Analysis Of The Incidence Factors Of Non-Traumatic Femoral Head Necrosis In Early And Middle Stage And Its Clinical Observation

Objective: to collect the clinical data and analyze the non-traumatic necrosis of the femoral head in the early and middle stages,Objective: To observe the clinical effect of Gubao capsule combined with atorvastatin calcium and alendronate sodium,and to evaluate the effect of the treatment on VAS pain score,Harris score,imaging evaluation,related laboratory indicators and toxic and side effects.Methods: 1.Regression analysis of pathogenic factors: a retrospective study was conducted on 264 patients with NONFH who met the inclusion criteria in orthopaedic outpatient and inpatient treatment in Affiliated Hospital of Shandong University of traditional Chinese medicine from March 2018 to March 2019,and 240 patients who met the inclusion criteria in the health and physical examination in Affiliated Hospital of Shandong University of traditional Chinese medicine from March 2018 to March 2019 without NONFH.In this study,two groups will be set up: the patients with NONFH are in the necrosis group;the patients without NONFH are in the control group.The two groups use self-designed forms,and the general baseline data and laboratory data required for the study of the members of the necrosis group and the control group will be collected and sorted out by a specially assigned person after unified training for statistical analysis.2.Drug clinical observation: 70 patients with NONFH in the early and middle period who met the inclusion criteria were randomly divided into experimental group(Gubao capsule combined with atorvastatin calcium and alendronate sodium)and control group(atorvastatin calcium combined with alendronate sodium)from March 2018 to August2019 in the orthopaedic outpatient and inpatient department of the Affiliated Hospital of Shandong University of traditional Chinese medicine.Each group contained 35 patients.The general baseline data of patients were collected,and VAS pain score,Harris score and shadow were measured before and after treatment Imaging evaluation,blood lipid level and other laboratory indicators,data analysis.Results: 1.Regression analysis showed that there were significant differences between the necrotic group and the control group in gender,drinking history,hormone use history,Serum triglycerides(TG),cholesterol(CHOL),low densith lipoprotein(LDL),D-dimer level,prothrombin time(PT),activated partial thrombin time(APTT)(P < 0.05).The results of multivariate logistic regression analysis showed that the genders were male(OR = 2.382,P = 0.010< 0.05),had drinking history(OR = 3.601,P = 0.008< 0.05),had hormone use history(OR = 7.474,P = 0.002 < 0.05),TG increased(OR = 1.414,P = 0.008< 0.05),CHOL increased(OR = 2.379,P = 0.009 < 0.05),LDL increased(OR = 1.632,P =0.027 < 0.05),D-dimer level increased(OR = 1.919,P = 0.006 < 0.05),prothrombin time(PT)(OR = 2.617,P = 0.002 < 0.05)and APTT(OR = 1.316,P = 0.002< 0.05)were independent risk factors for the occurrence of NONFH.The results of drug clinical observation showed that: after two courses of treatment(180 days),12 patients were excluded from the study(5 in the experimental group and 7 in the control group);the general clinical baseline data of the two groups(30 in the experimental group and 28 in the control group)were comparable(P > 0.05);after treatment,the experimental group improved the VAS pain score,Harris score,imaging evaluation and coagulation function of patients The level of energy,blood lipid and ALP in serum were better than those in the control group(P < 0.05).Neither the experimental group nor the control group had serious adverse reactions.Conclusion: 1.Male,drinking history and hormone use history were the independent risk factors for the onset of NONFH;the increase of serum triglyceride(TG),cholesterol(CHOL),low-density lipoprotein(LDL)and D-dimer were the independent risk factors for the onset of NONFH;the decrease of prothrombin time(PT)and activated partial thrombin time(APTT)were the independent risk factors for the onset of NONFH2.Gubao capsule combined with atorvastatin calcium tablets and alendronate sodium can effectively alleviate the symptoms of patients with NONFH,improve the limb function,promote osteogenesis,reduce the relevant laboratory indicators,and contribute to the prognosis of the disease.