目的观察中药健脾活骨方治疗早中期非创伤性股骨头坏死(nontraumatic osteonecrosis of the fem-oralhead,NONFH)痰瘀阻络证临床结果及疗效特点。方法采用回顾性配对对照研究方法,收集获得2年随访的早中期NONFH痰瘀阻络证患者,将经健脾...目的观察中药健脾活骨方治疗早中期非创伤性股骨头坏死(nontraumatic osteonecrosis of the fem-oralhead,NONFH)痰瘀阻络证临床结果及疗效特点。方法采用回顾性配对对照研究方法,收集获得2年随访的早中期NONFH痰瘀阻络证患者,将经健脾活骨方治疗者设为试验组(47例),经髓芯减压病灶清除植骨手术治疗者设为对照组(48例)。收集患者治疗前后X线和临床资料,将影像稳定率和Harris评分优良率作为疗效评价指标。结果 (1)试验组与对照组Harris评分优良率比较,差异无统计学意义(95.74%vs79.17%,P>0.05),但试验组在缓解疼痛,改善关节畸形、关节活动及Harris总分方面明显优于对照组(P<0.05,P<0.01);两组影像稳定率比较,差异无统计学意义(74.47%vs75.00%,P>0.05)。(2)试验组与对照组国际骨循环研究学会(AssociationResearchCirculationOsseous,ARCO)股骨头坏死分期Ⅱ期、Ⅲ期患者治疗后影像稳定率比较,差异均无统计学意义(82.05%vs80.00%,37.50%vs50.00%,P>0.05)。(3)试验组ARCOⅡ期患者治疗后影像稳定率及Harris评分优良率均明显高于本组Ⅲ期患者(82.05%vs37.50%,97.44%vs87.50%,P<0.01)。结论健脾活骨方治疗早中期NONFH影像稳定率与手术治疗结果相当,但在缓解疼痛程度、改善关节畸形和关节活动方面优于手术治疗。展开更多
Literature review shows that Chinese medicine and other related treatment are still the main stream treatment of knee osteoarthritis.Currently,there is short of handbook guiding Chinese medicine from evidence-based me...Literature review shows that Chinese medicine and other related treatment are still the main stream treatment of knee osteoarthritis.Currently,there is short of handbook guiding Chinese medicine from evidence-based medical evidence,so it is a top priority to develop a clinical guideline from the expert consensus.After several rounds of discussion during the conference and examination by letter,which has collected opinions from nearly one hundred experts,consensus was reached.Nonpharmacologic interventions include health education,medical exercise,acupuncture,massage,acupotomology,and physiotherapy.Pharmacological interventions are as follows.Topical application includes fumigation,application,hot compressed,ironing and iontophoresis with Chinese herbs,etc.Chinese patent medicine for external use includes plaster,ointment,etc.Western medicine for external use mainly includes emulsion,ointment,plaster and embrocation containing nonsteroidal anti-inflammatory drugs（NSAIDs）.Intraarticular injection mainly includes sodium hyaluronic acid,chitosan（for injection） with prudent use of glucocorticoid.Chinese herbal medicine and Chinese patent medicine can be taken referring to syndrome differentiation which mainly includes syndromes of qi stagnation and blood stasis,cold dampness,deficiency of Gan（Liver） and Shen（Kidney）,deficiency of qi and blood.Western medicine mainly includes analgesic,NSAIDs,diseases modifying drugs.Surgery procedures mainly include joint irrigation,arthroscopic surgery,osteotomy,arthroplasty,etc.展开更多
文摘目的观察中药健脾活骨方治疗早中期非创伤性股骨头坏死(nontraumatic osteonecrosis of the fem-oralhead,NONFH)痰瘀阻络证临床结果及疗效特点。方法采用回顾性配对对照研究方法,收集获得2年随访的早中期NONFH痰瘀阻络证患者,将经健脾活骨方治疗者设为试验组(47例),经髓芯减压病灶清除植骨手术治疗者设为对照组(48例)。收集患者治疗前后X线和临床资料,将影像稳定率和Harris评分优良率作为疗效评价指标。结果 (1)试验组与对照组Harris评分优良率比较,差异无统计学意义(95.74%vs79.17%,P>0.05),但试验组在缓解疼痛,改善关节畸形、关节活动及Harris总分方面明显优于对照组(P<0.05,P<0.01);两组影像稳定率比较,差异无统计学意义(74.47%vs75.00%,P>0.05)。(2)试验组与对照组国际骨循环研究学会(AssociationResearchCirculationOsseous,ARCO)股骨头坏死分期Ⅱ期、Ⅲ期患者治疗后影像稳定率比较,差异均无统计学意义(82.05%vs80.00%,37.50%vs50.00%,P>0.05)。(3)试验组ARCOⅡ期患者治疗后影像稳定率及Harris评分优良率均明显高于本组Ⅲ期患者(82.05%vs37.50%,97.44%vs87.50%,P<0.01)。结论健脾活骨方治疗早中期NONFH影像稳定率与手术治疗结果相当,但在缓解疼痛程度、改善关节畸形和关节活动方面优于手术治疗。
文摘Literature review shows that Chinese medicine and other related treatment are still the main stream treatment of knee osteoarthritis.Currently,there is short of handbook guiding Chinese medicine from evidence-based medical evidence,so it is a top priority to develop a clinical guideline from the expert consensus.After several rounds of discussion during the conference and examination by letter,which has collected opinions from nearly one hundred experts,consensus was reached.Nonpharmacologic interventions include health education,medical exercise,acupuncture,massage,acupotomology,and physiotherapy.Pharmacological interventions are as follows.Topical application includes fumigation,application,hot compressed,ironing and iontophoresis with Chinese herbs,etc.Chinese patent medicine for external use includes plaster,ointment,etc.Western medicine for external use mainly includes emulsion,ointment,plaster and embrocation containing nonsteroidal anti-inflammatory drugs（NSAIDs）.Intraarticular injection mainly includes sodium hyaluronic acid,chitosan（for injection） with prudent use of glucocorticoid.Chinese herbal medicine and Chinese patent medicine can be taken referring to syndrome differentiation which mainly includes syndromes of qi stagnation and blood stasis,cold dampness,deficiency of Gan（Liver） and Shen（Kidney）,deficiency of qi and blood.Western medicine mainly includes analgesic,NSAIDs,diseases modifying drugs.Surgery procedures mainly include joint irrigation,arthroscopic surgery,osteotomy,arthroplasty,etc.
