Clinical Study On The Treatment Of Advanced Hip Joint Lesions Of AS By Traditional Chinese Medicine Jideshu Paste And THA

Objective:Objective to investigate the clinical efficacy of jideshu combined with THA in the treatment of advanced AS hip lesions,and provide a new way for the treatment of AS patients with advanced hips.Methods:48 cases of AS advanced hip joint ankylosis admitted to Henan Traditional Chinese Medicine Hospital from Aujust 2015 to March 2017 were selected and randomly divided into control group and observation group,24 cases in each group according to the order of hospitalization.The control group was treated with THA combined with celecoxib and sulfasalazine,and the treatment group was treated with THA combined with the jideshu.The patients were followed up for 12 months.The ESR,CRP and hip joint function in two groups were compared before and after operation.Harris score,hip joint ROM,VAS scote,TCM syndrome score,quality of life scorepostoperative side effects,analysis of drug safety and postoperative 12 month efficacy were evaluated.According to the clinical data,all the results were statistically analyzed.Results:1.General informationAll patients were followed up for 12 months.There were no significant difference in gender,age,course of disease,main symptoms,secondary symptoms and severity of the disease between the two groups(P>0.05);and it had no significant difference in the average ESR,CRP,Harris score,hip ROM and VAS score between the two groups before operation(P>0.05).2.Clinical efficacy2.1 According to the ESR,CRP,Harris score,ROM of 1,3,6,12 months before and after therapy: In time factors,there was a significant difference between the two groups of ESR levels between different points of treatment(P<0.05),The two groups of ESR levels decreased with time;comparison between the two groups in different time(before operation),It had no significant difference between two groups on the ESR levels of 1,3,6,12 months(P<0.05).2.2 According to the VAS of 1,3,6,12 months before and after therapy: In time factors,there was a significant difference between the two groups of VAS between different points of treatment(P<0.05),The two groups of VAS levels increased with time;comparison between the two groups in different time(before operation).It had no significant difference between two groups on the VAS of 1,12 months(P>0.05).It had significant difference between two groups on the VAS of 3,6 months(P<0.05).2.3 After 12 months,according to the Harris score to compare the effects of two groups,the experimental group: 5 cases were excellent,good in 12 cases,general in 5 cases and poor in 2cases,the excellent rate was70.83%;control group: 5 cases were excellent,good in 14 cases,general in3 cases and poor in 2 cases,good rate of 79.17%;by Rank sum test.the difference was statistically significant(P>0.05).2.4 After 12 months of treatment,there were 5 cases of clinical control,14 cases,4 effective,1 ineffective,total effective 95.83%,and the rate of control(clinical control and effective)was 79.10%.In the control group,1 cases were clinically controlled,7 cases were markedly effective,12 cases were effective,4 cases were ineffective,the total effective rate was 83.33%,and the control rate was 33.33%.After statistical analysis,there was no significant difference in the total effective rate betwe en the two groups(P>0.05).There was a significant difference in control and display rate(P<0.01),and the effective rate of syndrome treatment in the experimental group was better than that in the control group.2.5 The average scores of the main and secondary symptoms of preoperative and last follow-up were compared.All the scores of the main and secondary symptoms of follow-up were lower in the test group and the control group,and there were significant differences between preoperative and the last follow-up(P<0.01).There was significant difference between the last follow-up groups(P<0.01 or P<0.05).It indicated that the two groups were effective in improving clinical symptoms,and the efficacy of the experimental group was better than that of the control group.2.6 Two groups of preoperative and postoperative physiological functions,physiological functions,physical pain,general health status,energy,emotional function,social function and mental health changes.After 1,3,6 and 12 months,the experimental group and the control group improved significantly in all dimensions,and the difference was statistically significant(P< 0.05).And the improvement degree of the experimental group was better than that of the control group,the difference was statistically significant(P<0.05).2.7 There was no significant difference in liver and kidney function between the two groups before and after treatment.After the operation,the side effects of the two groups were compared.5 patients in the experimental group had nausea and vomiting,2 cases of nausea and 2 constipation,8 cases in the control group,6 cases of nausea and vomiting,6 cases of nausea and 5 constipation.Conclusion:This study shows that the two groups can also reduce the inflammatory response of the whole body,improve the ROM,Harris score of the hip joint and improve the postoperative satisfaction.Moreover,THA combined with traditional Chinese medicine Ji Dishu paste has obvious advantages in relieving pain,improving TCM syndrome score,reducing postoperative complications and improving patients' quality of life.