摘要
目的探讨手法治疗结合功能训练治疗早期股骨头坏死(ONFH)的康复疗效。方法收集2012年7月—2013年12月在成都中医药大学附属医院和雅安职业技术学院附属医院进行治疗的早期ONFH(Ficat分期Ⅰ、Ⅱ期,股骨头塌陷前)患者40例(51髋),采用随机数字表法分为治疗组20例(28髋)和对照组20例(23髋),对照组患者采用基础治疗+功能训练,治疗组患者在基础治疗+功能训练的基础上采用手法治疗,10 d为1个疗程,连续治疗3个疗程。比较两组临床疗效、治疗前后髋关节功能Harris评分和血液流变学指标的变化。结果治疗后,对照组治疗效果优3髋、良7髋、可7髋、差6髋,治疗组治疗效果优11髋、良9髋、可4髋、差4髋,两组临床疗效比较,差异有统计学意义(Z=2.207,P<0.05)。两组治疗前髋关节功能Harris评分比较,差异无统计学意义(P>0.05);两组治疗后髋关节功能Harris评分比较,差异有统计学意义(P<0.05)。两组治疗前全血高切黏度、全血低切黏度、血浆黏度、血细胞比容比较,差异无统计学意义(P>0.05);两组治疗后全血高切黏度、全血低切黏度、血浆黏度、血细胞比容比较,差异有统计学意义(P<0.05)。治疗过程中,两组均未发现不良反应。结论手法治疗结合功能训练治疗早期ONFH疗效确切,能有效改善其髋关节功能Harris评分和血液流变学指标,且无不良反应,值得临床推广应用。
Objective To investigate the efficacy of manipulative therapy combined with functional training in the rehabilitation of early - stage osteonecrosis of the femoral head （ONFH） . Methods Enrolled 40 patients （51 hips） with ONFH （at Ficat Stage I and Ⅱ, before the collapse of the femoral head） in Teaching Hospital fo Chendu University of TCM and Affiliated Hospital of Yaan Polytechinc College from July 2012 to December 2013. Random number table method was used to divide the patients into treatment group （20 patients, 28 hips） and control group （20 patients, 23 hips） . The control group was administrated with basic treatment and functional training, and the treatment group was also administrated with manipulative therapy on the basis of basic treatment and functional training. One course of treatment lasted for 10 days, and three courses were undertaken eonseeutively. Comparison was made between the two groups in clinical efficacy, Harris score for hip function and changes in the hemodynamic indexes before and after treatment. Results After treatment, the number of hips with excellent, good, barely good and bad treatment efficacy were 3, 7, 7 and 6 respectively in control group, the number of hips withexcellent, good, barely good and bad treatment efficacy were 11, 9, 4 and 4 respectively in treatment group. The two groups were significantly different in clinical efficacy （ Z = 2. 207, P 〈 0.05 ） . The two groups were not significantly different in the Harris score for hip function before treatment （ P 〉 0. 05 ） ; the two group were significantly different in the Harris score for hip function after treatment （P 〈 0. 05） . The two groups were not significantly different in whole blood high - shear viscosity, whole blood low - shear viscosity, plasma viscosity and hematocrit （ P 〉 0.05 ） ; the two groups were significantly different in whole blood high - shear viscosity, whole blood low - shear viscosity, plasma viscosity and hematocrit （ P 〈 0. 05 ） . In the process of treatment, no adverse responses were found in the two groups. Conclusion Manipulative therapy combined with functional training have definite efficacy in the treatment of early - stage ONFH. The combined therapy could effectively improve Harris score for hip function and hemodynamic indexes and cause no adverse response, thus it is worth clinical promotion.
出处
《中国全科医学》
CAS
CSCD
北大核心
2015年第36期4506-4509,共4页
Chinese General Practice
基金
四川省中医药管理局项目(2012-B-068)
成都市科技局项目(12DXYB227JH)
成都中医药大学校基金(ZRMS2012270)
关键词
股骨头坏死
手法治疗
功能训练
康复治疗
Femur head necrosis
Manipulative therapy
Function training
Rehabilitation
