髓芯减压联合骨痹通消颗粒治疗肾虚血瘀型ARCO Ⅱ期股骨头坏死疗效观察OA
Clinical Efficacy of Core Decompression Combined with Gubi Tongxiao Granule in Treatment of ARCO Stage Ⅱ Femoral Head Necrosis with Kidney Deficiency and Blood Stasis
目的 观察髓芯减压联合骨痹通消颗粒治疗国际骨循环研究会(Association Research Circulation Osseous,ARCO)Ⅱ期肾虚血瘀型股骨头坏死的临床疗效.方法 将52例早期肾虚血瘀型股骨头坏死患者根据随机数字表法分为对照组和观察组,每组26例.对照组予以髓芯减压术治疗,观察组在对照组基础上联合骨痹通消颗粒治疗6个月.比较两组患者中医临床疗效及治疗前后Harris髋关节功能评分,疼痛视觉模拟量表(visual analogue scale,V AS)评分,N-端骨钙素(N-terminal midmolecule fragment of osteocalcin,N-MID)、Ⅰ 型胶原羧基端肽 β 特殊序列(β-C-terminal telopeptide of type Ⅰ collagen,β-CTX)、总 Ⅰ 型胶原氨基端延长肽(total N-terminal propeptide of type Ⅰ collagen,T-PINP)、25-羟基维生素 D[2 5-hydroxy vitamin D,25-(OH)D]水平,影像学 Kerboul 角大小.结果 术后3、6个月两组患者Harris评分均高于术前(P＜0.05),且观察组Harris评分高于对照组(P＜0.05);术后3、6个月两组患者VAS评分均低于术前(P＜0.05),且观察组VAS评分低于对照组(P＜0.05);术后6个月观察组N-MID、β-CTX、T-PINP水平均低于对照组(P＜0.05),25-(OH)D水平高于对照组(P＜0.05);术后6个月观察组Kerboul角小于对照组(P＜0.05),观察组△Kerboul角大于对照组(P＜0.05).观察组临床疗效优于对照组(P＜0.05).结论 髓芯减压术联合骨痹通消颗粒治疗ARCO Ⅱ期肾虚血瘀型股骨头坏死的临床疗效显著,可有效缓解患者髋部疼痛,减轻症状,促进髋关节功能恢复,有利于维持骨代谢平衡,实现保髋目标.
Objective To investigate the clinical efficacy of core decompression combined with Gubi Tongxiao Granule in the treatment of ARCO stage Ⅱ femoral head necrosis with kidney deficiency and blood stasis.Methods A total of 52 patients with early-stage femoral head necrosis with kidney deficiency and blood stasis were divided into control group and observation group using the random number table method,with 26 patients in each group.The patients in the control group were treated with core decompression alone,while those in the observation group were treated with Gubi Tongxiao Granule in addition to the treatment in the control group for 6 months.The two groups were compared in terms of traditional Chinese medicine(TCM)treatment outcome,as well as Harris hip function score,Visual Analogue Scale(VAS)score,N-terminal midmolecule frag-ment of osteocalcin(N-MID),β-C-terminal telopeptide of type Ⅰ collagen(β-CTX),total N-terminal propeptide of type Ⅰcollagen(T-PINP),25-hydroxyvitamin D[25-(OH)D],and Kerboul angle before and after treatment.Results Both groups had a significant increase in Harris score at 3 and 6 months after surgery(P＜0.05),and the observation group had a signifi-cantly higher Harris score than the control group at 3 and 6 months after surgery(P＜0.05).Both groups had a significant re-duction in VAS score at 3 and 6 months after surgery(P＜0.05),and the observation group had a significantly lower Harris score than the control group at 3 and 6 months after surgery(P＜0.05).At 6 months after surgery,compared with the control group,the observation group had significantly higher levels of N-MID,β-CTX,and T-PINP(P＜0.05)and a significantly lower level of 25-(OH)D(P＜0.05).The observation group had a significantly smaller Kerboul angle than the control group at 6 months after surgery(P＜0.05),as well as a significantly greater change in Kerboul angle(△Kerboul)than the control group(P＜0.05).The observation group had a significantly better clinical outcome than the control group(P＜0.05).Conclusion Core decompression combined with Gubi Tongxiao Granule has marked clinical efficacy in the treatment of ARCO stage Ⅱ femoral head necrosis with kidney deficiency and blood stasis,and it can effectively reduce hip pain,alleviate symp-toms,promote the recovery of hip joint function,maintain bone metabolism balance,and achieve the goal of hip preservation.
项新洪;孙佳乐;马志国;周正新;朱磊
安徽中医药大学第一临床医学院,安徽 合肥 230031||安徽中医药大学第一附属医院,安徽 合肥 230031||黄山市中医医院,安徽黄山 245000安徽中医药大学第一临床医学院,安徽 合肥 230031||安徽中医药大学第一附属医院,安徽 合肥 230031安徽中医药大学第一临床医学院,安徽 合肥 230031||安徽中医药大学第一附属医院,安徽 合肥 230031安徽中医药大学第一附属医院,安徽 合肥 230031安徽中医药大学第一附属医院,安徽 合肥 230031
医药卫生
股骨头坏死肾虚血瘀证骨痹通消颗粒髓芯减压术
osteonecrosis of the femoral headkidney deficiency and blood stasisGubi Tongxiao Granulecore decompression
《安徽中医药大学学报》 2026 (1)
25-30,6
丁锷全国名中医传承工作室项目(czbkjf20200037)安徽省级中医优势专科项目(zyyfw20220126)安徽省高等学校科学研究项目(2024AH040158)
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