Clinical Studies On Avascular Necrosis Of The Femoral Head Of Children Treated With Cheng Gu Tong Luo Wan

Background: Avascular necrosis of the femoral head of Children (Legg-Perthes disease LPD) is partly or wholy necrosis of femoral head epiphyses caused by deficit of blood circulation. There is no agreement among many views about the etiological factor. It's reported that operation treatment can gain significant effect. Many scholars certificate that traditional Chinese medicine can also gain significant effect. Via clinical observation and experimental investigation, we conclude that the principle is stagnasis of Qi and blood stasis, channel passage block and bone necrosis. We manufacture Cheng Gu Tong Luo Wan on the principle to treat LPD and verify the clinical effect by retrospective analysis to extend the application.Purpose: To observe the clinical curative effect on avascular necrosis of the femoral head of children treated with Cheng Gu Tong Luo Wan, which can activate the blood and eliminate the congestion and dredge Jing Luo to revive the necrotic bone.Methods: We collected the patients under 14 who were diagnosed to be avascular necrosis of the femoral head and treated in the traditional Chinese medicine hospital of ZhangZhou FuJian from 1997 to 2002. All the cases are divided into three groups: the herb group cooperated with skin traction, the surgery group cooperated with skin traction, the activated calcium soluble medicine group cooperated with skin traction according to the following up order and the treated method. We constitute the classifying criterion refering to the evaluation table constituted in the conference on vascular necrosis of the femoral head of adult which was held in 1995 in DanDong LiaoNing. We compared the curative effect of every groups on pain, function, activity of joint and X-ray stages by more point of view and more levels to conclude the difference among various methods.Results: 1-5 years' following up, the success rate of the herb group, the surgery contrast group and the activated calcium soluble medicine contrast group is 91.91%,90.00% and 58.82% respectively. Via T-test and Ridit-test, we can see that there are no significant difference between herb group and surgery group in curative effect (p>0.05), while there are significant difference between herb group and activated calcium soluble medicine group, and between surgery group and activated calcium soluble medicine group in curative effect (p<0.05). The X-ray representation of the herb group and thesurgery group is improved (p<0.01), while the X-ray representation can't be improved in the activated calcium soluble medicine group (p>0.01). In the three grade of X-ray, the prognosi of grade A is the best, grade C is the worst; The prognosi under 7 years old is better than that above 7 years old; The prognosi is better when the course is no more than 3 months, while it's worse when the course is more than 3 months; The effect of 1 year following up is better than that of 1-5 years; There are no diferrence between male and female on clinical curative effect.Conclusion: 1. It's suggested that the new critetion constituted according to the clinical evaluation critetion of avascular necrosis of the femoral head of adult is feasible. 2. Cheng Gu Tong Luo Wan can enhence the curative effect, relieve the pain, function, activity of joint and X-ray representation evidently. It has the similar curative effect with the surgery method. It's the available prescription to cure avascular necrosis of the femoral head of children, 3. There are close relation between the prognosi of LPD and clinical grade classifying, aging, the course, the following up. While There are no diferrence between male and female on clinical curative effect.