Clinical Observation On The Treatment Of Femoral Head Necrosis In The Treatment Of Collapsed Collapse By Tonifying The Spleen And Tonifying The Kidney Combined With Femoral Head

Objective:Based on clinical cases were analyzed retrospectively, observe curative effect after the femoral head plastic operation combined with traditional Chinese medicine, which is used as a treatment of the osteonecrosis of the femoral head (ONFH) in the time period surrounding collapse. Contrast this treatment method with traditional Chinese medicine only. And discusses it to treat ONFH the action mechanism, and for the treatment of ONFH in the time period surrounding collapse of the exploration of an effective surgical method, and the evidence of chosen.Methods:1.From June 2011 to March 2015,40 hips in 40 patients, who were diagnosed ONFH in the time period surrounding collapse in Guang’anmen Hospital, China Academy of Chinese Medical Sciences were gathered. To divide 40 cases ONFH patients into 2 groups,20 cases used traditional Chinese medicine is control group,20 cases used the femoral head plastic operation combined with traditional Chinese medicine is surgical group.2.All patients were adopted the preoperative and postoperative follow-up evaluation criteria of clinical curative effect by Harris score, preoperative X-ray analysis and postoperative symptoms, changes in X-ray films.Results:There are 40 patients totally in 2 groups, experimental group 15 men (15hips) 15,5 women (5 hips), control group 16 men (16 hips),4 women (4 hips). About follow-up time, surgical group is 1.75±0.60 years on average, the control group to observe time 1.56±0.65 years on average. The surgical cases by Steinberg stage, II stage 4 hips,III stage 1 hips, IV A stage 15 hips; The control group cases by Steinberg stage, II stage 7 hips, III stage 1 hip, IV A stage 12 hips. At the end of the follow-up of 1 year, in the surgical group,1 patients with II stage progress for IVA stage, in the control group,1 case II stage patients progress to III stage,2 cases of II stage patients progress to IVA,5 cases IVA stage patients progress to IVB stage, the rest of the patients with clinical stage does not change significant progress. By matching nonparametric test found that surgical group and the control group no statistical difference between the starting stage (P> 0.05); No statistical difference between surgical group and control group in end stage (P> 0.05). The collapse of two groups of patients with changes in the first 3 months, P= 0.000, P< 0.05, there is statistical significance. During3 to 6 months,6 to 9 months,9 to 12 months of observation period, P>0.05, and there is no statistical significance, it can be thought of its collapse degree changes have no difference. Harris scores from the observed initial collapse degree through after treatment to reduce 1.16±0.73 mm to 0.72±0.48 mm, control group since the initial collapse 1.04±0.98 increased to 1.35±0.96 mm. Scores of starting Harris scores of the surgical group is 71.90±9.93, up to the follow-up at the end of the 84.80±10.38; In the control group, Harris scores by 80.30±16.42 to 86.20±11.39. The start and end Harris score in the surgical group and the control group have no statistical difference (P> 0.05).Conclusion:1.Through the femoral head plastic operation combined with traditional Chinese medicine and traditional Chinese medicine only, they both can obviously improve the function of patients with hip joint, and the influence in increasing the degree of the hip joint function between the two treatments is quite.2. The femoral head plastic operation combined with traditional Chinese medicine can improve the blood circulation within the femoral head,at the same time, reduce bone internal pressure. In addition to this, using bone graft to provide the necessary support, prevent further collapse of the femoral head. No matter from the collapse of variations of follow-up period or the final subsidence extent comparing, the femoral head plastic operation combined with traditional Chinese medicine effect is more reliable. We can figures out in the process of long-term treatment, the treatment of the femoral head plastic operation combined with traditional Chinese medicine, can play a brake in the further development of collapse, consequently delay the joint replacement.