[1]王亚国 王官林董博 袁普卫 杨锋 刘德玉 欧国峰 王国柱.骨复生治疗股骨头坏死的临床疗效及其对血液流变学的影响[J].陕西中医药大学学报,2020,(5):070-75.[doi:10.13424/j.cnki.jsctcm.2020.05.018]
　Wang Yaguo,Wang Guanlin,Dong Bo,et al.Effect of Gufusheng on Clinical Efficacy and Hemorheology of Patients with Osteonecrosis[J].Journal of Shaanxi University of Traditional Chinese Medicine,2020,(5):070-75.[doi:10.13424/j.cnki.jsctcm.2020.05.018]
点击复制

骨复生治疗股骨头坏死的临床疗效及其对血液流变学的影响()
分享到：

《陕西中医药大学学报》[ISSN:2096-1340/CN:61-1501/R]

卷:
期数:
2020年5期
页码:
070-75
栏目:
出版日期:
2020-09-18

文章信息/Info

Title:
Effect of Gufusheng on Clinical Efficacy and Hemorheology of Patients with Osteonecrosis
文章编号:
2096-1340(2020)05-0070-06
作者:
王亚国1 王官林2董博2 袁普卫2 杨锋2 刘德玉2 欧国峰3 王国柱3
1.宝鸡市陈仓医院,陕西宝鸡721000;
2.陕西中医药大学附属医院,陕西咸阳712000;
3.陕西中医药大学第二附属医院,陕西咸阳712000
Author(s):
Wang Yaguo 1;  Wang Guanlin 2;  Dong Bo 2;  Yuan Puwei 2;  Yang Feng 2;  Liu Deyu 2; Ou Guofeng 3;  Wang Guozhu 3
1. Baoji Chencang Hospital, Baoji Shaanxi 721000;
2. Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang Shaanxi, 712000;
3. The Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang Shaanxi, 712000
关键词:
骨复生; 股骨头坏死; 疼痛; 关节功能; 血液流变学
Keywords:
TCM;  CAG;  syndrome differentiation;  review;  distention and fullness;  noisy;  stomachache
分类号:
R681.8
DOI:
10.13424/j.cnki.jsctcm.2020.05.018
文献标志码:
A
摘要:
目的通过对股骨头坏死患者治疗前后临床各疗效指标的评价,结合血液流变学指标的检测分析,探讨中药制剂骨复生对早中期股骨头坏死患者的临床疗效及血液流变学的影响,探讨其可能作用机理,为本方的临床合理应用提供依据?方法68例股骨头坏死患者按就诊顺序分为治疗组和对照组,每组各34例,治疗组给予中药骨复生治疗,对照组给予阿仑膦酸钠片治疗,连续服用3个月后观察各组患者治疗前后患髋关节疼痛(静息痛和活动痛)VAS评分?髋关节Harris评分以及血液流变学相关指标的变化?结果①两组治疗后的患髋关节静息和活动时疼痛VAS评分均低于治疗前,具有显著性差异(P<0.05);且治疗组VAS评分降低更明显,组间比较差异具有统计学意义(P<0.05)?②两组治疗后的髋关节Harris各项(疼痛?日常活动和行走能力?畸形?关节活动度)评分和总评分均高于治疗前,具有统计学意义(P<0.05);组间比较,治疗组Harris各项评分和总评分均稍高于对照组,差异具有统计学意义(P<0.05)?③治疗后两组患者的全血黏度200(1/s)?红细胞变形指数( erythrocyte deformation index TK, TK) ? 血浆纤维蛋白原( Fibrinogen b, Fb)?血沉方程K值( Erythrocytesedimentation rate - K, ESR - K) ?红细胞聚集指数( The red cell aggregation index, RE) ?卡松黏度( Casson viscosity c, ηc) ?高切相对黏度( High shear relative viscosity, HRV) ?低切相对黏度( Low Shear Relative Viscosity, LRV)?血浆粘度( Casson viscosity p, ηp) ?血沉( Erythrocyte sedimentation rate, ESR) ?红细胞电泳时间 ( Erythrocyte electrophoresis time, EPT)均较治疗前下降(P<0.05),且治疗组下降更明显,组间比较差异具有统计学意义(P<0.05);但治疗后的全血黏度3(1/s)?30(1/s)?红细胞压积(Hematocut,HCT)?卡松屈服应力( Casson Yield Stress c, γc) ?红细胞刚性指数 ( Index Of Rigidity Of Erythrocyte, IR)?平均网织红细胞体积( Mean reticulocyte volume, MRV)无明显变化(P>0.05)?结论骨复生能缓解早中期股骨头坏死患者的疼痛?改善关节活动受限等不适症状,对患者血液流变学的部分指标也有一定的改善作用?
