| ObjectiveEvaluate nontraumatic osteonecrosis of femoral head appear bone marrow edema in mri performance with the reason of disease and TCM syndrome differentiation and classification relationship, discuss nontraumatic osteonecrosis appear in bone marrow edema grading and the correlation in Harris score of before and after treatment, explore use benefiting kidney remove stasis Chinese traditional medicine group and remove phlegm stasis Chinese traditional medicine group, respectively treat the patients with steroid-induced osteonecrosis of the femoral head and the patients with alcohol-induced osteonecrosis of the femoral head about the correlation in Harris score of before and after treatment, further research the relationship in the classification of bone marrow edema and osteonecrosis of femoral head of the progression. Further enhance the knowledge of osteonecrosis of femoral head appear bone marrow edema and the knowledge of using differentiation syndrome of tcm to treat NONFH, guide our understanding of the disease prognosis and judgment.MethodsAnalyse the MRI representations of180NONFH patients(306hips), according to the reason of disease and TCM syndrome differentiation and parting is divided into:level0:no bone marrow edema(alcohol-induced25hips, steroid-induced57hips); level1:Bone marrow edema in limited to lesions(alcohol-induced34hips, steroid-induced24hips); level2:Bone marrow edema confined to the femoral head and femoral neck area(alcohol-induced21hips, steroid-induced56hips); level3:The extension of the femoral head bone marrow edema thick long(alcohol-induced64hips, steroid-induced25hips); compare and analys using benefiting kidney remove herbal treatment steroid-induced ONFH patients and using remove stasis eliminating phlegm to use herbal treatment alcoholic ONFH before the treatment and after treatment of different follow-up time Harris score, use column league table material X2inspection and more independent sample comparison of the rank and inspection to compare and analyse bone marrow edema classification respectively with the reason of disease and TCM syndrome differentiation type, Harris score, points NONFH rate of progression.ResultsBone marrow edema in coronary a T2WI and STIR on display the clear, steroid-induced, kidney blood stasis syndrome in patients with ONFH appear in bone marrow edema0,2levels (X2=mainly13.245, P<0.05), alcohol-induced, phlegm and blood stasis accumulate knot type ONFH patients’bone marrow edema1,3class to give priority to (X2=13.838, P<0.05); the severity of the bone marrow edema and after treatment NONFH of the correlation between progression, a statistically significant (X2=49.137, P<0.05); The rank and inspection revealed, and the severity of the bone marrow edema, due after treatment NONFH progression of rate increases; the severity of the bone marrow edema and after treatment NONFH avascular necrosis of the correlation between progression, a statistically significant (X2=49.137, P<0.05); The rank and inspection revealed, and the severity of the bone marrow edema, due after treatment NONFH progression of rate increases; Use benefiting kidney remove stasis herbal treatment steroid-induced ONFH of the patients in the follow-up of3months patients, before treatment (24hips in16cases) and treatment of Harris is after scoring statistics difference (P>0.05); Patients were followed up for6months, before treatment (20hips in13cases) and treatment of scoring more after Harris statistically significant di fference (P<0.05); follow-up of12months patients, before treatment (18hips in12cases) and treatment of Harris is after scoring statistics difference (P<0.05); the final follow-up patients, before treatment (20hips in13cases) and treatment of Harris is after scoring statistics difference (P<0.05); use remove stasis eliminating phlegm to Chinese medicine therapy and alcohol-induced ONFH of the patients in the follow-up of3months patients, before treatment (21hips in15cases) and treatment of Harris score after there wore no statistical difference (P>0.05); patients were fol lowed up for6months, before treatment (21hips in15cases) and treatment of Harris is after scoring statistics difference (P<0.05); Follow-up of12months patients, before treatment (20hips in14cases) and treatment of Harris is after scoring statistics difference (P<0.05); The final follow-up patients, before treatment (19hips in13cases) and treatment of Harris is after scoring statistics difference (P<0.05);138cases of bone marrow edema different classification (including0level40hips, grade1, level224hips, grade335hips) of joint of treatment and therapy before the disease progresses, the X2inspection, the results for the severity of the bone marrow edema and follow-up ONFH after the progress of the differences between rate are statistically significant (X2-49.137, P<0.001);141cases of bone marrow edema different classification of the hip treated with the before and after the treatment of Harris score, compared with that by using t-test, bone marrow edema for grade027hips, before and after the treatment of treatment is statistically significant Harris score (P<0.05); Bone marrow edema for grade141hips, before and after the treatment of treatment is statistically significant Harris score (P<0.05); Bone marrow edema for grade252hips, before and after the treatment of treatment is statistically significant Harris score (P>0.05); Bone marrow edema for grade333hips, before and after the treatment of treatment is statistically significant Harris score (P>0.05).ConclusionBone marrow edema NONFH is in the process of development with a signs, bone marrow, edema and reason of disease of the degree of correlation between age of onset, have no correlation; And NONFH progression of related, and the more serious bone marrow edema, NONFH progression rate also subsequently heighten; Bone marrow edema situation can as evaluation progress and outcome of the indicator; MRI shows edema of the bone marrow for Chinese medicine can delay the stasis theory provides an objective basis of dialectical imaging. |
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