Traditional Chinese Medicine Conservative Treatment Of Femoral Head Necrosis By Digital Evaluation

ObjectiveProvide a reference of the digitized evaluation method based on CT image processing software to analyze the traditional Chinese medicine conservative treatment of early and medium femoral head necrosis, femoral head necrosis volume, gray value changes, for the Chinese medicine conservative treatment stock bone necrosis clinical evaluation.Method1.we selected 36 cases of avascular necrosis of the femoral head by the first half of the conservative treatment of traditional Chinese medicine, By imaging experts on the case of image analysis, X-ray showed that patients with necrosis of femoral head, good stable morphology. A total of 24 patients were enrolled.2.CT. Data were collected before treatment in the Dicom 3 format. Respectively. By junior high and junior two groups of different clinical orthopaedics doctors using digital image processing software of avascular necrosis of the femoral head were CT DICOM data segmentation. Analysis of the patient’s image. And the line chart (Figure 15)by experts on patients with ONFH. Finally. A total of 14 cases of the two groups of staff after the division of the femoral head necrosis volume is consistent, in line with the selected cases.3.1n 14 cases, for Patient1-14 (P1-14), The normal test, the data of the two groups of bone necrosis volume (NV), gray (NI), femoral head gray (FI) Necrosis of femoral head and volume change ratio (VR), femoral head necrosis area and gray change ratio (IR) with teenage boy distribution).4.The area of necrosis of the femoral head after segmentation analysis. Mainly from the necrosis volume (volume of bone necrosis, NV), the volume of the femoral head (femur volume, FV), bone necrosis volume and the volume of the femoral head ratio (volume ratio, VR)=Necrosis Volume/(femur volume, VR=NV/FV) and treatment before and after volume change ratio (total, change in volume ratio, V变= (VR after-VR Before)/(VR after+VR Before).that some aspects of femoral head necrosis treated patients before and after the change of evaluation. Mainly from the aspects of the gray analysis(Necrosis Volume, NV)、(Femur Volume, FV)、(Volume Ratio, VR)=Necrosis Volume/(Femur Volume, VR=NV/FV) (Change Total in Volume Ratio, V变)= (VR after-VR Before)/(VR after+VR Before). At the same time, the traditional evaluation method, before and after the treatment, the patients with Harris evaluation, SF-36 evaluation, image evaluation were analyzed, observed before and after the treatment, the traditional indicators of efficacy evaluation, digital indicators of efficacy evaluation and their correlation.Conclusion1.The traditional evaluation results.(1)Before treatment,the Harris hip score for 73.39±12.51, pain score was 30.32±6.63 points, joint deformity 3.66±0.03 points, joint activity score for 4.40±0.96 points. After treatment for half a year, Harris score for 80.67±12.10 points, pain score was 34.42±6.23, joint deformity 3.98±0.09 points, joint activity score for 4.90±0.35 points. Average score increased 7.28±2.41 points, pain intensity score increased 4.10±1.40, joint deformities increase 0.32±0.06 points, joint activity score increase 0.50±0.24, Improved compared with before treatment, P<0.05, there was statistical significance. One year of treatment in patients with Harris hip score was 87.67±12.15 points, pain intensity score 38.42±5.26 points, the score of joint deformity of 3.98±0.09, joint activity score 4.90±0.55 points, scoring function is 40.48±5.51 points. Harris score increased an average of 13.68±4.36, pain score increased 8.10±3.37, joint deformity score increase 0.32±0.16, joint activity score increase 0.50±0.37, function score improved 5.58±2.25. Compared with before treatment improved significantly, P<0.01, there was statistical significance.(2)Before treatment, physiological function score 67.21±15.60 points, the scores of physiological functions to 32.45±7.28, overall health score 46.90±21.38, role emotional score 44.72±4.79 points, bodily pain score was 58.20±13.89, activity score 70.65±11.59 points, social function scores 56.38±17.24 points. Treatment for half a year and the physiological function score was 72.31±16.1 points, the scores of physiological function for 34.42±6.23, overall health score 51.90±23.35 points, role emotional score 50.72±3.76, bodily pain score 62.1±14.09, activity score 77.48±11.51 and social function scores 60.38±15.34 points. After treatment, the scores of physiological function for six months increased 5.10±2.50 points, physical function scores increase 1.79±1.03 points, general health scores improve 5.00±2.03 points, emotional function scores improve 6.00±1.03 points, bodily pain scores improve improve 3.98±1.10, vitality score 4±2.10 