To Retrospectively Analyze The Efficacy Of Yixin Bushen Decoction (modified And Subtracted) Combined With Shock Wave In The Treatment Of Early ONFH

Objective:This study intends to review and analyze the short-term efficacy of Yixin Bushen decoction combined with extracorporeal shock wave in the treatment of early osteonecrosis of the femoral head and the prescription rule of Yixin Bushen decoction.Besides,As well as the prescription rule of Yixin Bushen Decoction,it provides effective treatment methods and basis for the clinical treatment of the disease by TCM,clarifies the tutor's experience in treating this disease and the law of medication.Materials and methods:The medical records of patients with early femoral head necrosis treated in inpatient and outpatient departments of the Department of Orthopaedics I of the Second Hospital of Liaoning University of Chinese Medicine between January 2015 and December 2019 were reviewed.The 66 cases(88 hips)of patients who met the criteria were divided into 53 cases in the treatment group according to whether they were treated with Yixin tonifying kidney soup in the treatment protocol(53 cases,74 hips)and control group(13 cases,14 hips)according to whether Yixin Bushen decoction was used in the treatment plan.The general data,therapeutic efficacy index and prescription of patients were recorded.The two groups of clinical efficacy,imaging efficacy,Harris hip score,TCM syndrome score,MRI necrosis index range and prescription rules were analyzed.Results:1 Analysis of efficacy:(1)Clinical efficacy: The total effective rate of the treatment group was 89.19% and the total effective rate of the control group was 64.28%,the difference was statistically significant(P < 0.05).(2)Imaging effect: the total effective rate was 94.6% in the treatment group and 85.71% in the control group.The difference was not statistically significant(P > 0.05).2 Observational index analysis:(1)Harris hip score: 71.99 ±13.80 in the treatment group after treatment,which was significantly better than that before treatment 53.97 ±5.01(P < 0.01).This was statistically significant compared to 61.79 ± 15.38 in the control group after treatment(p < 0.05).(2)The score of TCM syndrome score: 10.61±5.20 in the treatment group was significantly improved(p<0.01)compared to 14.55±3.79 before treatment and statistically significant(p<0.01)compared to 13.43±3.32 in the control group after treatment.(3)The MRI necrotic index after treatment was 20.31±4.40,which was significantly better than that before treatment(20.68±3.29)(P < 0.05).Compared with 21.07 ±4.19 in the control group,was better than the control group,but not statistically significant(p > 0.05).3 Analysis of the law of prescription:(1)The top 10 traditional Chinese medicines were Radix Paeoniae Alba,Fructus psoraleae,Dipsacus,Radix Glycyrrhizae,Poria,Astragalus,Eucommia,tangerine peel,Panax notoginseng and Atractylodes.(2)The first three drugs in the four qi analysis were warm drugs(49.15%),cold drugs(25.45%)and mild drugs(21.61%).The top three in the five-flavor analysis were bitter medicine(34.19%),sweet medicine(30.17%)and pungent medicine(24.75%).The top five In the meridian analysis were liver meridian(23.24%),kidney meridian(18.03%),spleen meridian(17.92%),lung meridian(11.52%)and heart meridian(11.36%).The top five In the efficacy category analysis of traditional Chinese medicine were tonifying deficiency(36.2%),promoting blood circulation and removing blood stasis(19.17%),clearing heat(10.23%),promoting diuresis and permeating dampness(5.21%)and regulating qi(4.41%).Conclusion:Warm and bitter sweet are the main drugs,and most of them belong to the liver and kidney meridians in the modified prescription of Yixin Bushen decoction.The treatment is based on tonifying deficiency,invigorating blood and clearing heat,and the combination of extracorporeal shock wave treatment for early femoral head necrosis can improve the clinical symptoms such as hip function and TCM symptom score of patients delay or reverse the imaging changes of osteonecrosis of the femoral head,and the clinical effect is good.Generally speaking,it is an effective treatment scheme and is worthy of clinical application.