Kidney And Activating Blood Method In The Treatment Of Kidney And Blood Stasis Type Femoral Head Necrosis

lObject:Clinical efficacy studies, many ways by traditional Chinese medicine for the treatment of femoral head necrosis Kidney Blood inquiry late femoral head necrosis Chinese medicine in many ways the clinical efficacy, clear advanced femoral head necrosis in the Chinese medicine many ways therapy effectiveness and necessity.2Methods:According to the lssues related to the inclusion criteria, exclusion criteria and exclusion criteria, Wangjing Hospital of June2012to September2012, the income of Chinese Academy of Sciences joint three subjects diagnosed clinical ARCO stage Phase II, Phase III and Phase IV, TCMosteonecrosis of the femoral head in patients diagnosed with Kidney Blood femoral head necrosis, parallel in many ways the treatment of Chinese medicine (line intervention in patients during hospitalization the treatment+TCD oral treatment for6months) of35patients (54hips), according to the exclusion criteria andexclusion criteria,2patient (3hip) off the remaining33patients (51hips), including18hips phase Ⅱ, Ⅲ of29hips, IV phase6hips, its clinical observation to collect general information and collectpatients before and after3months and6months imaging data, Harris score sheet, and SF-36form, more than three subjects intermediate grade doctors in Wangjing Hospital, China Academy of Traditional Chinese Medicine joint expert group, the radiographic parameters of patients enrolledmultiple sets of data using one-way ANOVA analysis methods were evaluated to establish the database, application SPSS19.0for windows statistical software, Measurement data were、expressed as mean±standard deviation (x±S), multiple sets of data using a single-factor analysis of variance and expressed as mean±standard error (Mean±SD).3Results:3.1General informationCollected35cases (54hips), according to exclude and excluding standard, there are2case (3hips) fall off, the remaining33cases (51hips). Male28cases,5cases were female, male to female ratio was5.6:1, the biggest age70years, the minimum age is22years old, average age43.35+43.35. ARCO stage for type ⅡA-Ⅳ,18hips (35.30%) with stage Ⅱ, Ⅲ hips (56.86%),29IV.4hips (7.84%), traditional Chinese medicine (TCM) should be used in many ways therapy for6months.3.2imaging resultsAccording to the expert group of51hips’, breaststroke X line piece of the evaluation results shew:(1) were followed up for3months(compared with before treatment):stable33hips, stability factor64.71%, increase18hips, increase rate of35.29%. Among them18hips in phase Ⅱ,12hips stability, stability factor66.67%, aggravating6hips, increase rate of33.33%; Phase III in29hips, stabilize the19hips, stability factor65.52%, increase10hips, increase rate of34.48%; Stage IV4hips,2hip stability, stability factor50.00%, compound2hip, increase rate of50.00%.(2) followed up for6months(compared with3-month-follow-up):38hips stability(continue to be stable in the3months stable group of33hip31hip, hip increased;3months plus18hips restructuring into a stable for7hips, continues to grow for11hips.7new stable hip Ⅱ of hip Phase Ⅲ3hip IV of hip, new emphasis hip2hip, all Phase Ⅱ), stability factor74.51%, aggravating13hips, increase rate of25.49%. Among them18hips in phase II, stable14hips, stability factor77.78%, compound4hips, increase rate of22.22%; Phase Ⅲ29hips,21hips stability, stability factor72.41%, increase8hips, increase rate of27.59%; Stage IV4hips,3hip stability, stability factor75.00%, increase1hips, increase rate of25.00%.3.3Harris scoring resultsUsing LSD method analysis, into the group of patients before treatment, treatment after3months and6months after the Harris score were compared. By analysis of variance test, highly statistically significant differences between the three sets of data.According to issued by the state administration of traditional Chinese medicine in the diagnosis of disease and curative effect of TCM standards and related literature put forward curative effect evaluation standard:(1)3months after treatment, clinical control0cases, accounting for0%; To patients were markedly improved in1case,3.03%; Achieve effective patients (19cases), accounting for57.58%; To invalid in13cases, accounting for39.39%.(2)6months after treatment, clinical control of patients for1case,3.03%; To reach patients for4cases had marked effect,12.12%; Achieve effective in15patients (45.45%); Achieve invalid patients of13cases, accounting for39.39%. The overall efficiency of more than60%.3.4SF-36table analysis resultsLSD was used eight dimensions of the SF-36Table which is PF (Physiological function for measuring the health status of whether or not to impede the normal physiological activities、RP (Physiological functions for measuring functional restrictions caused due to physical health problems)、BP (Bodily pain, used to measure the degree of pain and pain on daily activities). GH (General health, is used to measure the individual evaluation of their own health status and trends)、VT (Energy used to measure the individual subjective feelings of energy and fatigue)、SF (Social function, measuring the impact of the physical and psychological problems caused by the quantity and quality of social activities for the evaluation of health effects of social activities)、RE (Emotional function for measuring the functional restrictions caused due to emotional problems) and HM (Mental health, is used to measure the four types of mental health programs, including incentives, depression, behavioral or emotional control, psychological subjective feelings) before treatment, after3months of treatment and after6months of treatment integrator comparator, wherein in the PF BP2a dimension between3sets of data, the difference was highly statistically significant, while in the remaining six dimensions3the difference between the set of data does not have statistically significant.3.5The results of correlation analysisThe patients is divided into of two group with after the the treatment for6months in accordance with the the assessed the statistically of of the by imaging results, stability group and processors restructuring, and the two sets of data is carried out T-test. From the results we can be drawn P=0.954>0.05between the two sets of data does not have statistically significant, indicating that the two sets of data relatively close, we can see little difference from the mean of the two sets of data, imaging results were different, but the actualthe score results are close to the imaging is not the only way for the evaluation of femoral head necrosis treatment and results.Conclusion:(1) From the perspective of imaging analysis, traditional Chinese medicine in many ways the treatment of kidney and Blood necrosis of femoral head in the first course of treatment, the overall efficiency of up to60%within six months, and3months of treatmentand6months of treatment, the clinical differences is not obvious.(2)Late in clinical efficacy in patients with avascular necrosis of the femoral head from the correlation analysis, imaging results alone can not determine the same treatment program can not determine the results of imaging alone, it should be combined with multi-angle analysis, synthesis judgment. Imaging results in patients with advanced hip anteroposterior and frog X-ray film is divided into stable group processing restructuring and for comparison, there is no significant difference in the Harris hip score results of the comparison, advanced in patients with avascular necrosis of the femoral head can also use traditional Chinese medicine in many ways therapy.(3) Harris scoring system integrated into the clinical judgment of the physician, that has obvious significance for the assessment early in the course of treatment.(4) SF-36scoring system also has a reference, but taking into account the femoral head necrosis treatment of early medical advice is more restrictive objectively affected that score, but the score of each dimension in the overall trend of stable or rising, the ratings results shou(?) be and analyzed elinieal practice.