【摘要】：目的： 目前針對(duì)小兒股骨頭壞死,關(guān)于其治療方法的選擇仍舊存在相關(guān)爭(zhēng)議,本研究旨在觀察補(bǔ)腎活血中藥配合外展固定對(duì)小兒股骨頭壞死的臨床療效來(lái)說(shuō)明中醫(yī)藥在治療小兒股骨頭壞死方面存在有一定優(yōu)勢(shì)。 方法： 回顧性研究收集2009年12月-2012年4月在我院診斷為小兒股骨頭壞死的患兒,進(jìn)行病例隨訪,對(duì)治療方法分為如下兩組：對(duì)照組、治療組。對(duì)照組除給予臥床休息外,未予行其它治療,治療組給予口服補(bǔ)腎活血中藥以及外展固定,兩組均最低隨訪2年,評(píng)價(jià)治療后兩組在世界衛(wèi)生組織(WHO)的疼痛分級(jí),Stulberg分型,Mose環(huán)標(biāo)準(zhǔn),臨床癥狀等有無(wú)差異。 結(jié)果： 對(duì)照組15例,其中男性10例,女性5例,平均年齡(6.87±2.133)歲,治療組38例,其中男性32例,女性6例,平均年齡(7.80±2.274)歲。兩組病例在性別,年齡,Catterall分型方面比較,均為P0.05,差異無(wú)顯著性,具有可比性。兩組患兒在經(jīng)過(guò)治療后其疼痛程度較前明顯減輕,治療前后對(duì)比有顯著性差異(P0.001)。股骨頭的外形按Mose環(huán)標(biāo)準(zhǔn)在兩組間對(duì)比有顯著性差異(P0.01),治療組恢復(fù)得較好,其中良好10髖,可23髖,差6髖,對(duì)照組可6髖,差10髖。頭臼的匹配情況按照Stulberg分型,治療組和對(duì)照組之間存在差異(P0.05),其中治療組優(yōu)良占32髖,可占5髖,差占2髖,對(duì)照組優(yōu)良占7髖,可占6髖,差占3髖。 整體的療效評(píng)價(jià)用臨床癥狀評(píng)價(jià),結(jié)果顯示補(bǔ)腎活血中藥配合外展固定治療兒童股骨頭壞死較好,優(yōu)良率為76.92%,兩組相比優(yōu)良率存在差異(P0.05)。而在同一Catterall分型中,治療組和對(duì)照組在Ⅱ型以及Ⅲ型臨床癥狀存在差異,在Catterall Ⅳ型之間臨床癥狀未見(jiàn)明顯差異,說(shuō)明對(duì)于Catterall Ⅳ型保守治療未存在明顯優(yōu)勢(shì),以上結(jié)果表明補(bǔ)腎活血中藥配合外展固定治療兒童股骨頭壞死對(duì)于Catterall Ⅱ型和Ⅲ型在影像學(xué)和臨床癥狀方面均具有較好的療效。 結(jié)論： 補(bǔ)腎活血中藥生脈成骨膠囊配合外展固定治療兒童股骨頭壞死在恢復(fù)股骨頭的圓形輪廓和改善股骨頭與髖臼的匹配性以及臨床癥狀方面較對(duì)照組具有較好的療效。
[Abstract]:Objective: at present, the choice of treatment for femoral head necrosis in children is still controversial. The purpose of this study was to observe the clinical effect of Bushen Huoxue Chinese medicine combined with abduction fixation on the necrosis of the femoral head in children to show that Chinese medicine has some advantages in treating the necrosis of the femoral head in children. Methods: the patients with femoral head necrosis diagnosed in our hospital from December 2009 to April 2012 were collected and followed up. The treatment methods were divided into two groups: control group and treatment group. The control group was not treated with any other treatment except bed rest. The treatment group was treated with oral Chinese medicine for tonifying kidney and activating blood circulation and external fixation. The two groups were followed up for a minimum of 2 years. To evaluate whether there were any differences between the two groups in the pain grading and Stulberg classification of the two groups after treatment at the World Health Organization (WHO) and whether there were any differences between the two groups in the criteria of the Mose ring and the clinical symptoms. Results: there were 15 cases in the control group, including 10 males and 5 females with an average age of (6.87 鹵2.133) years. 38 cases in the treatment group were male (32 cases) and female (6 cases) with an average age of (7.80 鹵2.274) years. There was no significant difference in sex, age and Catterall classification between the two groups (P 0.05). After treatment, the pain degree of the two groups was obviously alleviated, and there was significant difference before and after treatment (P0.001). There was significant difference in the shape of femoral head according to Mose ring standard between the two groups (P0.01). In the treatment group, the recovery was better, including good 10 hips, fair 23 hips, poor 6 hips, control group 6 hips and poor 10 hips. According to Stulberg classification, there was significant difference between the treatment group and the control group (P0.05), in which 32 hips were excellent in the treatment group, 5 hips were good, 2 hips were poor, 7 hips were excellent in the control group, 6 hips were excellent, and 3 hips were poor. The overall evaluation of the efficacy of clinical symptoms evaluation, the results showed that Bushen Huoxue Chinese medicine combined with abduction fixation treatment of children with femoral head necrosis is better, the excellent and good rate is 76.922.There is a difference between the two groups of excellent and good rate (P0.05). In the same Catterall classification, the clinical symptoms of type 鈪，

本文編號(hào)：2190442