[1]张胜杰,吴秀丽,张宇,等.化湿生骨方联合体外冲击波治疗痰湿型早中期激素性股骨头坏死临床研究[J].中国中医骨伤科杂志,2024,32(12):31-37.[doi:10.20085/j.cnki.issn1005-0205.241206 ]
　ZHANG Shengjie,WU Xiuli,ZHANG Yu,et al.Clinical Study of Dampness-Reducing and Bone-Setting Decoction Combined with ESWT on the Treatment of Steroid-Osteonecrosis of Femoral Head in Early and Middle Stage with Phlegm-Dampness Syndrome[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2024,32(12):31-37.[doi:10.20085/j.cnki.issn1005-0205.241206 ]
点击复制

化湿生骨方联合体外冲击波治疗痰湿型早中期激素性股骨头坏死临床研究()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第32卷
期数:
2024年12期
页码:
31-37
栏目:
临床研究
出版日期:
2024-12-15

文章信息/Info

Title:
Clinical Study of Dampness-Reducing and Bone-Setting Decoction Combined with ESWT on the Treatment of Steroid-Osteonecrosis of Femoral Head in Early and Middle Stage with Phlegm-Dampness Syndrome
文章编号:
1005-0205(2024)12-0031-07
作者:
张胜杰1; 吴秀丽1; 张宇1; 阎晓霞1; 2△; 任之强2; 孙楠2
1河南中医药大学(郑州,450046)
2河南省洛阳正骨医院(河南省骨科医院)
Author(s):
ZHANG Shengjie1; WU Xiuli1; ZHANG Yu1; YAN Xiaoxia1; 2△; REN Zhiqiang2; SUN Nan2
1Henan University of Chinese Medicine,Zhengzhou 450046,China; 2Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Zhengzhou 450016,China.
关键词:
化湿生骨方;  激素性股骨头坏死;  髋关节积液;  骨髓水肿;  体外冲击波
Keywords:
dampness-reducing and bone-setting decoction;  steroid-osteonecrosis of femoral head;  hip joint effusion;  bone marrow oedema;  extracorporeal shock wave
分类号:
R681.8
DOI:
10.20085/j.cnki.issn1005-0205.241206
文献标志码:
A
摘要:
目的:观察化湿生骨方联合体外冲击波治疗痰湿型早中期激素性股骨头坏死的临床疗效。方法:纳入痰湿型激素性股骨头坏死患者60例,随机均分为对照组和观察组,对照组30例采用体外冲击波治疗,观察组30例给予化湿生骨方联合体外冲击波治疗,治疗3个月后,随访观察其骨髓水肿等级、髋关节积液等级、视觉模拟量表(VAS)评分和临床疗效。结果:治疗前观察组和对照组组间各指标差异无统计学意义(P>0.05); 治疗3个月后观察组髋关节积液等级较治疗前降低(P<0.05),对照组髋关节积液等级较治疗前无明显变化(P>0.05); 治疗3个月后两组患者VAS评分、骨髓水肿等级均显著下降(P<0.05),且观察组VAS评分、骨髓水肿等级、髋关节积液等级均低于对照组,差异均有统计学意义(P<0.05); 总有效率观察组为93.33%,显著高于对照组的83.33%,差异有统计学意义(P<0.05)。结论:化湿生骨方联合体外冲击波治疗痰湿型早中期激素性股骨头坏死临床疗效确切,能明显缓解患者疼痛,减轻髋关节积液,改善骨髓水肿,优于单纯体外冲击波治疗。
Abstract:
Objective:To observe the clinical efficacy of dampness-reducing and bone-setting decoction combined with extracorporeal shock wave therapy(ESWT)on the treatment of steroid-induced osteonecrosis of the femoral head(SONFH)in early and middle stage with phlegm-dampness syndrome.Methods:60 cases of patients with SONFH with phlegm dampness syndrome were included and randomly divided into control group and observation group.30 cases in the control group were treated with ESWT,and 30 cases in the observation group were given dampness-reducing and bone-setting decoction combined with ESWT,and their bone marrow oedema grades,hip joint effusion grades,visual analogue scale(VAS)scores and clinical efficacy were observed in the follow-up after 3 months of treatment.Results:There was no statistically significant difference between the observation group and the control group before treatment(P>0.05); after 3 months of treatment,the grade of hip joint effusion in the observation group was lower than that before treatment(P<0.05),and there was no significant change in the grade of hip joint effusion in the control group compared of that before treatment(P>0.05); VAS scores and bone marrow oedema grades of the two groups were significantly lower than those after treatment(P<0.05),and VAS scores,bone marrow oedema grades and hip joint effusion grades in the observation group were lower than those of the control group,with statistically significant differences(P<0.05).The total effective rate was 93.33% in the observation group,which was significantly higher than that of the control group,which was 83.33%.Conclusion:Dampness-reducing and bone-setting decoction combined with ESWT is clinically effective in SONFH in early and middle stage with phlegm-dampness syndrome,which can significantly relieve patients' pain,reduce hip joint effusion,improve bone marrow oedema,and is better than single ESWT.

