| 高玉龙,陶慧君.桃红四物汤加减在早期股骨头坏死术后的应用效果分析[J].中国烧伤创疡杂志,2022,(5):352~356. |
| DOI： |
| 中文关键词: 桃红四物汤 股骨头坏死 髓芯减压 自体髂骨打压植骨 中医证候积分 Ｈａｒｒｉｓ 评分 血液 流变学 炎症因子 |
| 英文关键词:Taohong Siwu Decoction Femoral head necrosis Core decompression Autologous iliac bone impaction graft TCM syndrome score Harris score Hemorheology Inflammatory factor |
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| 中文摘要: |
| 【摘要】 目的 研究探讨桃红四物汤加减在早期股骨头坏死术后的应用效果。方法 选取2018年6月至 2019年10月驻马店段庄孙全贵骨科医院收治的62例早期股骨头坏死患者作为研究对象,按照随机数表法将其随机分为观察组(31例)与对照组(31例),两组患者均行髓芯减压联合自体髂骨打压植骨术治疗, 观察组患者术后在常规外科换药处理的基础上联合口服加减桃红四物汤,对照组患者术后单纯行常规外科换药处理, 对比观察两组患者血液流变学指标及炎症因子水平变化情况、中医证候积分、髋关节功能评分及日本骨科协会(JOA)评分。结果 治疗第7天及3个月后, 观察组患者全血黏度(WBV)、血浆黏度(PV)、红细胞沉降率(ESR)、红细胞压积 (HCT)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-1β( IL-1β)水平均明显低于对照组(治疗第7天: t=2.298、2.553、2.176、2.095、2.345、2.085、2.060,P =0.025、0.013、0.034、0.040、0.022、0.041、0.044;治疗3个月:t= 2.186、2.131、2.711、2.642、2.209、2.178、2.059,P =0.033、0.037、0.009、0.011、0.031、0.034、0.044)。治疗3个月后, 观察组患者中医证候各项积分均明显低于对照组(t=2.117、2.414、2.085、2.111、2.594、2.236,P = 0.038、0.019、0.041、0.039、0.012、0.029),Harris评分及JOA评分均明显高于对照组(t = 2.377、3.193,P =0.021、0.002)。结论 早期股骨头坏死髓芯减压联合自体髂骨打压植骨术后在常规外科换药处理的基础上联合应用桃红四物汤加减可有效降低炎症因子水平、改善中医证候、促进患肢血液循环,进而提高髋关节功能,疗效显著,临床应用价值较高。 |
| 英文摘要: |
| 【Abstract】 Objective To study the application effect of modified Taohong Siwu Decoction after surgery for early-stage femoral head necrosis. Methods 62 patients with early-stage femoral head necrosis, admitted to SUN Quangui Orthopedic Hospital, Duanzhuang Village in Zhumadian City from June 2018 to October 2019, were enrolled as research subjects, and then divided, using the random number table, into study group (n=31) and control group (n= 31). All patients in the two groups underwent core decompression combined with autologous iliac bone impaction graft. Patients in control group were managed with routine surgical dressing change after surgery, while patients in study group, besides the routine surgical dressing change after surgery, took modified Taohong Siwu Decoction after surgery orally. Changes of hemorheological indexes and inflammatory factors, TCM syndrome score, hip joint function score and Japanese Orthopaedic Association (JOA) score were compared between the two groups. Results On day 7 of treatment and after 3 months of treatment, the levels of whole blood viscosity (WBV), plasma viscosity (PV), erythrocyte sedimentation rate (ESR), hemato- crit (HCT), C-reactive protein (CRP), tumor necrosis factor-α(TNF-α) and interleukin-1β (IL-1β) of patients were all significantly lower in study group compared with control group ( on day 7 of treatment: t = 2.298、2.553、2.176、2.095、2.345、2.085 and 2.060,P =0.025、0.013、0.034、0.040、0.022、0.041 and 0.044; after 3 months of treatment: t= 2.186、2.131、2.711、2.642、2.209、2.178 and 2.059,P =0.033、0.037、0.009、0.011、0.031、0.034 and 0.044).After 3 months of treatment, the accumulated scores of TCM syndromes of patients in study group were significantly lower than control group(t=2.117、2.414、2.085、2.111、2.594 and 2.236,P = 0.038、0.019、0.041、0.039、0.012 and 0.029),and Harris scores and JOA scores of patients were significantly higher than control group(t = 2.377 and 3.193,P =0.021 and 0.002).Conclusion After core decompression and autologous iliac bone impaction graft for Early-stage femoral head necrosis, the application of modified Taohong Siwu Decoction, in addition to routine surgical dressing change, can effectively decrease levels of inflammatory factors, improve TCM syndromes, promote blood circulation of the affected limbs, and further improve hip joint functions. Given its remarkable curative effect, modified Taohong Siwu Decoction deserves to be promoted in clinical practice. |
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