Clinical Observation Of Kidney-reinforcing And Blood Circulation-activating Decoction Treatment Of Bone Marrow Edema Symptom

Objective:To determine a feasible and effective way to treat bone marrow edema symptom by using kidney-reinforcing and blood circulation-activating decoction. By observing the clinical effectiveness and patients’ conditions before and after the treatment, we were able to identify the functional mechanism of kidney-reinforcing and blood circulation-activating decoction.Methods:20 patients(11 male,9 female) who had bone marrow edema symptom selected for this study during June 2013 to December 2014 from outpatients and inpatients of Wuhan Chinese Medicine Hospital Orthopedics department. Based on patients’ medical history, symptoms, vital signs, X-Ray and MRI, 2 patients were diagnosed with double side hip necrosis and 18 patients had single side hip necrosis. Hip radiography and MRI of double side hip were performed for all patients.10 patients were randomly selected as test subjects and the other 10 as control. The 10 test subjects were mainly treated with the kidney-reinforcing and blood circulation-activating decoction: Golden Cypress 10g; Rhizoma Atractylodis 10g; Semen Coicis 30g; Radix Cyathulae 15g; Astragalus Mongholicus 20g; Angelica Sinensis 15g; Rehmannia 15g; RhizomaDioscoreae 10g; Poria Cocos 15g; Rhizoma Alismatis 10g; Cortex Moutan 10g; Dogwood 10g; Caulis Spatholobi 30g; Turmeric 10g; Pawpaw 20g; Scorpio 6g; Rhizoma Drynariae 10 g.During the trial period, all other related treatments were discontinued The control subjects were mainly treated with the Celecox capsules. Patients’ conditions such as pain level of the hip, range of motion of the hip joint and Harris hip scores were recorded before and after the treatment. Detailed recorded the changing of patients’ symptoms, understood its clinical efficacy and safety of the medicine.Results:Among 10 cases of the treatment group, 7 subjects were significantly improved, 2 subjects were improved, 1 subject showed no observable response to the treatment,the total efficiency of the treatment group was 90.0%. In the meanwhile, the results of the control subjects as follows: 3 subjects were significantly improved, 3 subjects were improved, 4 showed no observable response to the treatment, total efficiency was 60.0%. Statistical analysis of the results indicated the test subjects had clinical efficacy.The results of the Harris hip scores of the test subjects before and after the treatment were: 54.65±11.61; 84.8±12.32 respectively(P<0.05). The Harris Hip scores showed significant improvements after the treatments, indicating that the efficacy of the Kidney-reinforcing and Blood Circulation-activating Decoction. Subjects from the treatment group also showed significant improvements for hip joint function, hip pain and limp symptoms.Conclusion:The purpose of this study is to ues the kidney-reinforcing and blood circulation-activating decoction for treatment of bone marrow edema symptom. The clinical efficacy and safety research showed that both treatment and control groups haddifferent degrees of recovery. This decoction can treat both symptoms and root causes. Modern pharmacological research and analysis indicated that the functional mechanism might be as follows: 1.Tonify the liver and kidney; 2.Invigorate the circulation of Qi; 3.Clearing heat and promoting diuresis; 4.Promote the organization circulation. Therefore, the treatment for bone marrow edema symptom is effective but warrants further exploration.