Abstract:
Objective Combining with the detection and analysis of hemorheology indexes, to evaluate the clinical curative effect and hemorheology of osteonecrosis before and after treatment to explore the clinical effect of Gufusheng and hemorheology of patients in the early and middle stage as well as its possible mechanism, providing the basis for the clinical application of the prescription. Methods 68 patients with osteonecrosis were divided into treatment group and control group according to their registration time with 34 cases in each group. The treatment group was treated with Chinese medicine Gufusheng, and the control group was treated with alendronate sodium tablets. The VAS score of hip joint pain ( rest pain and activity pain) , Harris score of hip joint and hemorheology related indexes were observed before and after treatment in each group. Result ① The VAS scores of hip joint pain at rest and activity in the two groups after treatment were lower than those before treatment with significant difference ( P < 0. 05) ; The VAS score of the treatment group decreased more significantly, and the difference between the two groups was statistically significant ( P < 0. 05) . ② Harris scores and total scores of hip joint ( pain, daily activities and walking ability, deformity, joint range of motion) and total scores of the two groups after treatment were higher than those before treatment with statistical significance ( P < 0. 05) . The Harris scores and total scores in the treatment group were slightly higher than those in the control group with statistical significance ( P < 0. 05) . ③ After treatment, the whole blood viscosity 200 ( 1 / s) , TK, FB, ESR - K, re ( erythrocyte aggregation index) , HC ( Casson viscosity) , HRV, LRV, η P, ESR, EPT ( erythrocyte electrophoresis time) of the two groups were decreased after treatment ( P < 0. 05) , and the decrease in the treatment group was more obvious, the difference between the two groups was statistically significant ( P < 0. 05) . However, the whole blood viscosity 3 ( 1 / s) , 30( 1 / s) , HCT, γ C, IR, MRV had no significant changes after treatment ( P > 0. 05) . Conclusion Gufusheng can relieve the pain of patients with avascular necrosis of the femoral head in the early and middle stage, improve the joint activity limitation and other discomfort symptoms, and also can improve some indexes of hemorheology。

