体外冲击联合桃红四物汤加减治疗早期股骨头坏死临床观察.docVIP

体外冲击波联合桃红四物汤加减治疗早期股骨头坏死临床观察 　　【摘 要】目的：观察体外冲击波联合桃红四物汤加减治疗早期股骨头坏死的临床疗效。方法：将64例早期股骨头坏死患者随机分为治疗组和对照组，每组32例。对照组口服桃红四物汤加减治疗，治疗组在对照组的基础上联合体外冲击波治疗。2组疗程均为3个月。观察2组临床疗效及Harris评分。结果：治疗组治愈14例，显效9例，有效5例，无效4例，总有效率为87.50%；对照组治愈11例，显效7例，有效5例，无效9例，总有效率为71.88%。2组比较，差异有统计学意义（P 中国论文网 /1/viewhtm　　【关键词】 股骨头坏死；早期；体外冲击波；桃红四物汤 　　【ABSTRACT】Objective：To observe the clinical curative effect of extracorporeal shock wave combined with Taohong Siwu Tang （桃红四物汤） in the treatment of early osteonecrosis of the femoral head.Methods： 64 cases of early osteonecrosis of the femoral head were randomly divided into a treatment group and a control group，32 cases in each group.The control group was orally given Taohong Siwu Tang，while the treatment group，based on the treatment of the control group，was treated with extracorporeal shock wave.Both groups were treated for 3 months.The clinical effect and Harris scores of the two groups were observed.Results：In the treatment group，14 cases were cured，9 cases were markedly effective，5 cases were effective，and 4 cases were ineffective，the total effective rate being 87.50%；while in the control group，11 cases were cured，7 cases were markedly effective，5 cases were effective，and 9 cases were ineffective，the total effective rate being 71.88%.The difference between the two groups was statistically significant （P 0.05），具有可比性。 　　1.2 纳入标准 ①符合ARCO分期；②签署知情同意书。 　　1.3 排除标准 ①患髋部恶性肿瘤、感染或恶性病变者；②对中药过敏或者无法服用者；③患有严重心脏病、肾病及其他严重内科疾病者。 　　2 方 法 　　2.1 治疗方法 　　2.1.1 对照组 给予桃红四物汤加减治疗。药物组成：桃仁9 g、红花6 g、川芎6 g、当归12 g、熟地黄12 g、白芍9 g。痰湿型，加半夏9 g、陈皮6 g、茯苓9 g、白术9 g；气滞血瘀型，加穿山甲6 g、地龙6 g、郁金9 g、没药9 g、木香9 g；风寒型，加桂枝9 g、干姜6 g、羌活9 g、独活9 g、桑寄生9 g；气血虚弱型，加党参9 g、黄芪15 g；肝肾亏虚型，加牛膝9 g、枸杞子6 g、紫河车9 g、杜仲9 g。水煎，每袋200 mL，早、晚各1次，温服。7 d为1个疗程，共8个疗程，每个疗程间隔2 d。 　　2.1.2 治疗组 在对照组治疗基础上加用ESW（深圳市慧康医疗器械有限公司 HK-ESWO-AJII型骨科冲击波治疗仪）治疗。患者取仰卧位，以ONFH区域及其周围骨质为靶点进行冲击治疗，操作过程中注意避开重要血管及神经。每次治疗后，在护士指导下，嘱患者行股四头肌等长收缩锻炼及髋关节被动屈曲、内收、外展、内旋活动[4]。每次冲击3500次，能流密度0.16 mj?mm-2，每周2次，8次为1个疗程，共3个疗程。 　　2.2 疗效评定标准 按照国家中医药管理局《中医病证诊断疗效标准》[5]中ONFH疗效