[1]朱本俊,王志洲,严伟,等.骨痿康颗粒联合髓芯减压+纳米羟基磷灰石/聚酰胺66骨诱导活性材料治疗气滞血瘀证股骨头坏死的临床研究[J].中国中医骨伤科杂志,2026,34(04):79-86.[doi:10.20085/j.cnki.issn1005-0205.260413]
　ZHU Benjun,WANG Zhizhou,YAN Wei,et al.[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2026,34(04):79-86.[doi:10.20085/j.cnki.issn1005-0205.260413]
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骨痿康颗粒联合髓芯减压+纳米羟基磷灰石/聚酰胺66骨诱导活性材料治疗气滞血瘀证股骨头坏死的临床研究()

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

卷:
第34卷
期数:
2026年04期
页码:
79-86
栏目:
临床研究
出版日期:
2026-04-10

文章信息/Info

Title:
文章编号:
1005-0205(2026)04-0079-08
作者:
朱本俊1; 王志洲1; 严伟1; 蔡柯1; 葛炎炎1; 姜红江1△
1山东省文登整骨医院(山东 威海,264400)
Author(s):
ZHU Benjun1; WANG Zhizhou1; YAN Wei1; CAI Ke1; GE Yanyan1; JIANG Hongjiang1△
1Shandong Wendeng Orthopaedic Hospital,Weihai 264400,Shandong China.
关键词:
股骨头坏死;  纳米羟基磷灰石/聚酰胺66(nHA/PA66);  骨痿康颗粒;  髓芯减压术;  中西医结合
Keywords:
osteonecrosis of the femoral head;  nano-hydroxyapatite/polyamide 66(nHA/PA66);  Guweikang granules;  core decompression;  integrated Chinese and Western medicine
分类号:
R681.8
DOI:
10.20085/j.cnki.issn1005-0205.260413
文献标志码:
A
摘要:
目的:探讨骨痿康颗粒联合髓芯减压+纳米羟基磷灰石/聚酰胺66(nHA/PA66)骨诱导活性材料治疗气滞血瘀证股骨头坏死的临床疗效与安全性。方法:回顾性分析 2022 年10月至2023 年10 月收治的 ARCO Ⅱ/ⅢA 期股骨头坏死患者32例(32髋),术中髓芯减压并植入nHA/PA66骨诱导活性材料,术后第1天口服骨痿康颗粒,2次/d,2个月为1个疗程,共3个疗程。随访12～18个月(中位数 14 个月),以髋关节Harris评分、中医影像学评分和中医证候评分评估疗效,并记录并发症。结果:手术平均切口长度为(2.63±0.48)cm,手术时间为(37.53±5.30)min,术中出血(50.63±5.83)mL; 无血栓、感染等并发症。末次随访Harris评分为(85.56±9.38)分,显著高于术前(70.81±8.78)分,差异有统计学意义(P<0.05),优良率由 15.6% 提升至 78.1%。影像学评分由2(1,3)分降至1(1,1.25)分,差异有统计学意义(P<0.05)。中医证候评分由术前(18.50±3.66)分降至末次随访(4.81±5.69)分,差异有统计学意义(P<0.05),证候痊愈率为40.6%,总有效率为90.6%。3 例(9.4%)进展为塌陷并转为全髋关节置换。未见药物相关不良反应。结论:骨痿康颗粒联合髓芯减压+nHA/PA66骨诱导活性材料治疗早中期气滞血瘀证股骨头坏死,在缓解疼痛、改善髋关节功能及影像学稳定性方面优于单一髓芯减压或材料植入,且安全性良好,可为临床保髋治疗提供新的中西医结合方案。
Abstract:
Objective:To investigate the clinical efficacy and safety of Guweikang granules combined with a nano-hydroxyapatite/polyamide 66(nHA/PA66)osteoinductive active material in treating osteonecrosis of the femoral head(ONFH)associated with the syndrome of Qi stagnation and blood stasis.Methods:A retrospective analysis of 32 patients(32 hips )with ARCO Ⅱ/ⅢA stage ONFH between October 2022 and October 2023.During the operation,core decompression and implantation of an osteoinductive nHA/PA66 composite were performed.On the first day after surgery,Guweikang granules was administered orally twice daily for a course of 2 months,with a total of 3 courses.The patients were followed up for 1218 months(median 14 months).Efficacy was assessed using the Harris hip score,the traditional Chinese medicine imaging scale,and the traditional Chinese medicine syndrome score,with complications also documented.Results:The average incision length was(2.63±0.48)cm,the operation time was(37.53±5.30)min,and the intraoperative blood loss was(50.63±5.83)mL.There were no complications such as thrombosis and infection.The Harris score at the last follow-up(85.56±9.38)points was significantly higher than that before surgery(70.81±8.78)points(P<0.05),and the excellent and good rate increased from 15.6% to 78.1%.The imaging score decreased from 2(1,3)points to 1(1,1.25)points(P<0.05).The traditional Chinese medicine syndrome score decreased from(18.5±3.66)points preoperatively to(4.81±5.69)points at the last follow-up(P<0.05).The syndrome cure rate was 40.6%,and the overall response rate was 90.6%.Three cases(9.4%)progressed to femoral head collapse and subsequently required to total hip replacement.No drug-related adverse reactions were observed.Conclusion:Guweikang granules combined with core decompression and nHA/PA66 bone-inductive active materials for treating early-to-mid-stage Qi stagnation and blood stasis syndrome in ONFH demonstrated superior efficacy in alleviating pain,improving hip function,and achieving radiographic stability compared to literature reports on core decompression or material implantation alone.With favorable safety profiles,this approach offers a novel,integrated Chinese-Western medicine solution for clinical hip-preserving treatment.

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(收稿日期:2025-06-14)

备注/Memo

备注/Memo:
基金项目:山东省中医药科技项目(Z-2023110)
威海市中医药科技项目(2023I-3)
山东省医药卫生科技项目(202304071340)
△通信作者 E-mail:boneman@163.com
更新日期/Last Update: 2026-04-15