Clinical Study Of Treating Early-stage Adult Steroid-induced Avascular Necrosis Of Femoral Head With Gufuhuotang And Interventional Therapy In The Near Future

Objective: To observe and compare Gufuhuotang and Interventional Therapy and Xianlinggubao and Interventional Therapy short-term clinical efficacy of treatment Adult SANFH in InternationalⅠandⅡphases, and evaluate Gufuhuotang right Interventional Therapy treatment of the impact of short-term clinical efficacy of Adult SANFH in InternationalⅠandⅡphases.Method: Select 50 patients which confirm to the diagnostic criteria and inclusion criteria of Adult SANFH in InternationalⅠandⅡphases. Use completely randomized block design of clinical research. 26 patients are treated with Gufuhongtang and Interventional Therapy as the treatment group, 24 patients are treated with Xianlinggubao and Interventional Therapy as the control group. The two groups before treatment are treated by preoperative questionnaire and physical examination, completed preoperative the score of Harris. Both groups use conventional Seldinger method of femoral artery puncture intervention 4 times, each time interval of 7 days. Details for the infusion of drugs are Urokinase 200000 unit,Dextran 40 and Amino Acids Injection 30 mL, PaPaverine 30 mg and injection of red sage root 30 ml. After interventional therapy, both groups are oral enteric-coated aspirin and calcium tablets to enhance drug efficacy, lower limb is not weight-bearing. After the first interventional therapy, the treatment group oral Gufuhuotang which is decocted in water, 1dose per day, oral for 30 days as a course. Observe the therapeutic effect after 1 courses. After the first interventional therapy, the control group Xianlinggubao, 3 pills each time, 3times a day, oral for 30 days as a course. Observe the therapeutic effect after 1 courses. After treatment, complete the score of Harris by questionnaire and physical examination. According to the standards listed in "BONE FRACTURE JOURNAL OF TRADITIONAL CHINESE MEDICINE" and the assessment of response of clinical experience, compare the efficacy of the treatment group with the control group by statistics.Results:Curative effect criteria for evaluation consulted the score of Harris, to compare the difference of the score of Harris between treatment group and control group; and Curative effect criteria for evaluation consulted the standard listed in "BONE FRACTURE JOURNAL OF TRADITIONAL CHINESE MEDICINE" and the assessment of response of clinical experience,to compare curative effect between treatment group and control group.1 The comparison of the difference of the score of Harris between treatment group and control group: Of 36 hips of treatment group, the score of Harris was improved from 73.22士8.07 to 86.86士8.93, the improvement of the score of Harris was 13.64士3.29; Of 35 hips of control group, the score of Harris was improved from 74.06士8.43 to 82.51士10.81, the improvement of the score of Harris was 8.46士3.42. There was significant difference by T test(P<0.05), so the curative effect of treatment group is better than control group.2 The comparison of curative effect between treatment group and control group: Of 36 hips of treatment group, 10 hips were cured, 15 valid, 9 improved, 2 invalid,and the effectiveness was 94.4%; Of 35 hips of control group, 8 hips were cured, 9 valid, 10 improved,8 invalid,and the effectiveness was 77.1%; There was significant difference byⅹ2 test(P=0.036<0.05), so the curative effect of treatment group is better than control group.3 The comparison of effect between phases of treatment group: Of 7 hips inⅠ-A phase, 6 were cured, 1 was valid; of 6 hips inⅠ-B phase, 3 were cured, 3 were valid; of 5 hips inⅠ-C phase, 1 was cured, 2 were valid, 2 were improved; of 7 hips inⅡ-A phase, 4 were valid, 3 were improved; of 7 hips inⅡ-B phase, 4 were valid, 3 were improved; of 4 hips inⅡ-C phase, 1 was valid, 1 was improved, 2 were invalid. There was significant difference by Kruskal-WallisH test(P<0.05).4 The comparison of effect between phases of control group: Of 7 hips inⅠ-A phase, 5 were cured, 1 was valid, 1 was improved; of 5 hips inⅠ-B phase, 3 were cured, 1 was valid, 1 was improved; of 6 hips inⅠ-C phase, 4 were valid, 2 were improved; of 7 hips inⅡ-A phase, 2 were valid, 3 were improved, 2 were invalid; of 5 hips inⅡ-B phase, 1 was valid, 1 was improved, 3 were invalid; of 5 hips inⅡ-C phase, 2 were improved, 3 were invalid. There was significant difference by Kruskal-WallisH test (P<0.05).5 The comparison of curative effect by Interventional Therapy: Of 70 hips of treatment by Interventional Therapy, the score of Harris was improved from 73.63士8.20 to 84.72士10.07, the improvement of the score of Harris was 11.09士1.54. There was significant difference by T test(P<0.05); 18 hips were cured, 24 valid, 19 improved, 10 invalid, and the effectiveness was 85.9%.Conclusion: To treat Adult SANFH in InternationalⅠandⅡphases, Gufuhuotang and Interventional Therapy is better than Xianlinggubao and Interventional Therapy.The result of treating Adult SANFH in InternationalⅠandⅡphases with Interventional Therapy is satisfactory. Early treatment is superior to the later treatment by Gufuhuotang and Interventional Therapy, and early treatment is access to better results.