Clinical Study Of Jianpi Zhubi Decoction Combined With Extracorporeal Shock Wave In The Treatment Of Phlegm-stasis Blocking Collateral Necrosis Of Femoral Head

Objective: To investigate the clinical efficacy of Jianpi Zhubi Decoction combined with extracorporeal shock wave in the treatment of patients with phlegm-stasis blocking necrosis of femoral head and evaluate the therapeutic effect.Methods: A total of 76 patients who were treated in the orthopaedics Department of the East Hospital of Shijiazhuang Hospital of Traditional Chinese Medicine from December 2021 to December 2022 were seleted,then they were divided into the treatment group and control group using the random number table method,with 38 cases in each group.The control group was treated using extracorporeal shock wave therapy combined with functional exercise,while the treatment group was given Jianpi Zhubi Decoction orally on the basis of the control group.Visual simulation scores,Harris hip function scores,imaging scores,and TCM syndrome scores of the two groups before and after treatment were recorded respectively to calculate the TCM efficacy.SPSS25.0 software was used for statistical analysis of relevant data,and P > 0.05 indicated no statistically significant difference.P < 0.05 indicated statistically significant difference,and P <0.01 indicated statistically significant difference.Results:(1)Visual analogue scale comparison: after treatment,the intra-group comparison showed that the ONFH related conditions were both improved(P < 0.01).Compared between the two groups,the effect in the treatment group was significant difference(P < 0.01).(2)Harris hip function score comparison: After treatment,both of them were improved(P< 0.01),and the treatment effect of the treatment group was significant difference(P < 0.01).In terms of contents,after treatment,the pain,function,deformity and mobility of the two groups were all enhanced(P <0.01).By comparison between the two groups,the results showed that the treatment effect of the treatment group was better in terms of pain,function and activity(P < 0.01),but there was no difference in the effect of deformity between the two groups(P > 0.05).(3)Comparison of imaging scores: X-ray score,after treatment,the treatment group had a significant improvement(P < 0.01),the control group was not good(P > 0.05),the comparison between the two groups,the treatment group was better than the control group(P < 0.05).After treatment,the effective rate of femoral head morphology and necrotic area in the treatment group was higher than that in the control group,and the effective rate of osteoarthritis in the two groups was the same.In terms of BME score,after treatment,compared within the two groups,the treatment group had a significant improvement(P < 0.01),while the control group had a poor effect(P > 0.05).Compared between the two groups,the treatment group had a better effect than the control group(P < 0.05).(4)After treatment,compared within the two groups,the overall TCM syndromes were improved(P < 0.01);compared between the two groups,the therapeutic effect was more significant in the treatment group(P < 0.01).In terms of various contents,after treatment,the two groups in pain,joint heaviness,chest fullness and tightness,cough,sputum and saliva,tongue image,pulse image,the treatment group in terms of tongue image,effective treatment(P < 0.05),in terms of pain,joint heaviness,chest fullness and tightness,cough,sputum and saliva,pulse image,there were significant therapeutic effects(P < 0.01).In the control group,the treatment effect on chest fullness,cough,sputum and salivation,tongue and pulse was not good(P > 0.05),and the treatment effect on pain and joint heaviness was significant(P < 0.01).The results showed that the treatment effect of the treatment group was similar to that of the control group in terms of pain(P > 0.05),the clinical efficacy of the treatment group was better than that of the control group in terms of joint heaviness and pulse image(P < 0.05),and the clinical efficacy of the treatment group was significantly better than that of the control group in terms of chest swelling and stuffy,cough,sputum and tongue image(P < 0.01).(5)Comparison of curative effect of traditional Chinese medicine: after treatment,the effective rate of the treatment group was 91.18%,and that of the control group was 55.88%.After comparison between the two groups,the difference was statistically significant,indicating that the effect of the treatment group was significant(P < 0.01).Conclusion: Jianpi Zhubi Decoction combined with extracorporeal shock wave therapy can effectively improve the pain,dysfunction and TCM related syndroms of patients with phlegm-stasis blocking collateral necrosis of femoral head,improve the imaging manifestations,and the treatment process is safe and reliable.