| ObjectiveThrough the application of the Soup of invigorating Kidney and activating Blood cooperate with implant tantalum rod to treatment the early untrauma Avascular Necrosis of the Femoral Head(ANFH),according to the imaging and Harris evaluation,exploring the method’s curative effect,therapeutic effect and possible mechanism.MethodsSelection 36 cases of the early untrauma ANFH from Chinese medicine hospital in henan province and since the January 2013 to January 2014,which conform the diagnostic criteria of ANFH,the standard of Yang deficiency and blood stasis type and the staging criteria of ARCO stage ofⅠorⅡ.Accor ding to the order of contacting the patient,adopting the principle of random divided into the experimental group 18 cases(21 hips)and the control group 18cases(20hips).The examination group,14 cases of male,female 4 cases;the age from 37 to 53(44.2±4.8)years,the duration of the disease from 6 to 15.6(10.0±2.6)months;glucocorticoid-induced 7 cases,6 patients with alco holic,for unknown reasons in 5 cases;On the left side of the 7 cases,right side of the 8 cases,both sides of the 3 cases;ARCO stage,ⅠC stage 3cases,ⅡA stage 3 cases,ⅡB stage 8 cases,ⅡC stage 7 cases;the preoperatively of Harris score was 59.0±3.4 points.The control group,15 cases were male,female 3 cases;the age from 29 to 52(43.1±5.8)years,the duration of the disease from 6 to 16.8(9.9±2.7)months;Glucocorticoid-induced 6 cases,7 patients with alcoholic,for unknown reasons in 5 cases;On the left side of the 9 cases,right side of the 7 cases,both sides of the 2 cases;ARCOstage,ⅠC stage 4 cases,ⅡA stage 5 cases,ⅡB stage 6 cases,ⅡC stage5 cases;the preoperatively of Harris score was 59.1±3.8 points.The comparison between the two groups of age,sex,duration of the disease,cause,site,staging and the Harris score(P>0.05),there was no statistically significant.The control group apply implant tantalum rod surgery,the examination group on the basis of implant tantalum rod surgery,add the soup of invigorating kidney and activating blood,two groups were given conventional postoperative treatment and function exercise.By imaging and Harris score evaluation postoper ative two weeks,six weeks,three mouths,six mouths,one year,two years of the two groups’ curative effect,Compare the differences between two groups preoperative and postoperative,at the same time the postoperative two groups.ResultsTwo groups of patients with follow-up time of 24.5-24.5(26.4±4.3)months.And allⅠhealing of incision,does not appear the adverse complications such as obvious postoperative pain,around the fracture and infection.1.Imaging evaluation results:after 2 years of follow-up,The examination group of 20 hips have no obvious progress;1 hip femoral head slightly sunken,sac variable range increased,byⅡC progress toⅢA.No obvious progress in the control group of 13 hips,in a stable state;2 hips femoral head of bone mineral density is a bit falling,sac change occurs,byⅡA progress toⅡB;3 hip bone mineral density loose within the femoral head is aggravating,sac change scope increased,byⅡB progress toⅡC;1 hip femoral head mild collapse,sac change scope increased,byⅡC progress toⅢA;1 hip serious collapse of femoral head,secondary osteoarthritis change,fromⅡC progress toⅣperiod,the last line of artificial hip replacement.Image evaluation compared two groups,P<0.05,the difference was statistically significant.2.Harris score evaluation results:The examination group and control group in the phase observation to rated,respectively:59.0±3.4,71.3±4.8,80.0±3.1,88.7±4.1,88.6±3.6,88.6±3.8,88.7±4.2 and 58.6±3.8,64.3±3.4,70.4±4.5,79.9±6.4,78.8±9.4,78.7±10.7,77.1±18.9.Compared the two groups postoperative 2 years with before treatment,P<0.05,the difference was statistically significant;Compared the two groups postoperative 3 mouths with postoperative 2 years, P>0.05,there was no statistically significant difference.Postoperative 2 years,Compared with the two groups,P<0.05,the difference was statistically significant.According to the evaluation of Harris score,after 2 years of follow-up,The examination group that optimal in 8 cases(38.1%),good 12 cases(57.1%),general 1 case(4.8%),and poor 0 cases(0%);The control group that optimal in cases(10.0%),good 12 cases(60.0%),general 5 cases(25.0%),poor 1 case(5.0%).The two groups of excellent-good rate was compared,P<0.05, the difference was statistically significant.Conclusion1.the soup of invigorating kidney and activating blood cooperate with implant tantalum rod can Stable the imaging appearances of non traumatic femoral head necrosis,and the latter more stable on imaging appearances,even a benign reverse effect.2.the soup of invigorating kidney and activating blood cooperate with implant tantalum rod can obviously alleviate the pain of hip joint,improve joint function,prevent deformity happening,increase of motion;and the latter more advantages on Harris score evaluation.3.the soup of invigorating kidney and activating blood cooperate with implant tantalum rod can removal of necrotic bone,reduce pressure in the bone,provide effective mechanical support in advance,effectively reduce the femoral head in the bone marrow edema,promote the blood supply of necrotic area reconstruction and the subchondral bone repair and shape,to prevent the collapse of the femoral head.Can yet be regarded as a kind of effective method of prevention and treatment of early ANFH. |
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