钻孔减压配合海桐皮汤加味治疗股骨头坏死的临床观察1-clinical observation of drilling decompression combined with haitongpi decoction in the treatment of femoral head necrosis 1.docx

成都中医药大学 成都中医药大学 2007 级硕士学位论文 第 第 PAGE 1 页 摘 要 目的：探讨钻孔减压配合海桐皮汤加味治疗对股骨头坏死的修复效果。 方法：回顾性分析在 2007 年至 2009 年成都中医药大学附属医院与四川省骨科 医院非创伤性股骨头坏死减压术后患者 60 例，其中男性 33 例，女性 27 例。左 髋 30 例，右髋 41 例。年龄 21 岁～68 岁，平均 45 岁。病程 7 月－4 年。坏死骨 共 71 侧，单髋 26 例，双髋 34 例。股骨头坏死按 steinberg 分期：Ib8 侧，Ic11 侧，IIa12 侧，IIb16 侧，IIc14 侧，IIIa10 侧。其中治疗组 30 例，服用海桐皮 汤加味一年。对照组 30 例常规康复治疗。分析两组随访结果，评价临床治疗效 果。 结果：60 例患者获得随访。患者在接受钻孔减压术后服用海桐皮汤加味 1 年， 根据 Harris 评分标准，患者治疗前后髋部疼痛、行走距离与步态、关节活动度。 经统计学处理，结果显示治疗组疗效优良率优于对照组，差异具有统计学意义 (p0.05)。 结论：钻孔减压术后配合海桐皮汤加味治疗能有效地改善股骨头缺血性坏死患 者的临床症状，提高其生活质量。 关键词：非创伤性股骨头缺血性坏死，钻孔减压术，海桐皮汤加味 Abstract Objective: To explore the repair effect of drilling decompression combined Hai Tong Pi tang modification on the necrosis of femoral Head. Methods: 60 patients with necrosis of fe moral head after decompression were collected from 2007 to 2009 in chengdu university of Traditional Chinese Medicine teaching hospital and Orthopedic Hospital of Si Chuan Province. 33 cases were male, female 27 cases. 30 cases of left hip, right hip in 41 cases. Age of 21 to 68 years, mean 45 years. -4 Year course of the disease in July. A total of 71 necrotic bone adjacent to a single hip in 26 cases, 34 cases of bilateral hip. Femoral head necrosis by steinberg stages: Ib8 side, Ic11 side, IIa12 side, IIb16 side, IIc14 side, IIIa10 side They were assigned to control group (treated by routine convalescent treatment ) and treatment group (took hai tong pi tang modification orally except routine convalescent treatment) randomly and there were 30 patients in both groups. Analysis of two sets of follow-up results, the evaluation of clinical treatment. Results: The patients had took hai tong pi tang modification orally for 1 year after drilling decompression operation. The following symptoms got much improved : hip pain,discomfortable sensation of hip ， walking distance and gait, joint activity. Statistical analysis showed an excellent rate of treatment group than the control group, the difference was statistically si