Clinical Observation On The Treatment Of Early Femoral Head Necrosis (phlegm And Blood Stasis Obstruction Syndrome) With Analgesic And Bone-strengthening Prescription Combined With Adipose-derived Stem Cell

Objective:To observe the clinical effect of adipocytes and zhitongjiangu decoction combined with adipocytes in the treatment of early femoral head necrosis(phlegm and blood stasis blocking collateral syndrome).Methods:In adult avascular necrosis of femoral head necrosis in the clinical diagnosis and treatment guidelines(2016)(ONFH)diagnostic criteria and phlegm and blood stasis resistance collaterals syndrome patients 30 cases of femoral head necrosis,randomly divided into treatment group,the adipose stem cells group and combination group three groups,including foundation treatment group(10 cases,adipose stem cells group of 10 cases,combined treatment group(10 cases.The basic treatment group was treated with decompression of the pulp core.The adipose stem cells group was isolated and cultured from abdominal adipose tissue,and then injected into the decompression orifice of the pulp core.The combined treatment group was additionally treated with Zhitong Jiangu Granule for oral treatment on the basis of adipocytes group.The basic data of patients were recorded,and Harris score,imaging score and TCM symptom integral quantitative score were observed in the three groups before treatment,1 month after treatment,3 months after treatment and 6 months after treatment.Statistical software SPSS23.0 was used for statistical analysis of all observed data.Results:Intra-group efficacy analysis: There were no significant differences in Harris score,imaging score and TCM symptom quantification score of patients in the three groups before treatment by one-way an OVA test,indicating comparability.Repeated measurement test showed that Harris score,imaging score and TCM symptom quantification score trend of patients in the three groups were different with different observation time,and there was an interaction between treatment effect and time.Analysis of intergroup efficacy:(1)Harris score: The Harris score of patients in the three groups was significantly improved compared with that before treatment,and the trend was different with the observation time.At 3 and 6 months after treatment,Harris scores in the adipose stem cell group and the combined treatment group improved more significantly than those in the basic treatment group(P < 0.05),and at6 months after treatment,the effect of the combined treatment group was better than that of the adipose stem cell group(P < 0.05).(2)Imaging score: The imaging score of patients in the three groups was significantly lower than that before treatment,and the trend was different with the observation time.At 3 and 6 months after treatment,the reduction in imaging scores was more significant in the adipose stem cell group and the combined treatment group(P < 0.05),and the combined treatment group had better effects(P < 0.05).(3)TCM symptom quantification score: THE TCM symptom quantification score of patients in the three groups was significantly lower than before treatment,and the trend was different with the observation time.At 1,3and 6 months after treatment,the effect of the combined treatment group with Chinese medicine was more obvious(P < 0.05).(4)Effective rate: significant P values between the three groups were all > 0.05 at 3 months and 6 months after treatment,indicating that there was no significant difference in effective rate between the three groups at 3 months and 6 months.Safety evaluation and adverse reactions: Before and during the treatment,the patient’s vital signs were stable,and there were no obvious abnormalities in three routine tests and electrocardiogram.There was 1 case of hip pain in the conventional treatment group,3 cases in the adipose stem cell group,and 1 case in the combined treatment group,all of which underwent no special treatment and resolved within 1week.During the follow-up period,there were no cases of fever,infection,immune rejection,canceration or death.Conclusion:The treatment of femoral head necrosis by decompression of marrow core combined with adipocytes and oral analgesic and bone strengthening prescription can effectively relieve pain and dysfunction and improve TCM related symptoms.The effect of zhitong Jiangu prescription combined with pulpocore decompression and adipose stem cell therapy was more obvious in Harris score,imaging score and TCM symptom quantitative score compared with that of pulpocore decompression and adipose stem cell therapy.