双合汤联合微创保髋术对围塌陷期非创伤性股骨头坏死患者的临床疗效

Clinical effects of Shuanghe Decoction combined with minimally invasive hip-preserving surgery on patients with non-traumatic osteonecrosis of the femoral head in peri-collapse stage

目的 考察双合汤联合微创保髋术对围塌陷期非创伤性股骨头坏死患者的临床疗效。方法 96例患者随机分为对照组与观察组,每组48例,对照组给予微创保髋术,观察组在对照组基础上加用双合汤。检测临床疗效、临床症状评分(中医证候、Harris、SF-36)、血液流变学指标(全血高切黏度、全血低切黏度、全血还原黏度、血浆黏度、红细胞聚集指数)、骨代谢指标(BGP、TRAP、CTX-Ⅱ、BMP-2)、生化标志物(DKK-1、脂联素)、骨坏死面积变化。结果 观察组总优良率高于对照组(P<0.05)。术后6、12个月,2组临床症状评分改善(P<0.05),血液流变学指标、TRAP、CTX-Ⅱ、DKK-1降低(P<0.05),BGP、BMP-2、脂联素升高(P<0.05),股骨头坏死面积减少(P<0.05),以观察组更明显(P<0.05)。结论 双合汤联合微创保髋术可有效缓解围塌陷期非创伤性股骨头坏死患者临床症状,降低血液黏度,改善骨代谢与生化标志物水平,促进坏死骨修复。

AIM To investigate the clinical effects of Shuanghe Decoction combined with minimally invasive hip-preserving surgery on patients with non-traumatic osteonecrosis of the femoral head in peri-collapse stage.METHODS Ninety-six patients were randomly assigned into control group(48 cases)for intervention of minimally invasive hip-preserving surgery,and observation group(48 cases)for intervention of both Shuanghe Decoction and minimally invasive hip-preserving surgery.The changes in clinical efficacy,clinical symptom scores(TCM symptoms,Harris,SF-36),hemorheological indices(high blood viscosity,low blood viscosity,reduced blood viscosity,plasma viscosity,red cell aggregation),bone metabolic indices(BGP,TRAP,CTX-Ⅱ,BMP-2),biochemical markers(DKK-1,adiponectin),and osteonecrosis area were detected.RESULTS The observation group demonstrated higher excellent and good rate than the control group(P<0.05).At 6 and 12 months after the operation,the two groups displayed improved clinical symptom scores(P<0.05),decreased hemorheological indices,TRAP,CTX-Ⅱand DKK-1(P<0.05),increased BGP,BMP-2 and adiponectin(P<0.05),and reduced osteonecrosis area(P<0.05),especially for the observation group(P<0.05).CONCLUSION For the patients with non-traumatic osteonecrosis of the femoral head in peri-collapse stage,Shuanghe Decoction combined with minimally invasive hip-preserving surgery can effectively alleviate clinical symptoms,reduce blood viscosity,improve bone metabolism and biochemical marker levels,and promote the repair of necrotic bones.