| Objective:Through the study of osteonecrosis of the femoral head,To further analyze the physical distribution of ONFH patients,and to make statistics on the patients’gen der,age,nationality,occupation,body mass index,etiology,location of disease,treatm ent type,biochemical items,coagulation series,blood routine data,so as to explore th e risk factors of TCM Constitution of ONFH patients and the value of constitution de termination Objective to provide a reference for further exploring the pathogenesis of ONFH,and to provide a diagnosis and treatment idea for the early and mid-term TC M treatment of ONFH patients.Methods:In the inpatient department of Gansu Provincial Hospital of traditional Chines e medicine,1126 cases of ONFH patients from 2015 to 2020 were collected and scre ened in strict accordance with the inclusion and exclusion criteria.A total of 1126 cas es were determined by TCM Constitution and medical records were reviewed.Excel d atabase was established with fields including gender,age,nationality,occupation,body mass index,etiology,location of disease,treatment type,biochemical items,coagulati on series and blood routine Rules.Spss25.0 statistical software was used to analyze th e data,and the correlation between different constitutions of ONFH patients and the a bove data was obtained.Results:(1)A total of 1126 ONFH patients were included in this study.Among the bi ased constitutions,blood stasis accounted for 25.40%,Qi deficiency accounted for 15.99%,phlegm dampness accounted for 13.77%,Yang deficiency accounted for 11.01%,while qi depression,yin deficiency,damp heat and special nature were relatively less.The ratio of male to female was 1.21:1.The average age of this study population:54.14±5.53 years old,male:52.26±5.53 years old,female:56.43±10.78 years old.Traumatic ONFH accounted for 29.40%,non traumatic ONFH accounted for 70.60%,non traumatic ONFH hormone accounted for 24.40%,alcohol accounted for 7.05%,ot her accounted for 68.55%.BMI<18.5 accounted for 1.95%,18.5≤BMI<24 accou nted for 40.32%,24≤BMI<28 accounted for 46.80%,BMI≥28 accounted for 10.93%.Grade I manual labor accounted for 19.27%,grade II manual labor accounted fo r 15.54%,grade III manual labor accounted for 13.68%,grade IV manual labor accou nted for 51.51%.The Han nationality accounted for 90.32%,and the minority national ity accounted for 9.68%.Single hip accounted for 68.65%,double hip accounted for 31.35%,left hip accounted for 46.57%,right hip accounted for 53.43%.(2)Compared with non Qi deficiency ONFH patients,the mean value of high density lipoprotein,tri glyceride and plasma fibrinogen were higher,and there was correlation between Qi de ficiency ONFH patients and plasma fibrinogen.The difference of platelet and indirect bilirubin between ONFH patients with Yang deficiency and non Yang deficiency was s tatistically significant.Compared with non Yang deficiency ONFH patients,the mean v alue of platelet was higher and the mean value of indirect bilirubin was lower.Moreo ver,there was correlation between ONFH patients with Yang deficiency and platelet.Compared with non phlegm dampness ONFH patients,the mean value of serum uric acid was higher,the mean value of serum iron was higher,the mean value of serum chlorine was lower,and there was correlation between phlegm dampness ONFH patien ts and serum uric acid.There were significant differences in hemoglobin,carbon dioxi de binding capacity,zinc and calcium between patients with and without damp heat O NFH.Compared with patients with non damp heat ONFH,the mean value of hemogl obin was higher,the mean value of carbon dioxide binding capacity was lower,the m ean value of zinc was higher,and the mean value of calcium was higher.Moreover,patients with damp heat ONFH were correlated with hemoglobin,zinc and calcium.C ompared with non blood stasis ONFH patients,the mean value of leukocytes,basophil s and phosphorus were lower,and the patients with blood stasis ONFH were correlate d with the absolute value of leukocytes and basophils.Conclusion:(1)The high incidence of bias constitution in ONFH patients in this study was blood stasis,Qi deficiency and phlegm wet quality in turn;the patients were ma le,obese,middle-aged,and engaged in level IV physical labor(i.e.heavy manual labo r),non-traumatic ONFH patients were more than those with traumatic ONFH,and mor e patients with right hip joint.(2)The relationship between the determination of ONF H and plasma fibrinogen was found.If the plasma fibrinogen was≥2.745g/l,it was possible to diagnose the patients with ONFH as Qi deficiency.The patients with Yang deficiency had correlation with platelet and indirect bilirubin,and it was possible to diagnose the patients with ONFH as Yang deficiency when the platelet was≥2.745 ~x10~9/l;when the indirect bilirubin≥10.605umol/l,it was possible to diagnose the pati ents with ONFH as Yang deficiency.There was a correlation between the patients wit h ONFH and the blood uric acid,and it was possible to diagnose the patients with O NFH as phlegm wet matter when the serum uric acid was 326.5umol/l.The patients with wetness and heat matter were correlated with hemoglobin,zinc and calcium,and it was possible to diagnose the hygrothermal in ONFH patients when hemoglobin wa s≥134.5g/l;when zinc≥14.115mmol/l,it was possible to diagnose the patients with ONFH as hygrothermal;when calcium≥2.435mmol/l,it might be the diagnosis of t he hygrothermal in ONFH patients.The patients with blood stasis ONFH have correlat ion with the absolute values of leukocyte and basophil,and it may be diagnosed that the patients with ONFH are blood stasis when the leukocyte is≥5.495~x10~9/l;if the a bsolute value of basophils is≥0.025~x10~9/l,it is possible to diagnose the blood stasis in ONFH patients. |
PDF Full Text Request