补肾益肝活血方治疗早期缺血性股骨头坏死的疗效

Effects of the Bushen Yigan Huoxue decoction on early ischemic necrosis of femoral head

目的:评估补肾益肝活血方治疗早期缺血性股骨头坏死的疗效。方法:选取2019年7月-2020年7月聊城市中医医院治疗的早期缺血性股骨头坏死患者70例,依据入院时间顺序随机纳入对照组和观察组,每组35例。在两组均给予常规治疗的基础上,观察组增加补肾益肝活血方治疗。对比两组治疗后临床疗效、骨髓水肿、髋关节功能改善情况、中医证候积分水平、股骨头坏死相关实验室指标及用药不良反应发生情况。结果:观察组的治疗总有效率高于对照组。观察组的0级骨髓水肿占比高于对照组,Ⅱ级骨髓水肿占比低于对照组,P<0.05;两组的Ⅰ级骨髓水肿占比无明显差异,P=0.33。观察组的关节疼痛情况评分、关节畸形情况评分、关节活动范围评分、关节功能水平评分及总体评分均高于对照组P<0.05)。观察组的髋关节疼痛、跛行、腰膝酸软、神疲乏力、脉沉细涩及舌淡暗苔薄白均低于对照组,P<0.05。观察组的骨钙素及骨形态发生蛋白-2指标数值均高于对照组,其碱性磷酸酶指标数值低于对照组,P<0.05。两组用药不良反应总发生率相比无明显差异,P=0.23。结论:常规疗法联合补肾益肝活血方加减治疗早期缺血性股骨头坏死可明显提高整体临床疗效,且不易出现不良反应,具有一定的推广价值。

Objective:To investigate the clinical effects of the Bushen Yigan Huoxue decoction(补肾益肝活血方)on early ischemic necrosis of femoral head.Methods:A total of 70 patients with early ischemic femoral head necrosis treated in the hospital from July 2019 to July 2020 were selected.They were randomly divided into the control group and observation group,with 35 patients in each group.Both groups were given conventional treatment.And on this basis,the observation group was treated with the Bushen Yigan Huoxue decoction.The clinical efficacy,bone marrow edema,improvement of hip joint function and the occurrence of adverse drug reactions were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group.The proportion of grade 0 bone marrow edema in the observation group was higher than that in the control group,and the proportion of grade II bone marrow edema was lower than that in the control group.There was no significant difference in the proportion of grade I bone marrow edema between the two groups.The joint pain score,joint deformity score,joint range of motion score,joint function score and overall score in the observation group were all higher than those in the control group.The scores of hip joint pain,lameness,waist and knee aches,fatigue,heavy and thin pulse and light tongue,dark tongue and thin white fur in the observation group were lower than the control group.The values of osteocalcin and bone morphogenetic protein-2 in the observation group were higher than the control group,and the value of alkaline phosphatase index was lower than the control group.There was no significant difference in the total incidence of adverse drug reactions between the two groups.Conclusion:Conventional treatment plus the Bushen Yigan Huoxue decoction has a significant clinical effect on early ischemic femoral head necrosis,which can significantly improve the overall clinical effect,with less adverse reactions,and has a certain promotion and application value.