舒筋活血胶囊联合髓芯减压治疗早期股骨头坏死的临床疗效

Clinical efficacy of the Shujin Huoxue capsules combined with core decompression for the treatment of early-stage femoral head necrosis

目的观察舒筋活血胶囊联合髓芯减压治疗早期股骨头坏死(ONFH)的临床疗效。方法选取2019年3月至2020年3月河南省中医院关节病科收治的48例早期ONFH患者作为研究对象,按入院时间随机分为治疗组和对照组,每组24例。对照组行髓芯减压术,治疗组在对照组基础上口服舒筋活血胶囊。比较两组治疗前后视觉模拟评分法(VAS)评分、髋关节Harris评分,并根据末次Harris评分及影像学资料评估两组治疗效果。结果两组VAS、Harris评分组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:治疗后6、12个月,两组VAS评分低于治疗前,Harris评分高于治疗前,但对照组治疗后12个月VAS评分高于治疗后6个月,差异有统计学意义(P<0.05)。组间比较:治疗前,两组VAS、Harris评分比较差异无统计学意义;治疗后6、12个月,治疗组VAS评分低于对照组,Harris评分高于对照组,差异有统计学意义(P<0.05)。治疗后12个月末次随访时,治疗组优良率为79.17%,高于对照组的50.00%,差异有统计学意义(P<0.05)。治疗组治疗总有效率为87.50%,高于对照组的58.33%,差异有统计学意义(P<0.05)。所有患者术后切口均良好愈合,随访期间未出现不良反应。结论舒筋活血胶囊联合髓芯减压对早期ONFH近期临床疗效确切,优于单纯髓芯减压治疗,可减轻患者术后疼痛,改善患者术后髋关节功能活动等,且无药物相关不良反应。

Objective To observe the clinical efficacy of Shujin Huoxue capsules combined with core decompression for the treatment of early-stage femoral head necrosis.Methods Forty-eight patients with early stage femoral head necrosis admitted to the Department of Arthropathy of He'nan Province Hospital of Traditional Chinese Medicine from March 2019 to March 2020 were selected as the study subjects,and they were randomly divided into the treatment group and the control group according to admission time,with 24 cases in each group.The control group underwent core decompression,and the treatment group was given Shujin Huoxue capsule on the basis of the control group.The visual analogue scale(VAS)score and hip joint Harris score were compared between the two groups before and after treatment,and the therapeutic effect of the two groups was evaluat-ed according to the last Harris score and imaging data.Results There were significant differences in visual acuity between the two groups of group,time points and interaction(P<0.05).Comparison within group:6 months and 12 months after treatment,VAS score of the two groups was lower than before treatment,Harris score was higher than before treatment,but the VAS score in the control group at 12 months after treatment was higher than that at 6 months after treatment,the differences were statistically significant(P<0.05).Comparison between groups:there were no significant differences in VAS score and Harris score between the two groups before treatment;at 6 and 12 months after treatment,VAS score of the treatment group was lower than that of the control group,and Harris score was higher than that of the control group,the differences were statistically signifi-cant(P<0.05).At the follow-up at the end of 12 months after treatment,the excellent and good rate of the treatment group was 79.17%,which was higher than 50.00%in the control group,and the difference was statistically significant(P<0.05).The total effective rate of treatment group was 87.50%,which was higher than 58.33%in the control group,the difference was statistically significant(P<0.05).The incision healed well in all pa-tients,and no adverse reactions occurred in the treatment group after follow-up.Conclusion The Shujin Huoxue capsules combined with core de-compression has a recent clinical effect for early-stage femoral head necrosis and is better than the treatment of pure core decompression,it can re-duce postoperative pain and improve postoperative hip joint functional activities of patients,and no drug-related adverse reactions.