摘要
目的:观察除湿虎潜丸加减联合髓芯减压术治疗Ⅰ,Ⅱ股骨头坏死湿热痹阻证的疗效及其对骨代谢指标[骨钙素(BGP),骨形态发生蛋白-2(BMP-2),骨特异性碱性磷酸酶(BALP)],血脂[载脂蛋白A(ApoA),载脂蛋白B(ApoB),载脂蛋白C3(ApoC3)],蛋白表达[基质金属蛋白酶-2(MMP-2),基质金属蛋白酶-9(MMP-9),基质金属蛋白酶组织抑制剂-2(TIMP-2)]的影响。方法:90例患者被随机分为对照组和观察组,各45例。对照组给予髓芯减压术+仙灵骨葆,观察组给予髓芯减压术+除湿虎潜丸加减,疗程均为6个月。分别观察两组髋关节功能量表(HHS),外缘股骨头指数(LHI),中医证状;检测骨代谢指标(BGP,BMP-2,BALP)水平,血脂(ApoA,ApoB,ApoC3)水平,蛋白表达(MMP-2,MMP-9,TIMP-2)水平;比较两组临床疗效、不良反应和随访36个月复发情况。结果:观察组总有效率97.73%(43/44),高于对照组的80.95%(34/42)(χ~2=5.915,P<0.05);随访36个月,观察组复发率4.65%(2/43),低于对照组的35.29%(12/34)(χ~2=5.317,P<0.05);观察组治疗后HHS,LHI较对照组明显升高(P<0.05),中医证状评分较对照组明显降低(P<0.05);治疗后与对照组比较,观察组BGP,BMP-2,BALP,MMP-2,MMP-9水平明显升高(P<0.05),ApoA,ApoB,ApoC3,TIMP-2水平明显降低(P<0.05);治疗期间未见明显不良反应。结论:除湿虎潜丸加减联合髓芯减压术可明显改善Ⅰ,Ⅱ股骨头坏死湿热痹阻证患者的临床症状,骨代谢指标,血脂和蛋白表达水平。
Objective:To observe the efficacy of modified Chushi Huqianwan combined with core decompression onⅠ,Ⅱstage osteonecrosis of femoral head due to hot and humid syndrome,and the effect on bone metabolism index[osteocalcin(BGP),bone morphogenetic protein-2(BMP-2),bone isoenzyme alkaline phosphatase(BALP)],blood lipid[apolipoprotein A(ApoA),apolipoprotein B(ApoB),apolipoprotein C3(ApoC3)],protein expression[matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),tissue inhibitor of matrix metalloproteinase-2(TIMP-2)].Method:A total of 90 cases were divided into control group and observation group,with 45 cases in each group.The control group was given core decompression+Xianling Gubao,while the observation group was given core decompression+modified Chushi Huqianwan for6 months.The hip harris score(HHS),lateral head index(LHI)and traditional Chinese medicine(TCM)syndrome were observed between two groups.The serum bone metabolic indices(BGP,BMP-2,BALP),blood lipid(ApoA,ApoB,ApoC3),protein expressions(MMP-2,MMP-9,TIMP-2)were detected between two groups.The clinical efficacy,adverse reaction and recurrence in 36-month follow-up were compared between two groups.Result:The total effective rate was 97.73%(43/44)in observation group,which was higher than 80.95%(34/42)in control group(χ~2=5.915,P<0.05).The recurrence rate was 4.65%(2/43)in observation group,which was lower than 35.29%(12/34)in control group(χ~2=5.317,P<0.05)during the 36-month follow-up.HHS and LHI in observation group were significantly higher than those in control group(P<0.05),and TCM syndrome score was significantly lower than that in control group(P<0.05).Compared with control group after treatment,BGP,BMP-2,BALP,MMP-2 and MMP-9 in observation group were significantly increased(P<0.05),whereas ApoA,ApoB,ApoC3,TIMP-2 were significantly decreased(P<0.05).No obvious adverse reactions were observed during the treatment.Conclusion:Modified Chushi Huqianwan combined with core decompression can significantly improve clinical symptoms,bone meta
作者
王勤俭
李泊泊
董良杰
王燕
WANG Qin-jian;LI Bo-bo;DONG Liang-jie;WANG Yan(Henan Province Hospital of Traditional Chinese Medicine,Zhengzhou 450002,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2020年第22期71-76,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家中医临床研究基地科研专项(2019JDZX055)
河南省中医药科学研究专项(2018ZY2136)
河南省科技厅科技攻关项目(162102310446)。
关键词
除湿虎潜丸加减
髓芯减压术
股骨头坏死
湿热痹阻证
modified Chushi Huqianwan
core decompression
necrosis of femoral head
hot and humid syndrome
