1.北京按摩医院,北京 100035
2.中国中医科学院 望京医院,北京 100102
3.鄄城县舜城医院,山东 鄄城 274600
金涛,主任医师,从事中医推拿和疼痛治疗研究,E-mail:jintao1966@sina.com
支满霞,主任医师,教授,硕士生导师,从事中西医结合疼痛临床研究,E-mail:zhimanx@msn.com
收稿:2024-09-19,
录用:2024-11-06,
网络出版:2024-11-08,
纸质出版:2025-04-20
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金涛,马福长,黄诚等.脉络宁复合液行髋关节周围神经阻滞治疗髋关节疼痛的临床疗效[J].中国实验方剂学杂志,2025,31(08):152-158.
JIN Tao,MA Fuchang,HUANG Cheng,et al.Clinical Observation on Treatment of Hip Joint Pain with Mailuoning Compound Solution via Nerve Blocks around Hip Joint[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(08):152-158.
金涛,马福长,黄诚等.脉络宁复合液行髋关节周围神经阻滞治疗髋关节疼痛的临床疗效[J].中国实验方剂学杂志,2025,31(08):152-158. DOI: 10.13422/j.cnki.syfjx.20250794.
JIN Tao,MA Fuchang,HUANG Cheng,et al.Clinical Observation on Treatment of Hip Joint Pain with Mailuoning Compound Solution via Nerve Blocks around Hip Joint[J].Chinese Journal of Experimental Traditional Medical Formulae,2025,31(08):152-158. DOI: 10.13422/j.cnki.syfjx.20250794.
目的
2
观察脉络宁复合液以髋关节周围神经阻滞方法治疗髋关节疼痛的临床疗效及其安全性。
方法
2
2015年3月至2019年3月收治符合纳入标准的髋关节疼痛患者136例,依照随机数字表法分为观察组和对照组。其中6例由于没有完成5次治疗,形成病例脱落,最终130例患者进入临床观察,每组65例。观察组应用脉络宁复合液进行髋关节周围神经阻滞(含闭孔神经,股神经分支,臀上神经和髋筋膜);对照组应用脉络宁复合液单纯进行闭孔神经阻滞。观察治疗前后两组患者视觉模拟评分(VAS)和髋关节Harris评分的差异。记录患者在治疗过程中有无药物不良反应和不良事件发生。
结果
2
与本组治疗前比较,两组患者治疗后VAS评分均显著降低(
P
<
0.01)。与对照组治疗后比较,降低更显著(
P
<
0.01)。与本组治疗前比较,两组患者Harris评分总分及疼痛、功能、关节活动度分项评分均显著升高
(P
<
0.01),与对照组治疗后比较,观察组患者髋关节Harris评分总分及疼痛、功能分项评分升高更显著(
P
<
0.01)。两组患者的髋关节Harris评分的临床疗效比较,观察组优良率84.62%(55/65),显著优于对照组的56.92%(37/65)(
χ
2
=12.05,
P
<
0.01)。随访结果显示,达到优良效果的患者,疗效稳定,复发率较低,观察组与对照组的复发率比较差异无统计学意义。病例分析表明,股骨头坏死患者治疗后,髋部X射线片可见股骨头的囊状透亮影明显减轻,骨小梁数量增加,低密度影减少;髋部骨质疏松患者治疗后,髋部X射线片可见骨小梁数目增加,低密度影减少。
结论
2
采用脉络宁复合液进行髋关节周围神经阻滞,充分发挥脉络宁复合液和神经阻滞的协同作用,能有效缓解髋关节疼痛,促进髋关节功能的恢复,降低致残率,提高患者的生活质量。早期干预,是治疗髋关节疼痛性疾病的重要环节,能有效地控制患者病情的发展。脉络宁复合液通过神经调控作用治疗髋关节疼痛,是一种新思路和新方法,该方法易操作,安全性高,治疗效果好。在今后的研究中需要扩大样本量,针对各个不同的髋关节疼痛疾病的影像学变化和作用机理进行更深入的研究。
Objective
2
To observe the clinical efficacy and safety of Mailuoning compound solution in the treatment of hip joint pain via nerve blocks around the hip joint.
Methods
2
From March 2015 to March 2019,a total of 136 patients with hip joint pain who met the inclusion criteria were admitted and divided into an observation group and a control group according to the random number table method. Among them,six cases fell off due to failure to complete five treatments,and finally, 130 patients entered clinical observation,with 65 cases in each group. The observation group used Mailuoning compound solution for nerve blocks around the hip joint(including obturator nerve,femoral nerve branch,superior gluteal nerve, and hip fascia). The control used Mailuoning compound solution for a simple obturator nerve block. The differences in the visual analogue scale (VAS) and Harris score of hip joint of the two groups before and after treatment were observed. Any adverse drug reactions and adverse events during the treatment of the patients were recorded.
Results
2
The VAS score of the two groups was significantly decreased after treatment (
P
<
0.01). Th
e observation group had a more significant decrease compared to the control group(
P
<
0.01). The total Harris score of hip joint, pain degree,function score, and motion of joint of the two groups were significantly improved after treatment (
P
<
0.01). Compared with the control group,the improvement in the total Harris score of hip joint, pain degree,and function score was more significant in the observation group (
P
<
0.01). The clinical efficacy based on the Harris score of hip joint of the two groups was compared. The excellent and good rate of the observation group was 84.62% (55/65), which was significantly better than that of the control group [56.92% (37/65)] (
χ
2
=12.05,
P
<
0.01). The follow-up results showed that the patients who achieved excellent and good results had stable curative effects and low recurrence rates,and there was no significant difference in recurrence rate between the two groups. Case analysis showed that after treatment of femoral head necrosis,the saccular transparent shadow of the femoral head was significantly reduced,and the number of bone trabeculae increased. The low-density shadow decreased as can be seen on hip X-rays. In patients with hip osteoporosis after treatment,the number of bone trabeculae increased, and the low density shadow reduced.
Conclusion
2
The use of Mailuoning compound solution for nerve blocks around the hip joint gives full play to the synergistic effect of Mailuoning compound solution and nerve block. It can effectively relieve hip joint pain,promote the recovery of hip joint function,reduce the disability rate,and improve the quality of life of patients. Early intervention is an important link in the treatment of hip joint pain diseases,which can effectively control the development of the patient's disease. Mailuoning compound solution is a new idea and method to treat hip joint pain through neuroregulation,which is easy to operate,with high safety and good therapeutic effect. In future studies,a larger sample size is needed,and more in-depth research should be conducted on the imaging changes and mechanisms of action for various hip joint pain diseases.
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