| Objective:By comparing the different influence factors on the acupotomy curative effects for the treatment of femoral head necrosis.Analysis of influence of acupotomy therapy related factors to improve joint function in patients with Osteonecrosis of the Femoral Head.Providing theoretical basis and application reference for acupotomologic therapy of avascular necrosis of the femoral head,the clinical treatment scheme optimization of osteonecrosis of the femoral head,further improve the curative effect.Methods:From February 2014 to June 2015 in Wangjing Hospital inpatients receiving traditional Chinese medicine bone joint administration and the acupotomologic therapy of avascular necrosis of the femoral head case,according to the inclusion and exclusion criteria,finally included in the study of 50 cases,a total of 75 hips,5 hips of 4 cases lost.All groups according to the degree of patients with dysfunction in patients with clinical symptoms and selective Acupotomy by different methods.The main hip joint capsule with Acupotomy,hip medial acupotomy,hip lateral release.In 1 weeks,after 2 weeks of treatment,3 months of clinical follow-up after 6 months of follow up each time fill with Write the CRF table.CRF table entry using double double check book,special way.Finally,the data packet processing using SPSS20.0 statistical software,statistical significance.P<0.05 analysis of curative effect of acupuncture therapy to improve the joint function of the patients with femoral head necrosis and compare in etiology,duration,occupation,effect of differences in factors related to stage image.Results:In this study,patients with follow-up data of 46 cases of 70 hips over six months.There were 27 male and 40 female 19 cases of hip,30 hips.Physical labor in 9 cases accounted for 19.57%,non physical labor in 20 cases accounted for 43.48%,17 cases of no occupation accounted for 36.95%;idiopathic avascular necrosis of the femoral head in 17 cases of traumatic femoral head accounted for 36.96%,Necrosis in 2 cases accounted for 4.34%,15 cases of femoral head necrosis accounted for 32.61%,alcohol induced osteonecrosis of the femoral head in 12 cases accounted for 26.09%;15 cases accounted for 32.61%of the course within half a year,half a year to one yearin 13 cases accounted for 28.26%,1 more than 18 years Cases accounted for 19.13%;were classified according to the ARCO staging criteria:the femoral head necrosis ?:20 hips;stage ?:33 hips;?:17 hips.The overall results showed that the VAS score before and after Acupotomy treatment:before treatment,4.65 ± 1.303,3.79±1.167(P<0.05)1 weeks after treatment,2.48±1.188(P<0.05)6 months after treatment;Harris score:before treatment,68.34±14.22,3 months after treatment was 83.04±12.79(P<0.05),6 months after the treatment of 85.18±10.49(P<0.05);joint activity:before treatment,184.36 ±49.63,227.14 ± 35.16(P<0.05)and 1 weeks after treatment,6 months after treatment was 242.13±33.61(P<0.05).Different image staging joint activity multiple comparison:1 weeks follow-up,stage ? joint activities and were improved by 44.206± 10.941(P<0.05),joint activities stage and third stage compared with degree improvement of 30.312 ±9.902(P<0.05);6 months of follow-up,stage ? and ? compared with closed Festival activity improved by 59.941±10.738(P<0.05),joint activities stage and third stage compared with degree improvement of 38.275 ±9.718(P<0.05);the results showed ? than stage ? patients with stage ?,joint activity improved more obviously,the difference was statistically significant(P<0.05).VAS score at follow-up:multiple comparison at week 1,? than stage ?,? patients pain improved more;and in the 6 month follow-up stage ? than stage ? and stage ? patients pain improvement,there was no statistically significant difference(P>0.05).The different causes of joint activity Comparison of hormone with idiopathic and alcoholic patients with joint activity improved,there was no statistically significant difference(P>0.05).VAS score comparison of hormone is idiopathic and alcoholic patients pain improvement,there was no statistically significant difference(P>0.05).Multiple comparison of different course of joint activities the duration of>1 years,with the joint activity improved,there was no statistically significant difference(P>0.05).VAS score comparison in the 1 week of follow-up duration improvement than duration<6 months and>1 years better in June-1 years of pain degree,and in the follow-up of 6 Month course of>1 years of pain degree improvement than the course in June-1 and<6 months is better,the difference was not statistically significant(P>0.05).Multiple comparison of different types of joint occupation activities,with joint activities without occupation of improvement,there was no statistically significant difference(P>0.05).VAS score multiple comparison,no the occupation pain relief degree,the difference was not statistically significant(P>0.05).Conclusion:1.For patients with osteonecrosis of the femoral head,needle knife therapy has a good effect on relieving pain symptoms and improving joint mobility,especially in the improvement of joint activity and function.2.Preoperative image staging is an important factor affecting the efficacy of acupotomy in the treatment of joint necrosis of femoral head.3.Acupotomy treatment can improve the pain and mobility of the patients,regardless of the etiology,duration of the disease and the occupation of osteonecrosis of the femoral head. |
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