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[1]劉冠虹,吉萬(wàn)波,劉錦濤,等.股密葆方治療早中期非創(chuàng)傷性股骨頭壞死腎虛血瘀證的臨床研究[J].中醫(yī)正骨,2022,34(02):12-14+23.
　LIU Guanhong,JI Wanbo,LIU Jintao,et al.A clinical study of oral application of Gumibao Fang(股密葆方)for treatment of early- and mid-stage non-traumatic osteonecrosis of the femoral head with kidney-deficiency and blood-stasis syndrome[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(02):12-14+23.
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股密葆方治療早中期非創(chuàng)傷性股骨頭壞死腎虛血瘀證的臨床研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年02期
頁(yè)碼:
12-14+23
欄目:
臨床研究
出版日期:
2022-02-20

文章信息/Info

Title:
A clinical study of oral application of Gumibao Fang(股密葆方)for treatment of early- and mid-stage non-traumatic osteonecrosis of the femoral head with kidney-deficiency and blood-stasis syndrome
作者:
劉冠虹; 吉萬(wàn)波; 劉錦濤; 姜宏
南京中醫(yī)藥大學(xué)附屬蘇州市中醫(yī)醫(yī)院,江蘇 蘇州 215009
Author(s):
LIU Guanhong; JI Wanbo; LIU Jintao; JIANG Hong
Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Suzhou 215009,Jiangsu,China
關(guān)鍵詞:
股骨頭壞死;  股密葆方;  治療結(jié)果;  存活率分析
Keywords:
femur head necrosis;  Gumibao prescription;  treatment outcome;  survival analysis
摘要:
目的:觀察股密葆方治療早中期非創(chuàng)傷性股骨頭壞死腎虛血瘀證的臨床療效。方法:2010年1月至2018年12月收治57例(61髖)非創(chuàng)傷性股骨頭壞死腎虛血瘀證患者,男33例、女24例; 年齡28～63歲,中位數(shù)41歲; 國(guó)際骨微循環(huán)研究學(xué)會(huì)(association research circulation osseous,ARCO)分期Ⅰ期7髖、Ⅱ期41髖、ⅢA期13髖。均采用口服股密葆方治療,每日1劑,水煎服,早晚各1次,3個(gè)月為1個(gè)療程,共治療4個(gè)療程。采用Harris髖關(guān)節(jié)評(píng)分標(biāo)準(zhǔn)和歐洲五維健康量表(EuroQol-5 dimension,EQ-5D)進(jìn)行療效評(píng)價(jià)。治療及隨訪期間復(fù)查雙側(cè)髖關(guān)節(jié)正位、蛙位X線片,記錄觀察時(shí)間及患髖ARCO分期,以ARCO分期超過(guò)ⅢA期為塌陷標(biāo)準(zhǔn),作為觀察終點(diǎn)進(jìn)行生存分析。結(jié)果:所有患者均觀察隨訪至治療開(kāi)始后2年以上(治療開(kāi)始后25～76個(gè)月,中位數(shù)43個(gè)月)。至觀察結(jié)束時(shí),共有13髖發(fā)生塌陷(進(jìn)展至ⅢA期以上),其中Ⅱ期8髖(19.51%)、ⅢA期5髖(38.46%)。股骨頭生存時(shí)間(64.51±3.61)個(gè)月,中位生存時(shí)間66個(gè)月。治療開(kāi)始后2年時(shí),患者的Harris髖關(guān)節(jié)評(píng)分總分及其中的疼痛評(píng)分、關(guān)節(jié)功能評(píng)分、關(guān)節(jié)活動(dòng)度評(píng)分均較治療前提高[(73.58±10.02)分,(84.92±7.56)分,t=3.130,P=0.016;(32.25±6.17)分,(38.67±5.06)分,t=4.210,P=0.000;(34.42±5.85)分,(39.00±3.66)分,t=3.960,P=0.000;(3.25±0.53)分,(4.35±0.53)分,t=2.100,P=0.023],關(guān)節(jié)畸形評(píng)分與治療前的差異無(wú)統(tǒng)計(jì)學(xué)意義[(3.67±1.13)分,(3.50±1.35)分,t=-1.460,P=0.230]; EQ-5D指數(shù)也較治療前提高(0.54±0.16,0.66±0.13,t=2.300,P=0.021)。結(jié)論:采用股密葆方治療早中期非創(chuàng)傷性股骨頭壞死腎虛血瘀證,可有效緩解髖關(guān)節(jié)疼痛、改善髖關(guān)節(jié)功能,提高患者生活質(zhì)量,延緩股骨頭塌陷。
Abstract:
Objective:To observe the clinical outcome of oral application of Gumibao Fang(股密葆方,GMBF)in treatment of early- and mid-stage non-traumatic osteonecrosis of the femoral head(NONFH)with syndrome of kidney-deficiency and blood-stasis.Methods:Fifty-seven kidney-deficiency-blood-stasis-type NONFH patients(61 hips)recruited from January 2010 to December 2018 were enrolled in the study,and they consisted of 33 males and 24 females and ranged in age from 28 to 63 years(Median=41 yrs).According to the staging standard issued by the association research circulation osseous(ARCO),the NONFH belonged to ARCO stageⅠin 7 hips,stageⅡin 41 hips and stageⅢA in 13 hips.All patients were treated with oral application of GMBF,one dose a day in the morning and evening respectively for consecutive 4 courses of treatment,3 months for each course.The clinical outcome was evaluated according to Harris hip score(HHS)and EuroQol-5 dimension(EQ-5D).The X-ray examination of bilateral hip in normotopia and froglike position were performed during the treatment and follow-up period.The observation timepoints and ARCO stage of the affected hips were recorded.The observation was terminated when ARCO stage of the hips was beyond ARCO stageⅢA,which was considered as the criterion of collapse,and the survival analysis was conducted.Results:All patients were followed up for 25-76 months(Median=43 months)after the start of treatment.By the end of follow-up,the collapse was found in 13 hips(stageⅢA or above),among which 8 hips at stageⅡ(19.51%)and 5 hips at stageⅢA(38.46%).The survival time of femur head was 64.51±3.61 months with a median of 66 months.The HHSs including total scores,pain scores,function scores and scores of range of motion were higher at 2 years after the start of treatment compared to pre-treatment (73.58±10.02 vs 84.92±7.56 points,t=3.130,P=0.016; 32.25±6.17 vs 38.67±5.06 points,t=4.210,P=0.000; 34.42±5.85 vs 39.00±3.66 points,t=3.960,P=0.000; 3.25±0.53 vs 4.35±0.53 points,t=2.100,P=0.023),while there was no statistical difference in joint deformity scores between the 2 timepoints(3.67±1.13 vs 3.50±1.35 points,t=-1.460,P=0.230).Furthermore,the EQ-5D index increased at 2 years after the start of treatment compared to pre-treatment(0.54±0.16,0.66±0.13,t=2.300,P=0.021).Conclusion:Oral application of GMBF can effectively relieve the hip pain,improve hip function,delay femoral head collapse and improve patient's life quality in treatment of early-middle NONFH with kidney-deficiency and blood-stasis syndrome.

