:A total of 66 patients with ARCO stageⅠandⅡfemoral head necrosis admitted to author’s hospital were studied from November 2018 to November 2019.They were randomly divided into two groups.33 patients in the control group only underwent core decompression,and 33 cases in the treatment group treated with core decompression+modified Bushen Huoxue Decoction.The Harris scores of the hip joint of the two groups were compared before the operation,6 months after the operation,and 1 year after the operation.The femoral head line sign and bone marrow edema on MRI in both groups were evaluated before operation and 1 year after operation.Result:The Harris scores and MRI scores of the two groups before surgery were not statistically significant(P>0.05),however,the treatment group were better than the control group in the hip score 6 months after surgery,1 year after surgery,and MRI evaluation 1 year after surgery,and the differences were statistically significant(P<0.05).Conclusion:The treatment of early femoral head necrosis with modified Bushen Huoxue Decoction combined with core decompression can continuously improve hip joint function and is worthy of clinical promotion.