| Objective: This project investigates the clinical efficacy of the treatment of bone marrow edema syndrome of the hip(BMESH)based on the therapy of kidney-tonifying,blood-invigorating and water-ciculation-promoting.Methods: Forty-two cases of 46 hips(24 males and 18 females,4 positive cases of bilateral affected hip bone marrow edema and 38 positive cases of unilateral affected hip bone marrow edema)were selected from the outpatient and inpatient departments of the Department of Bone and Joint Diseases of the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from September 2018 to September 2020,and the patients were selected based on the history of onset,symptoms of onset,physical signs and bilateral hip magnetic resonance(The diagnosis was clarified based on the history,symptoms,signs and imaging examinations such as MRI of bilateral hip joints.The 42 cases that met the inclusion criteria were divided into 21 cases in the treatment group and 21 cases in the control group according to the principle of randomization.During the treatment period,the subjects were strictly required to limit hip joint activities,reduce weight-bearing walking on the lower extremities,and pay attention to strengthening daily lying rest.The treatment method was based on the formula of kidney-tonifying,blood-invigorating and water-ciculation-promoting,supplemented with basic treatment in the treatment group,and basic treatment(oral celecoxib capsule,continuous skin traction and braking of the affected limb and strict restriction of hip movement)in the control group.Mc Gill score,Harris hip function score,and magnetic resonance imaging(MRI)of the hip joint were reviewed at week 12,and the area of bone marrow edema measured in the sagittal plane of MRI images of the hip joint was compared between the two groups,and the statistical software SPSS 26.0 was used for comparative analysis.Results:After the full course of treatment,the treatment results of the two study groups were as follows.(1)Simplifield Mc Gill Pain Scale scores: The SF-MPQ scores of both study groups decreased before and after treatment,and the changes in pain scores at each time point in the treatment group were: 39.12±1.23,29.07±1.28,18.43±1.11,and 6.75±0.90,while the changes in the control group were: 39.35±0.93,35.31±1.12,29.25± 1.16,20.20±0.82,within the group for comparison between pre-treatment and 12 weeks after treatment,the Z-values of the two groups were:-5.411,-5.411,P<0.05,the difference was statistically significant;compared with the control group between groups,the results of the treatment group in the post-treatment nodes decreased sharply,Z-values were:-2.976,-4.789,-5.304,P< 0.05,the difference is statistically significant(P<0.05).(2)Harris hip function scores: Harris hip function scores improved in both study groups before and after treatment,and the changes in scores at each time point in the treatment group were: 51.75±0.93,62.93±0.94,78.33±0.75,92.45±0.69,and in the control group were: 51.10±0.74,57.17 ± 0.75,64.74 ± 0.84,77.51 ± 0.71,within the group for the comparison between pre-treatment and 12 weeks after treatment,the Z values of the two groups were:-5.411,-5.412,P<0.05,the difference was statistically significant;compared with the control group between the groups,the treatment group rose more significantly,Z values were:-3.680,-5.412,-5.412,P<0.05,the difference statistically significant(P<0.05).(3)The area of bone marrow edema on MRI images reviewed at 12 weeks after treatment: The comparison of MRI images of both groups before and 12 weeks after treatment showed that the area of bone marrow edema was significantly reduced,and the change of area in the treatment group was959.77±22.23 and 174.97±19.97,while that in the control group was958.52±17.20 and 457.59±12.98.The Z-values of the two groups were:-5.410 and-5.410,respectively,P<0.05,and the difference was statistically significant;compared between the two groups,the regression of bone marrow edema area in the treatment group was significantly better than that in the control group,with a Z-value of:-5.322,P<0.05,and the difference was statistically significant(P<0.05).Conclusion:The present study showed that the use of the method of tonifying the kidney,activating blood and promoting water can significantly reduce the pain of the affected hip joint,improve the functional activity of the affected hip joint,and substantially reduce bone marrow edema in the study subjects.Its clinical effect is remarkable,and the patient’s compliance is good,so it can be widely extended to clinical treatment. |
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