| Objective : By observing the clinical efficacy of Zheng ’s massage combined with external application of traditional Chinese medicine in the treatment of early ARCO I and II stage of qi stagnation and blood stasis type femoral head necrosis,to evaluate its safety and clinical application value,and to provide clinical evidence and data support for the treatment of early femoral head necrosis by Zheng ’s massage combined with external application of traditional Chinese medicine.Methods : From June 2021 to March 2022,80 patients who met the diagnostic criteria and inclusion criteria of early femoral head necrosis were randomly divided into treatment group(40 cases)and control group(40 cases).The control group was treated with external application of traditional Chinese medicine,oral Jintiange capsule,lower limb traction and hip joint function exercise.The treatment group was treated with Zheng ’s massage for 12 weeks on the basis of the control group.The Harris score of hip joint,VAS visual analogue score and X-ray or MRI of hip joint were compared between the two groups,and the adverse reactions were recorded.Finally,the clinical efficacy of the two groups was compared after treatment,and the clinical efficacy of Zheng ’s massage combined with external application of traditional Chinese medicine in the treatment of early qi stagnation and blood stasis type femoral head necrosis was evaluated.Results : A total of 77 patients were included,including 38 in the treatment group and 39 in the control group.(1)The Harris hip scores of the treatment group and the control group were 67.03 ± 6.63 and 65.74 ± 8.06 before treatment,70.92 ± 6.08 and68.28 ± 9.08 at 1 month after treatment,75.84 ± 6.14 and 72.26 ± 8.06 at 3 months,79.84 ± 8.98 and 74.08 ± 8.09 at 6 months,and 84.42 ± 8.88 and 78.46 ± 8.61 at 12 months.The Harris scores of the two groups showed an upward trend with time,and there was a time-group interaction effect(F = 3.777 P = 0.027).The single effect showed that there was no statistical difference between the two groups before treatment and after 1 month of treatment(P > 0.05).After 3 months,6 months and 12 months of treatment,the difference was statistically significant(P < 0.05).(2)The VAS pain scores of the treatment group and the control group were 6.42± 0.826 and 6.10 ± 1.165 before treatment,5.34 ± 0.847 and 5.10 ± 1.119 one month after treatment,4.34 ± 1.021 and 4.41 ± 1.093 three months after treatment,3.58 ±1.004 and 3.95 ± 1.050 six months after treatment,and 2.71 ± 0.956 and 3.15 ± 0.904 twelve months after treatment.The VAS scores of the two groups showed a downward trend with time,and there was a time-group interaction effect(F = 4.976,P = 0.002).The single effect showed that there was no statistical difference between the two groups before treatment,1 month,3 months and 6 months after treatment(P > 0.05),and the difference was statistically significant after 12 months of treatment(P < 0.05).(3)Imaging evaluation showed that there was no statistical difference in the number of cases of improvement,stability and deterioration between the two groups after 1month and 3 months of treatment(P > 0.05).There was a statistical difference in the number of cases of improvement,stability and deterioration between the two groups after 6 months and 12 months of treatment(P < 0.05).(4)After 12 months of treatment,the effective rate of the treatment group was68.4 %,and the effective rate of the control group was 35.9 %.There was significant difference between the two groups(z =-2.650,P = 0.012).Conclusion : Zheng ’s massage combined with external application of traditional Chinese medicine,oral Jintiange capsule,combined with functional exercise and limb traction in the treatment of early ARCO I and II stage of qi stagnation and blood stasis type femoral head necrosis is effective and safe.It can effectively improve the hip function of patients,reduce the pain of patients,improve the quality of life of patients,improve bone marrow edema,promote bone growth,stabilize the shape of femoral head,and delay the progress of the disease.The clinical efficacy is better than that of the control group,which is worthy of clinical application and promotion. |
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