Observation Of The Curative Effect Of Traditional Chinese Medicine Fumigation And Washing With Extracorporeal Shock Wave In The Treatment Of Proximal Femur Bone Marrow Edema Syndrome

Objective: To observe the clinical effect of fumigation combined with extracorporeal shock wave in the treatment of proximal femur bone marrow edema syndrome and to provide a new treatment method for the treatment of proximal femur bone marrow edema syndrome.Methods: From January 2016 to December 2016,32 patients with bone marrow edema syndrome of proximal femur were selected from outpatient department of hip injury in Luoyang Zhenggu Hospital,Henan Province.The Chinese medicine fumigation washing was given in the treatment.The temperature of fumigation and washing medicine in the fumigation bed was 60 ? in the external focus impact and functional exercise.The affected side was fumigated for 30 minutes once a day for 20 times.The focal shock wave in vitro was treated with the projective area of bone marrow edema and its surrounding tenderness point as the main shock target with3000 shocks per time.The energy flux density was 9KV(0.16mj/mm2),once every 2days for 10 times.End of treatment The patients were followed up for 12 months.The pain visual score scale(VAS)and hip joint Harris function score were followed up at the 1st and 2nd month after treatment.The patients were followed up with the symptoms of the hip joint after the pain disappeared,and the patients were followed up 12 months after the treatment with MRI.To compare the pain VAS score and hip Harris function score before treatment and 1 and 2 months after treatment,and compare the different bone marrow edema stages,different ages,different course of disease,different site of disease,different TCM syndromes 2 months after treatment.The efficacy of the patients was observed,and whether the MRI image returned to normal after the pain disappeared.Results: 1 cases were removed in the course of treatment and 1 patients were eliminated,and 30 patients completed the test.The total excellent rate of Chinese medicine fumigation combined with extracorporeal shock wave therapy in the treatment of proximal femur bone marrow edema syndrome was 93%,the stability rate of imaging stage was 100%,and the VAS score of pain was significantly lower than that before treatment for first months and 2 months after treatment.All of them were statistically significant(P < 0.05);the Harris function scores of the hip joint were significantly higher than before first months and 2 months after treatment.The difference was statistically significant(P < 0.05).There was no significant difference in the curative effect between the two groups(P > 0.05).The course of treatment was4.51 ±0.99.When the pain disappeared,MRI also returned to normal.No recurrence or necrosis of the femoral head was found in all patients at the end of follow-up.Conclusion: the efficacy of fumigation combined with extracorporeal shock wave in the treatment of proximal femoral bone marrow edema syndrome is significant and safe,and the clinical efficacy is not affected by sex,age,course of disease,TCM syndrome type,site,extent of bone marrow edema and so on.It can be widely used in clinic.When the pain disappeared,the MRI image also returned to normal.The prognosis of the disease is good,generally no recurrence,will not be converted to necrosis of the femoral head.