Evaluation Of The Efficacy Of Acupuncture And Needle-knife In The Treatment Of Early And Mid-term Femoral Head Necrosis And Screening Of Advantageous Programs

PurposesThrough searching the clinical evidence of acupuncture and needle-knife treatment of early-stage ONFH,the clinical efficacy was evaluated and the best treatment plan was screened by AHP in medical information decision-making to provide the basis for clinical decision-making and application.Methods1.Through computerized and manual retrieval,a comprehensive random controlled trial of acupuncture and needle-knife treatment of early-stage ONFH of the femoral head before December 31,2017.According to the modified version of Jadad,high-quality clinical RCTs were screened,and literature information was extracted.RevMan5.3 software was used to make statistical analysis of the outcome of each study.2.Based on high-quality clinical evidence,using AHP,the factors form the descending hierarchy model.Each factor was used to construct a pair wise comparison matrix,and the weights were calculated to obtain the comprehensive scores of the program layers.The comprehensive scores were sorted and the best scheme of acupuncture or needle-knife for the treatment of early-middle stage ONFH was screened out.ResultsThe study included a total of 17 studies were high quality RCT,Meta analysis showed that: there is clear evidence to support acupuncture or needle knife treatment of early and mid-term ONFH of the total efficiency,Harris score,VAS score has some advantages 95% CI [3.15,9.90],P <0.00001,I2 = 0%);There is clear evidence to support acupuncture or acupuncture combined traditional Chinese medicine in the markedly effective,total efficiency,Harris score,VAS score was superior to simple oral Chinese medicine or Topical Chinese medicine treatment(RR = 1.42,Heterogeneity: Tau2 = 0.00;Chi2 = 6.90,df = 9(P = 0.65);I2 = 0%).In the study,there were 7 articles in the study.After screening,the existing clinical evidences were sorted by AHP,and the best scheme was obtained: acupotomy release(release hip and adductor Group point,iliotibial band and tensor fascia muscle point,groin point,hip epithelial nerve point,the starting point of hamstrings,postoperative points to sterile gauze cover once a week,March for a course of treatment).ConclusionsMeta-analysis based on high-quality clinical RCTs showed that acupuncture or needle-knife combined with other traditional Chinese medicine treatment of early-stage ONFH of the femoral head in the efficiency,pain relief,Harris and VAS efficacy are superior to simple Chinese medicine.Based on the clinical evidence at the present stage,the best scheme of acupuncture and needle-knife therapy for early and mid-stage ONFH of the femoral head is acupotomy release(loosening the greater trochanter,gluteal and adductor muscles,Bundle and tensor fasciae points,groin point,gluteal nerve points,hamstring starting point,postoperative points to sterile gauze cover once a week,March for a course of treatment).