何凯毅　易生辉　秦刚

[摘要] 目的 探讨生骨汤联合改良髓芯减压植骨术治疗早期股骨头坏死的临床效果。方法 选取2014年5月～2016年4月广西中医药大学第一附属医院早期股骨头坏死患者60例，按随机数字表法分为两组，每组各30例，对照组组采用改良髓芯减压植骨术治疗，观察组则在对照组的基础上加用生骨汤。观察两组临床疗效、髋关节功能评分和治疗前后影像学评价。 结果 观察组治疗总有效率明显高于对照组（P < 0.05），两组治疗后影像学分期有明显改善（P < 0.05），髋关节功能评分均有明显提高（P < 0.05），且观察组改善明显优于对照组（P < 0.05）。 结论 生骨汤结合改良髓芯减压植骨术治疗早期股骨头坏死不仅能改善患者的髋关节功能和影像学表现，且能提高患者生活质量。

[关键词] 生骨汤；改良髓芯减压植骨术；早期股骨头坏死

[中图分类号] R681.8 [文献标识码] A [文章编号] 1673-7210（2017）09（c）-0097-04

[Abstract] Objective To explore the clinical effect of Shenggu Decoction combined with core decompression and bone grafting in the treatment of early femoral head necrosis. Methods From May 2014 to April 2016， in First Affiliated Hospital of Guangxi University of Chinese Medicine， 60 patients with early femoral head necrosis were selected， according to random number table， they were divided into two groups， with 30 cases in each group， the control group was given modified core decompression and bone graft treatment， the observation group was given Shenggu Decoction based on control group. The clinical efficacy， hip function score and imaging evaluation before and after treatment were observed. Results The total effective rate of the observation group was significantly higher than that of the control group （P < 0.05）， the imaging scores of the two groups were significantly improved after treatment （P < 0.05）， the hip function scores were significantly improved （P < 0.05）， and improvement of the observation group was better than that of the control group （P < 0.05）. Conclusion Shenggu Decoction combined with modified core decompression and bone grafting treatment of early femoral head necrosis can not only improve the patients' hip function and imaging performance， but also improve the quality of life of patients.

[Key words] Shenggu Decoction； Core decompression and bone grafting； Early femoral head necrosis

股骨头坏死在骨科中是一种疑难疾病，且发病率较高。由于血液循环障碍是其主要的发病机制，因此又称股骨头缺血性坏死[1]。股骨头坏死是一种进展性疾病，在晚期有这非常高的致残率，对人们的生活质量影响十分明显[2-3]。如果早期能得到正确治疗，可避免股骨头塌陷和延缓髋关节置换术时间[4-5]。当前还未找到非常特效的治疗方法，病情严重的患者往往需要进行手术治疗[6-7]。股骨头坏死在临床上主要表现为髋部功能障碍及髋部疼痛[8]。近年来，股骨头坏死早期的中医治疗逐渐得到临床认可，并彰显出特有的治疗优势。因此，为了探讨生骨汤联合改良髓芯减压植骨术治疗早期股骨头坏死的临床疗效。本研究选取广西中医药大学第一附属医院（以下简称“我院”）的早期股骨头坏死患者作为研究对象进行分析，现报道如下：

1 资料与方法……