[1]张胜杰,阎晓霞△,任之强,等.筋骨平衡理论指导下手法联合中药治疗股骨头坏死的临床研究[J].中国中医骨伤科杂志,2025,33(04):56-62.[doi:10.20085/j.cnki.issn1005-0205.250411 ]
　ZHANG Shengjie,YAN Xiaoxia,REN Zhiqiang,et al.Clinical Study on the Treatment of ONFH with Manipulation Combined with TCM under the Guidance of Muscle and Bone Balance Theory[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(04):56-62.[doi:10.20085/j.cnki.issn1005-0205.250411 ]
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筋骨平衡理论指导下手法联合中药治疗股骨头坏死的临床研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年04期
页码:
56-62
栏目:
临床研究
出版日期:
2025-04-10

文章信息/Info

Title:
Clinical Study on the Treatment of ONFH with Manipulation Combined with TCM under the Guidance of Muscle and Bone Balance Theory
文章编号:
1005-0205(2025)04-0056-07
作者:
张胜杰1; 阎晓霞1; 2△; 任之强2; 王震2; 韩崇涛3
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); 3河南中医药大学第三附属医院
Author(s):
ZHANG Shengjie1; YAN Xiaoxia1; 2△; REN Zhiqiang2; WANG Zhen2; HAN Chongtao3
1Henan University of Chinese Medicine,Zhengzhou 450046,China; 2Luoyang Orthopedic-Traumatological Hospital of Henan Province(Henan Provincial Orthopedic Hospital),Zhengzhou 450016,China; 3The Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003,China.
关键词:
筋骨平衡;  手法;  中药;  股骨头坏死;  骨盆倾斜
Keywords:
muscle and bone balance;  manipulation;  traditional Chinese medicine;  osteonecrosis of the femoral head;  pelvic obliquity
分类号:
R681.8
DOI:
10.20085/j.cnki.issn1005-0205.250411
文献标志码:
A
摘要:
目的:观察筋骨平衡理论指导下理筋整髋手法联合补肾生骨方治疗股骨头坏死的临床疗效及对髋关节功能、血清炎症因子和骨盆倾斜影像学的影响,并探究其作用机制。方法:将肝肾亏虚型非创伤性股骨头坏死患者70例,随机均分为两组各35例。对照组给予补肾生骨方治疗,观察组在补肾生骨方基础上联合理筋整髋手法。比较两组临床疗效和不良反应,治疗前后随访观察两组患者中医证候评分,对比健康调查简表(SF-36)、髋关节功能(Harris评分)和视觉模拟量表(VAS)评分,比较冠状面骨盆倾斜(PO)角度和血清炎症因子(肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-1β(IL-1β))水平。结果:治疗前组间差异无统计学意义(P>0.05),具有可比性。两组患者治疗3个月后Harris评分及SF-36评分较前均上升,VAS评分及中医证候评分较前均下降,血清IL-1β、IL-6和TNF-α水平较前均下降,差异有统计学意义(P<0.05); 观察组患者骨盆倾斜角度较前下降,差异有统计学意义(P<0.05),对照组骨盆倾斜角度变化不明显,差异无统计学意义(P=0.064)。治疗3个月后组间比较,观察组Harris评分及SF-36评分高于对照组,观察组VAS评分、中医证候评分、骨盆倾斜角度、TNF-α、IL-6、IL-1β均低于对照组,差异有统计学意义(P<0.05); 观察组总有效率为94.29%,显著高于对照组的82.86%,差异有统计学意义(P<0.05); 两组均无明显不良反应。结论:基于筋骨平衡理论运用理筋整髋手法联合补肾生骨方治疗股骨头坏死疗效可靠,相较于单纯补肾生骨方治疗,能进一步减轻患者疼痛,改善髋关节功能,提高生活质量; 结合观察组骨盆倾斜角度减小和TNF-α、IL-6、IL-1β下降趋势,理筋整髋手法可能通过纠正骨盆倾斜、调控炎症反应以进一步提升临床疗效,且具有较好的安全性。
Abstract:
Objective:To investigate the clinical efficacy of the ligament and hip manipulation technique guided by the theory of muscle and bone balance,in combination with the Bushen Shenggu recipe for the treatment of femoral head necrosis,as well as its impact on hip joint function,serum inflam-matory factors,and pelvic tilt radiology,and explore its mec-hanism of action.Methods:70 cases of non-traumatic femoral head necrosis patients with liver and kidney deficiency were randomly and evenly divided into two groups of 35 each.The control group was treated with Bushen Shenggu recipe,while the observation group received additional ligament and hip manipulation technique on top of the Bushen Shenggu recipe.The clinical efficacy and adverse reactions of the two groups were compared,and the traditional Chinese medicine symptom scores of the patients in both groups were observed before and after treatment.The Health Survey Short Form-36(SF-36),Harris hip score,and visual analogue scale(VAS)scores were compared,as well as the coronal plane pelvic obliquity(PO)angle and serum inflammatory factor levels,including tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-1β(IL-1β).Results:Before treatment,the differences between the groups were comparable(P>0.05); after 3 months of treatment,both groups showed increased Harris scores and SF-36 scores(P<0.05),decreased VAS scores and traditional Chinese medicine symptom scores(P<0.05),and reduced serum levels of IL-1β,IL-6,and TNF-α(P<0.05).The observation group showed a decrease in the PO angle(P<0.05),while the control group showed no significant change in the PO angle(P=0.064).After 3 months of treatment,when comparing the groups,the observation group had higher Harris scores and SF-36 scores than the control group(P<0.05),and lower VAS scores,traditional Chinese medicine symptom scores,PO angles,TNF-α,IL-6,and IL-1β levels than the control group(P<0.05).The total effective rate of the observation group was 94.29%,significantly higher than the control group's 82.86%(P<0.05),and no significant adverse reactions occurred in either group.Conclusion:The treatment of osteonecrosis of the femoral head using the ligament and hip manipulation technique combined with the Bushen Shenggu recipe,based on the theory of muscle and bone balance,is reliable and more effective than the Bushen Shenggu recipe alone in reducing patient pain,improving hip joint function,and enhancing the quality of life.The decreased PO angle and the downward trend of TNF-α,IL-6,and IL-1β in the observation group suggest that the ligament and hip manipulation technique may further enhance clinical efficacy by correcting pelvic tilt and regulating inflammatory responses,and it has good safety.

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备注/Memo

备注/Memo:
基金项目:河南省中医药科学研究重点课题(20-21ZY1026) 河南省中医药科学研究重大专项课题(2022ZYZD14) 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: 2025-04-10