points to improve the 6.83■1.23 and social function scores. Improved compared with before treatment, after statistical analysis, P<0.05, there was statistical significance. Treatment in a physiological function score 81.65±16.32 points, the scores of physiological functions to 42.36±3.28, overall health score was 59.51±17.44 points, emotional function score of 67.46±4.74, bodily pain score70.91±18.11, activity score was 71.74±16.85 points, social function scores 72.56 ±23.61 points. To improve the treatment, the physiological function scores improve 14.41±4.45, physical function scores improve 10.25±3.02, general health 9.39±4.27, emotional function score 23.28±8.45, bodily pain scores increase 12.71±5.73 and social function scores improved 12.23±5.67. Compared with before treatment improved obviously, after statistical analysis, P<0.05, there was statistical significance.(3)This group of patients were selected after treatment, X-ray showed good repair, the morphological stability of osteonecrosis of the femoral head in patients with, so half a year after treatment and before treatment compared image stabilization rate was 100%.2.Digital evaluation(1)Before treatment, the necrosis area volume 7325.29±4808.26 (mm3), maximum 17854 (mm3), minimum 2009 (mm3), After the treatment of bone necrosis volume 6460.29±3956.24 (mm3),maximum 15422 (mm3),minimum 1488 (mm3).By statistical analysis, numerical bone necrosis volume decreased, P<0.01, there was statistical significance.(2)Before the treatment of osteonecrosis of the gray value of 5958.64 ± 1655.50, gray maximum 9137, gray minimum 3903. After the treatment of osteonecrosis of the gray value 6610.71 ± 2088.75, maximum gray is 11409, gray minimum value is 3709. By statistical analysis, numerical bone necrosis area gray rise, P<0.05, there was statistical significance.(3) Before the treatment of femoral head gray value of 10386.14 ± 1138.58, maximum gray is 11975, gray minimum value 8637. The treatment of femoral head after the gray value is 10553.57 ± 1286.66, maximum gray is 11409, gray minimum value is 8667. By statistical analysis, the gray value of femoral head increased, P<0.05, there was statistical significance.(4)Before the treatment of osteonecrosis of the femoral head volume area volume ratio is 0.14±0.80, the maximum value is 0.33, the minimum value is 0.04. After the treatment of osteonecrosis of the femoral head volume area volume ratio is 0.13±0.65, the maximum value is 0.04, the minimum value is 0.28. By statistical analysis, bone necrosis volume for volume ratio of femoral head decreased, P< 0.01, have statistical significance.(5)Before the treatment of gray value accounted for the femoral head osteonecrosis region gray value ratio (IR) was 0.54±0.19, the maximum value is 0.82, the minimum value is 0.11. After the treatment of gray value accounted for femoral head necrosis bone gray value ratio (IR) was 0.57±0.22, the maximum value is 0.95, the minimum value is 0.03. Osteonecrosis region gray value accounted for femoral head gray value ratio, P= 0.15, (P> 0.05), no significant difference by statistical analysis.(6)The necrosis area ratio value of volume change after treatment, P1=-25.2, P2=-12.9, P3=-26.6, P4=-13.8, P6=-18.7, P7=-6.6, P8=-2.3, P9=-13.3, P10=-2, P12=-16.2, P14=-14.5, There is a decreasing trend. P5= 1.5, P11=33.7、P13=13, The ratio of gray change, P1=23.3, P4=0.9, P5=6.2, P6=16, P8=5.9, P9=17.9, P10=11.1, P12=3.3, P13=45.1, P14=3.1, The gray value changes of the ratio of upward trend.3.Correlation between evaluation and efficacy of digital imaging.(1)After treatment, the image stabilization rate was 100%, the volume change value reduction ratio of 78.57%, volume change value and a higher ratio of 21.43%, stable imaging rate evaluation and volume change ratio was negatively correlated.(2)After treatment, the image stabilization rate was 100%, the gray value ratio increased 78.57%, volume change value ratio decreased by 21.43%, stable imaging rate evaluation and gray value is positively correlated with the ratio.Results(1)Traditional Chinese medicine conservative treatment can effectively improve the shares of patients with osteonecrosis of the femoral head hip joint function and relieve the hip pain, stability and reduce femoral head necrosis region volume, improve the stock bone necrosis area of the gray value, thereby effectively enhancing the support ability of ONFH of the weight-bearing area and lower femoral head necrosis collapse risk.(2)The application of digital image processing software to assess the clinical efficacy of traditional Chinese medicine conservative treatment is feasible. Through digital indicators, for TCM preserving hip treatment of early and medium ONFH clinical curative effect provides a new method for evaluating the efficacy.