参考文献/References:

[1] 张杰,曹建泽,刘永飞,等.激素性股骨头坏死发病机制的研究进展[J].中国矫形外科杂志,2024,32(7):620-624.
[2] 孙昭杰,张宁,李明阳,等.激素性股骨头坏死的中西医治疗进展[J].中医药学报,2023,51(6):105-109.
[3] 欧阳飞,陈瑜,石磊.股骨头坏死非手术治疗研究进展[J].国际骨科学杂志,2024,45(1):15-18.
[4] 黄泽青,李泰贤,高欢欢,等.深化股骨头坏死证候生物学基础研究的重要性探讨[J].中医正骨,2024,36(3):68-70.
[5] 赫龙,王海涛,王树鹏,等.基于骨髓间充质干细胞探讨从“痰”论治激素性股骨头坏死的可能性[J].现代中西医结合杂志,2022,31(23):3280-3283.
[6] 中国研究型医院学会冲击波医学专业委员会,中国人民解放军总医院第三医学中心,中国医学科学院整形外科医院,等.中国骨肌疾病体外冲击波疗法指南(2023年版)[J].中国医学前沿杂志(电子版),2023,15(9):1-20.
[7] 世界中医药学会联合会骨质疏松专业委员会,上海中医药大学附属龙华医院,中日友好医院,等.股骨头坏死中西医结合诊疗专家共识[J].世界中医药,2023,18(7):901-910.
[8] 中国微循环学会骨微循环专业委员会,中日友好医院多尼尔高研院,中日友好医院冲击波医学中心,等.股骨头坏死临床诊疗技术专家共识(2022年)[J].中国修复重建外科杂志,2022,36(11):1319-1326.
[9] 中华中医药学会.股骨头坏死中医辨证标准(2019年版)[J].中医正骨,2019,31(6):1-2.
[10] 袁强,张颖,林继红,等.股骨头坏死硬化带分型与骨髓水肿及疼痛程度的相关性分析[J].中国中医骨伤科杂志,2023,31(1):40-45.
[11] 史珊,杨学东,罗萍,等.ARCO 2-4期股骨头坏死MR征象对Harris评分影响分析[J].中国骨伤,2023,36(12):1185-1190.
[12] 中华中医药学会.股骨头坏死中医疗效评价标准(2019年版)[J].中医正骨,2019,31(6):3-6.
[13] 罗斯佳,赵俊,曾宇,等.糖皮质激素性骨质疏松症中医发病机制的研究[J].时珍国医国药,2023,34(9):2216-2219.
[14] ZHANG Y,LIU Y W,SUN R B,et al.“Sclerotic Band” type of classification system and measurement of necrotic area for osteonecrosis of the femoral head[J].Medicine,2020,99(36):e22106.
[15] SOBTI A,JAMES J,SOBTI S,et al.Bone marrow edema syndrome,revisiting a forgotten entity[J].Open Journal of Orthopedics,2020,10:21-24.
[16] AKHAVAN S,MARTINKOVICH S C,KASIK C,et al.Bone marrow edema,clinical significance,and treatment options:a review[J].J Am Acad Orthop Surg,2020,28(20):e888-e899.
[17] 任之强,阎晓霞,赵志强,等.股骨头坏死疼痛与Ⅰ型胶原羧基端肽β交联肽及骨髓水肿的相关性[J].中国中医骨伤科杂志,2024,32(7):52-56.
[18] 龚飒,周峰峰,朱祎,等.从“血不利则为水”探讨糖尿病肾病的中医证治[J].中医药导报,2020,26(14):168-170.
[19] 赵汝顺,张堃,鲁超,等.基于《金匮要略》“气血水”理论探讨股骨头骨髓水肿的治疗[J].中医药导报,2023,29(8):187-190.
[20] 魏秋实,何伟,张庆文,等.围塌陷期股骨头坏死不同影像学表现研究[J].中国修复重建外科杂志,2021,35(9):1105-1110.
[21] 魏秋实,何伟,洪志楠,等.股骨头坏死MRI脂肪抑制像软骨下低信号带与软骨下骨折的相关性分析[J].中国骨与关节损伤杂志,2020,35(10):1009-1012.
[22] 武瑞臣,崔书伟,李双庆.牛膝甾酮抑制miR-98-5p促进激素性股骨头坏死大鼠BMSC自噬及成骨分化[J].中医学报,2023,38(6):1139-1145.
[23] 徐鹏,于栋华,周琦,等.牛膝引经功效与骨髓间充质干细胞相关性研究进展[J].中药药理与临床,2024,40(7):1-11.
[24] 陈鸿泰,罗毅文,陈东风,等.牛膝杯苋甾酮激发大鼠骨髓间充质干细胞体外迁移及CXCR4表达的研究[J].中国骨质疏松杂志,2019,25(11):1550-1555.
[25] 张绵钰,韩杰,曾浩,等.中药调控成骨细胞铁死亡治疗激素性股骨头坏死[J].中国组织工程研究,2025,29(1):185-192.
[26] 宋红梅,谢文博,林菲菲,等.温阳补肾方对激素性股骨头坏死模型兔血清中成骨、成血管因子及H型血管标志物的影响[J].中国中医骨伤科杂志,2023,31(10):6-11.
[27] LV W X,YU M X,YANG Q Y,et al.Total flavonoids of Rhizoma drynariae ameliorate steroid-induced avascular necrosis of the femoral head via the PI3K/AKT pathway[J].Mol Med Rep,2021,23(5):345.
[28] 朱彩玉,周正新,顾一帆,等.骨痹通消颗粒调控成血管化与细胞凋亡干预兔激素性股骨头坏死[J].海南医学院学报,2022,28(19):1451-1457.
[29] 李辉明,邢涛,李盛华,等.中药干预血管新生防治非创伤性股骨头缺血性坏死研究进展[J].中国中药杂志,2024,49(10):2619-2628.

备注/Memo

备注/Memo:
基金项目:河南省科技攻关专项(232102310423)
△通信作者 E-mail:641594851@qq.com
更新日期/Last Update: 2024-12-05