參考文獻(xiàn)/References:

[1] MONT M A,HUNGERFORD D S.Non-traumatic avascular necrosis of the femoral head[J].J Bone Joint Surg Am,1995,77(3):459-474.
[2] ZALAVRAS C G,LIEBERMAN J R.Osteonecrosis of the femoral head:evaluation and treatment[J].J Am Acad Orthop Surg,2014,22(7):455-464.
[3] ZHAO D W,YU M,HU K,et al.Prevalence of Nontrau-matic osteonecrosis of the femoral head and its associated risk factors in the Chinese population:results from a nationally representative survey[J].Chin Med J(Engl),2015,128(21):2843-2850.
[4] 雷志強(qiáng),曾平,陳衛(wèi)衡,等.股骨頭壞死流行病學(xué)特點(diǎn)分析[J].中醫(yī)正骨,2020,32(1):4-6.
[5] ZALAVRAS C G,LIEBERMAN J R.Osteonecrosis of the femoral head:evaluation and treatment[J].J Am Acad Orthop Surg,2014,22(7):455-464.
[6] 張鶴山,李子榮.股骨頭壞死診斷與治療的專家建議[J].中華骨科雜志,2007,27(2):146-148.
[7] 鄭筱萸.中藥新藥臨床研究指導(dǎo)原則(試行)[M].北京:中國(guó)醫(yī)藥科技出版社,2002:354.
[8] GARDENIERS J W M.A new international classification of osteonecrosis of the ARCO-committee on terminology and classification[J].ARCO News Letter,1992,4:41.
[9] HARRIS W H.Traumatic arthritis of the hip after dislocation and acetabular fractures:treatment by mold arthroplasty.An end-result study using a new method of result evaluation[J].J Bone Joint Surg Am,1969,51(4):737-755.
[10] 田斐,高建民,郭海濤,等.歐洲五維度健康量表(EQ-5D)研究與應(yīng)用概況[J].衛(wèi)生經(jīng)濟(jì)研究,2007(9):42.
[11] MONT M A,ZYWIEL M G,MARKER D R,et al.The natural history of untreated asymptomatic osteonecrosis of the femoral head:a systematic literature review[J].J Bone Joint Surg Am,2010,92(12):2165-2170.
[12] 吉萬(wàn)波,劉冠虹,劉錦濤,等.中藥股密葆治療大鼠激素性股骨頭壞死的生物力學(xué)作用機(jī)理研究[J].中國(guó)中醫(yī)骨傷科雜志,2013,21(9):7-10.
[13] 宋奕,姜宏,丁道芳,等.股密葆含藥血清對(duì)高濃度地塞米松干預(yù)后成骨細(xì)胞增殖分化作用的影響[J].中國(guó)骨傷,2014,27(8):668-672.
[14] 吉萬(wàn)波,劉冠虹,劉錦濤,等.益氣化瘀補(bǔ)腎法對(duì)大鼠激素性股骨頭壞死骨代謝的影響[J].廣州中醫(yī)藥大學(xué)學(xué)報(bào),2014,31(2):239-242.
[15] 吉萬(wàn)波,劉冠虹,劉錦濤,等.股密葆方對(duì)大鼠激素性股骨頭壞死脂質(zhì)代謝影響的實(shí)驗(yàn)研究[J].中國(guó)骨質(zhì)疏松雜志,2016,22(12):1580-1584.

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備注/Memo:
基金項(xiàng)目:江蘇省基礎(chǔ)研究計(jì)劃青年基金項(xiàng)目(BK20210102)
通訊作者:姜宏 E-mail:[email protected]
更新日期/Last Update: 2022-02-20