Analysis Of Perioperative TCM Syndromes In Alcohol-induced Femoral Head Osteonecrosis Patients

Objective:The purpose of this retrospective research is to review and summarize the perioperative TCM syndromes and the Chinese medicine principles of alcohol-induced femoral head osteonecrosis and the clinical symptom and signs of these patients during the period. We also want to analyze the risk of alcohol withdrawal symptoms for the operation, and the risk and difficulty for medical care and nursing after the operation. This will provide clinical guidelines to evaluate the safety of the surgical operation and perioperative clinical works, and help the rehabilitation of the patients.Method:666patients were hospitalized for primary diagnose of femoral head osteonecrosis in our hospital in the past8years(2003-2010). Completed data was obtained retrospectively from the hospital medical records. The general clinical information, such as the proportion of alcohol-induced femoral head osteonecrosis, the distribution, and related syndromes associated with withdrawal stages of alcohol abstinence, TCM syndromes and the Chinese medicine principles were all reviewed from the medical data of the inpatients. Clinical parameters such as the sex-specifics, bleeding volume of operation, wound drainage volume and the constitutions of the patient were analyzed with multiple statistics methods. TCM syndromes and the Chinese medicine prescription were summarized and analyzed to find the usual regular pattern.Results:There were132alcohol-induced femoral head osteonecrosis patients in666cases of the femeral head, account for19.8%of all the patients All the patients were male, aged49.7±22.7years old, and were mainly in middle-age. Deficiency of liver and kidney, Qi stagnation and blood stasis is the most types of TCM syndromes in these patients, there were71cases, and53.8%of all alcohol-induced femoral head osteonecrosis patients before the operation. And Qi stagnation and blood stasis was the main syndromes after the operation, account for54.3%of these patients. TAO HONG SI WU TANG with addition and subtraction was the most used proscription, and this reflected the therapy principle of promoting blood circulation to remove stasis in the prescription of TCM.Of all the alcohol-induced femoral head osteonecrosis patients,87cases were taken the total hip replacement(THR), accounting for61.4%, and35cases showed the alcohol withdrawal symptoms during hospitalization, about26.5%of these patients. The age of them is52.9±18.1years old.9cases occurred before operation (of which,3cases were discharged from hospital before operation with emotional requirements),32cases were surgery for THR,26cases showed the syndromes after the operation. There were not any withdrawal symptoms records during the operation period.The bleeding volume of alcohol-induced femoral head osteonecrosis (441.31+/-69.48mL) was significantly higher than that of the traumatic or none identify reason femoral head osteonecrosis (382.15+/-57.37mL) during total hip replacement operation (P<0.05). Comparing the wound drainage volume after the operation of the patients with alcohol withdrawal symptoms (487.37+/-51.16mL) and without these symptoms(378.56ml+/-51.16mL), alcohol-induced femoral head osteonecrosis (378.56+/-50.43mL) and the traumatic or none identify reason femoral head osteonecrosis (346.63+/-48.57mL), the difference was statistical significance.Conclusion:Pathological alcohol-induced femoral head osteonecrosis is mainly in young adults, Pathogenesis of TCM syndromes is mainly due to deficiency of liver and Kidney, Qi stagnation and blood stasis. The more bleeding volume and wound drainage volume, the more risk for the operation. The more alcohol withdrawal syndromes, the more risk and difficulty for per i opcrati ve modical care and nursing. And these were also not conductive to the rehabilitation for the operation patients.