参考文献/References:

[1] Zhang M, Shi CY, Zhou ZL, et al. Bone characteristics, histopathology, and chondrocyte apoptosis in femoral head necrosis induced by glucocorticoid in broilers[ J] . Poult Sci. 2017;96( 6) :1609 -1614.
[2] Fang S, Li Y, Chen P. Osteogenic effect of bone marrow mesenchymal stem cell - derived exosomes on steroid - induced osteonecrosis of the femoral head [ J] . Drug Des Devel Ther,2018,13:45 -55.
[3]朱峰峰,欧国峰,董博,等.补肾活血方对激素性股骨头坏死大鼠股骨头组织中RANKL?Cbfα1表达的影响[J].中医杂志,2019,60(09):779-783.
[4] Arbab D, K nig DP. Atraumatic Femoral Head Necrosis in Adults[ J] . Dtsch Arztebl Int. 2016;113( 3) :31 -8.
[5] Zhang Y, Sun R, Zhang L, et al. Effect of blood biochemical factors on nontraumatic necrosis of the femoral head :Logistic regression analysis[ J] . Orthopade. 2017; 46( 9) :737 -743.
[6]马剑雄,何伟伟,赵杰,等.股骨头坏死发病机制研究的最新进展[J].中国组织工程研究,2017,21(27):4397-4402.
[7]李盛华,邓昶,周明旺,等.中医药防治股骨头坏死临床应用现状[J].中国中医药信息杂志,2018,25(06):137-140.
[8]李晓奇,吉光荣.股骨头坏死保髋治疗现状[J].医学综述,2018,24(23):4683-4688.
[9]陈志伟,李泰贤,万晓旭,等.股骨头坏死误诊相关因素研究[J].中国骨伤,2017,30(11):1000-1003.
[10]赵德伟,胡永成.成人股骨头坏死诊疗标准专家共识(2012年版)[J].中华关节外科杂志(电子版),2012,6(3):479-484.
[11] Gardeniers JW. ARCO interational stage of osteonecrosis[ J] . ARCO Newletter,1993, 5:79 -82
[12] Huskisson EC. Measurement of pain. Lancet, 1974Nov, 2( 7889) :1127 -1131.
[13] Nilsdotter A, Bremander A. Measures of hip function and symptoms: Harris Hip Score ( HHS) , Hip Disability and Osteoarthritis Outcome Score ( HOOS) , Oxford Hip Score ( OHS) , Lequesne Index of Severity for Osteoarthritis of the Hip ( LISOH) , and American Academy of Orthopedic Surgeons ( AAOS) Hip and Knee Questionnaire[ J] . Arthritis Care Res ( Hoboken) . 2011 Nov;63 Suppl 11: S200-207.
[14]惠银银,刘又斌,王晶,等.非创伤性股骨头坏死病因的研究进展[J].中医正骨,2018,30(2):33-36.
[15]宋红梅,魏迎辰,李楠,等.温阳补肾方对兔激素性股骨头坏死组织中骨保护素和核因子-κB受体活化因子及其配体mRNA表达的影响[J].中国康复理论与实践,2019,25(2):178-183.
[16]李永志,董博,欧国峰,等.骨复生对激素性股骨头坏死大鼠骨组织中OPG及RANK表达的影响[J].中国中医骨伤科杂志,2018,26(11):1-6.
[17]吴曦.当归补血汤对早期股骨头坏死大鼠股骨头微结构?OPG/RANKL/RANK?VEGF164/VEGFR2影响的实验研究[D].湖北中医药大学,2018.
[18]范武.中药骨蚀灵胶囊对早期激素性股骨头坏死脂质代谢影响的研究[D].南昌大学,2018.
[19]魏秋实,张颖,曾平,等.活血通络法对静息性股骨头坏死的临床和影像表现的干预作用[J].时珍国医国药,2018,29(4):890-893.
[20]郭中华,都帅刚,张仲博,等.大活络丸加减治疗股骨头坏死痰瘀阻络证的疗效及安全性[J].中国实验方剂学杂志,2018,24(13):172-177.
[21]欧国峰,董博,姚洁,等.小针刀结合骨复生治疗早中期股骨头坏死疗效观察[J].现代中西医结合杂志,2017,26(22):2395-2397.
[22]袁普卫,贺西京,王国毓,等.骨复生胶囊治疗早期儿童股骨头缺血性坏死的临床观察[J].中国中西医结合杂志,2005,25(4):330-332.
[23]辛大森,范猛,姜文学.构建创伤性股骨头塌陷坏死大鼠模型及阿仑膦酸钠预防的机制[J].中国组织工程研究,2014,18(36):5781-5787.
[24]谭钢,康鹏德,裴福兴,等.骨小梁Micro-CT检测评价阿仑膦酸钠预防大鼠激素性股骨头坏死的效果[J].中华关节外科杂志(电子版),2013,7(4):534-538.

相似文献/References:

[1]邓攀,杨乐.中药配合髓芯减压植骨术治疗早中期股骨头坏死疗效分析及对脂代谢的影响[J].陕西中医药大学学报,2020,(6):080.[doi:10.13424/j.cnki.jsctcm.2020.06.018]
　Deng Pan,Yang Le.An Analysis of Curative Effect of Chinese Medicine Combined with Core Decompression and Bone Grafting in the Treatment of Early and Mid - term Femoral Head Necrosis and Its Impact on Lipid Metabolism[J].Journal of Shaanxi University of Traditional Chinese Medicine,2020,(5):080.[doi:10.13424/j.cnki.jsctcm.2020.06.018]

备注/Memo

备注/Memo:
基金项目:国家中管局科研专项(JDZX2015280);全国名老中医药专家传承工作室建设项目(国中医药人教发[2018]134号);陕西省教育厅计划项目(18JK0226);陕西省重点科技创新团队项目(2013KJT-26);关中李氏骨伤流派传承工作室项目(陕中医药发[2018]40号)
通信作者:王官林(1980-)男,硕士,副主任医师,研究方向:中医骨伤?E_mail:924643331@QQ.com
更新日期/Last Update: 2020-09-18