Clinical Study Of Bushen Zhuangjin Decoction Combined With Drilling Decompression And Autogenous Bone Grafting In Treatment Of Femoral Head Necrosis Of Liver And Kidney Deficiency

Objective: To observe and summarize the clinical effect of Bushen Zhuangjin Decoction combined with drilling decompression autobone grafting femoral head necrosis with deficiency of liver and kidney,and to provide theoretical support and basis for clinical hip preservation therapy.Methods: A total of 51 patients(72 hips)with femoral head necrosis in Luoyang Bone Boresetting Hospital(Henan Orthopaedic Hospital)and meeting the inclusion criteria were selected and divided into two groups according to the random number table method,in which 26 patients(39 hips)were in the experimental group and 25 patients(33 hips)were in the control group.The experimental group was given core decompression and bone grafting and Bushen Zhuangjin Decoction orally,while the control group was simply given core decompression and bone grafting only.The Harris hip score,visual pain analog score,TCM syndrome score and imaging evaluation were recorded before and 3 months after surgery,6 months after surgery and 12 months after surgery in 2 groups of patients.The data were analyzed and the efficacy of the two groups was compared.Results:(1)There was no statistical significance in gender,site of disease,etiology,age,course of disease,stage and other general data between the two groups(P>0.05),indicating comparability.(2)Harris score of hip joint: Compared with preoperative,Harris score of hip joint in2 groups was significantly improved after surgery,and the difference between each follow-up and intra-group comparison was statistically significant(P<0.05).Comparison between the two groups showed that at 3 months,6 months and 12 months after surgery,the Harris score of the test group was better than that of the control group,with statistical significance(P<0.05).(3)Visual pain analogue score: the postoperative VAS score of both groups was significantly lower than that before surgery,and the VAS score was significantly improved after each follow-up,with statistical significance(P<0.05).Comparison between the two groups showed that the VAS score of the experimental group was better than that of the control group 3 months,6 months and 12 months after surgery,with statistical significance(P<0.05).(4)TCM syndrome score: Compared with preoperative,TCM syndrome score in both groups was significantly improved after surgery,and was significantly improved in each follow-up,with statistical significance(P<0.05).Comparison between the two groups showed that TCM syndrome scores in the experimental group were better than those in the control group 3 months,6 months and 12 months after surgery,with statistical significance(P<0.05).(5)Imaging evaluation: 12 months after surgery,33 hips in the experimental group improved,3 remained unchanged,1 hips deteriorated,and 2 hips failed,with a total effective rate of 92.3%;In the control group,21 hips improved,6 hips remained unchanged,2 hips deteriorated,and 4 hips failed.The total effective rate was 81.8%,and the difference between the two groups was statistically significant(P<0.05).(6)There were no significant differences in liver and kidney function,respiration,pulse,blood pressure,body temperature and other vital signs between 2 groups before and 12 months after surgery(P>0.05).Aderse reactions occurred in both groups after surgery,including 6 cases in the experimental group and 8 cases in the control group,and there was no statistical difference(P>0.05).The symptoms were relieved after symptomatic treatment.Conclusion: Bushen Zhuangjin Decoction combined with drilling decompression autobone grafting in the treatment of ONFH with liver and kidney deficiency can effectively improve the range of motion and pain symptoms,promote repair and delay the progress of the disease,with clear efficacy and can be applied in clinical practice.