目的 研究中西医结合三联疗法治疗股骨头缺血性坏死(ANFH)的临床疗效和安全性.方法 将180例ANFH患者随机分为三组,每组各60例,三联组运用腰交感神经毁损术(LS)加针刀、中药联合治疗,针药组运用针刀加中药治疗,损毁组仅运用LS治疗.观察各组临床疗效和三联组治疗的安全性.结果 三联组愈显率明显高于其他两组(P < 0.05或P < 0.01);治疗前三组各项评分差异无统计学意义(P > 0.05);治疗后1周三联组和损毁组疼痛、功能和关节活动度评分均有非常显著地改善(P < 0.01),而针药组改善不明显(P > 0.05);治疗1年后针药组功能和关节活动度评分优于损毁组(P < 0.01),而三联组各项评分均优于其他两组(P < 0.05或P < 0.01);三联组各项指标的改善率随着ANFH分期的升高而显著下降(P < 0.01);三联组全部患者治疗前后未见明显不良反应和并发症.结论 三联疗法对ANFH早、中期具有良好疗效,对晚期能部分缓解疼痛症状,且本疗法安全可靠,对人体正常生理功能没有不良影响.%Objective To study the clinical effect and security of triple therapy in the treatment of avascular necrosis of femoral head (ANFH). Methods 180 cases of patients with ANFH were randomly assigned to three groups, each group had 60 cases. Triple group was treated with three therapies integrated lumbar sympathectomy (LS), acupotomy and traditional Chinese medicine (TCM). A-T Group was treated with two therapies comprising acupotomy and TCM. LS Group was only treated with LS. The curative effect of each group and the security of the triple group were observed. Results The recovery and excellence rate was significantly higher in the triple group than those in the other two groups (P < 0.05 or P < 0.01). Before treatment all scores had no difference among the three groups (P > 0.05). After one week of treatment, the pain, function and ROM scores of the triple group and LS group were significantly improved (P < 0.01), but all scores of the A-T Group had no significant improved (P > 0.05). After one year of treatment, the function and ROM scores of the A-T group were higher than those of the LS group (P < 0.01 ), while in the triple group each score was superior to the other two groups (P < 0.05 or P < 0.01 ). With the evolving of the ANFH stage, the rate of improvement of all scores dropped significantly (P < 0.01). In triple group before and after treatment, all patients had no significant adverse reactions and complications. Conclusion Triple therapy can have very good effect for early and middle stage of ANFH, but merely alleviates partial pain for the late stage. The therapeutics is safe and reliable and has no adverse effect on the body's normal physiological function.
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