活血补髓汤治疗成人早期非创伤股骨头坏死临床与实验研究硕士.doc

提 要 目的：观察活血补髓汤治疗股骨头缺血性坏死疗效、毒副作用及药物作用机理。方法：通过山东中医药大学附属医院骨科收治的成人早期非创伤性股骨头缺血性坏死患者，随机分为治疗组和对照组，治疗组采用张世华主任医师经验方活血补髓汤，对照组口服健骨生水丸。比较治疗前后两组在疼痛疗效、综合疗效、实验室检查等方面的差异。通过肝、肾功能监测活血补髓汤的毒副作用。实验选用200只体重20±2g昆明种小白鼠，50只体重100±10gWistiar种大白鼠，分别分组观察活血补髓汤的口服安全性、抗炎镇痛、抑制血管通透性、调节钙磷代谢及对试管内鸡胚胎骨生长的影响。结果：活血补髓汤不仅能明显缓解病人疼痛，改善病人临床症状，优良率达81.13％，并具有较好的改善血液高凝状态作用，降低血脂水平；实验证明活血补髓汤具有较好的安全性，抗炎镇痛效果，抑制血管通透性，提高钙磷乘积，促进试管内鸡胚胎骨生长的作用。结论：通过临床及实验研究，活血补髓汤无明显毒副作用，疗效优于对照组。其作用机制可能与改善血液流变学、改善微循环、降低骨内压，拮抗脂代谢紊乱，调节钙磷代谢、促进骨质形成有关。 关键词 股骨头缺血性坏死；活血补髓汤；临床研究；实验研究 Clinical and Experimental Study on Therapy of Adult Early non-traumatic avascu1ar necrosis of femoral head With Huo Xue Bu Sui Tang Decoction Speciality:Orthopaedicics of TCM Author:Teng Jiawen Tutor: Prof:Zhang Shihua Abstract Objective:To observe the curative effect and side-effect of avascular necrosis of femoral head(ANFH) through clinical observation with Huo Xue Bu Sui Tang Decoction(HXBST) and to investigate the mechanism.Methods:The treated group were treated with HXBST orally.The controlled group were treated with Jian Gu Sheng Pill orally.The difference on curerate,clinical symptoms,laboratory examinations and X-ray markers between the two groups were observed.The changes on liver and renal function were monitored to decide whether HXBST has ill effect. In experment study,We observe the effect of anti-inflammatory, relif of pain, restraining permeation of capillary, regulating metabolism of calcium and phosphor, accelerating the growth of chicken embryo in cuvette.Results:In clinical study,the cases with ANFH were treated and observed systematicly for three months. And the results show that HXBST can effectively improve the symptoms of ANFH. The totally effective rate amounts to 81.13% and significantly superior to the control group (P0.05). The animal experment prove that HXBST has fine effect of anti-inflammatory, relif of pain, restraining permeation of capillary, regulating metabolism of calcium and phosphor, accelerating the growth of chicken embryo in