股骨颈髓腔内药物注射联合口服补益肝肾中药治疗股骨头缺血性坏死的疗效观察-中医骨伤科学专业论文.docxVIP

成都中医药大学硕士学位论文 成都中医药大学硕士学位论文 PAGE PAGE 1 中文摘要 目的：探讨运用股骨颈髓腔内药物注射联合口服补益肝肾的中药治疗股骨 头缺血性坏死的临床疗效。 方法：采用随机、对照的研究方法，将符合纳入标准病例 80 例，随机分为 对照组和治疗组，各 40 例。对照组单纯口服补益肝肾的中药仙灵骨葆胶囊 3 个 疗程（9 个月），治疗组在对照组治疗的基础上，给予股骨颈基底部髓腔穿刺， 回抽出 5～10ml 髓腔血液，然后注射丹参酮ⅡA 磺酸钠注射液 2ml、骨肽注射液 4ml，每周一次，四周为一疗程，每疗程后休息 2 个月，共治疗 3 个疗程（9 个 月）。两组均辅助功能锻炼。将首次和治疗 3 个疗程后的髓腔血进行血液流变学 检测。依据 Harris 评分系统，对患者髋部的症状体征在治疗前后分别进行评分。 每个病例在治疗前后均常规摄骨盆正位 X 线片，由不参与本研究的专家依据 Ficat 分期标准进行评价。将两组治疗前后的 Harris 评分、血流变学数据及 Ficat 分期结果进行统计学处理分析。 结果：两组基线状况良好，分组均衡，可比性强（P0.05）。在症状体征方 面，两组患者治疗前后均有统计学意义（P0.05）,治疗后组间比较，治疗组疗 效优于对照组（P0.05）。治疗前后股骨颈髓腔血液血流变学检测治疗组有统计 学意义（P0.05）,对照组无统计学意义（P0.05）。治疗后组间比较显示，治 疗组优于对照组（P0.05）。但治疗前、后两组病例骨盆 X 线平片资料经秩和检 验无统计学意义。 结论：髓腔内注射配合仙灵骨葆胶囊口服的治疗方法优于单纯口服仙灵骨 葆胶囊，能够有效改善股骨头缺血性坏死患者的临床症状，改善患髋股骨颈髓 腔内血液微循环，提高患者的生存能力和生活质量。 关键词：髓腔内注射，补益肝肾，股骨头缺血性坏死，疗效观察 ABSTRACT Objective: To observe the curative effect of Marrow Cavity of Collum Femoris Injection coordinate with take Chinese medicine orally which is tonify the liver and kidney for the treatment of Avascular Necrosis of Femoral Head. Methods: Under the random and contrast research method, 80 cases were involved in this trial and divided randomly into two groups: Control group (treated with Xianlinggubao Capsules orally) and treatment group (treated with Marrow Cavity of Collum Femoris Injection coordinate with Xianlinggubao Capsule orally) for three courses (3 months), observe the patients system and sign amelioration level, according to the Harris marking system . The Patients’ blood rheology and hip X-ray were measured and observed at the before the treatment and after three courses. At last analyze the data by statistical method. Results: There was no significance in contrast and treat group from the baseline analysis. The patients’ system and sign amelioration level have significance in contrast and treatment group(P0.05). There were significant difference between treatment group and contrast group after treatment(P0.05). the blood rheology have significance only in contrast group(P0.