[1]刘　广　丰　哲　赖礼沐　冯轩朗　袁　宁.中西医外治疗法治疗股骨头坏死的研究进展[J].大众科技,2022,24(05):119-122.
　Research Progress of External Treatment of Traditional Chinese and Western Medicine in the Treatment of Osteonecrosis of the Femoral Head[J].Popular Science & Technology,2022,24(05):119-122.
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中西医外治疗法治疗股骨头坏死的研究进展()
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《大众科技》[ISSN:1008-1151/CN:45-1235/N]

卷:
24
期数:
2022年05
页码:
119-122
栏目:
医药与卫生
出版日期:
2022-05-20

文章信息/Info

Title:
Research Progress of External Treatment of Traditional Chinese and Western Medicine in the Treatment of Osteonecrosis of the Femoral Head
作者:
刘　广1　丰　哲2　赖礼沐1　冯轩朗1　袁　宁1　
（1.广西中医药大学研究生院，广西 南宁 530000； 2.广西中医药大学附属瑞康医院，广西 南宁 530011）
关键词:
股骨头坏死; 中医外治法; 西医外治法; 综述
Keywords:
osteonecrosis of the femoral head external treatment of traditional Chinese medicine external treatment of western medicine review
文献标志码:
A
摘要:
股骨头坏死也称为股骨头缺血性坏死，是由各种病因破坏股骨头血液供应造成的最终结果，其进一步发展将形成难治性、高致残性髋关节炎，是骨科临床一大难题。因此，对于处于早中期的ONFH患者，运用外治法能延缓其进一步发展，而对于中晚期的ONFH，外治疗法亦能够带来一定的疗效，其无创的特点也更为患者接受，值得广泛应用。文章将从中医推拿手法、针灸、针刀、中药外敷，以及西医的限制负重疗法疗法、高压氧、体外冲击波、脉冲电磁场进行综述。
Abstract:
Osteonecrosis of the femoral head, also known as avascular necrosis of the femoral head, is the final result of various causes that destroy the blood supply of the femoral head. Its further development will form refractory, highly disabled hip arthritis, which is a major orthopedic clinical problem. Therefore, for patients with ONFH in the early and middle stages, the use of external therapy can delay its further development, and for patients with advanced ONFH, external therapy can also bring certain curative effect, and its noninvasive characteristics are more acceptable to patients, which is worthy of wide application. This article will review the massage manipulation of traditional Chinese medicine, acupuncture, acupotomy, external application of traditional Chinese medicine, and western medicine limit weight-bearing therapy, hyperbaric oxygen, extracorporeal shock wave, pulsed electromagnetic field.

参考文献/References:

[1]　Hines J T, Jo W L, Cui Q, et al. Osteonecrosis of the femoral head: an ypdated review of ARCO on pathogenesis, staging and treatment[J]. Journal of Korean Medical Science, 2021, 36(24): e177. [2]　李子荣. 科学诊断和治疗股骨头坏死[J]. 中国修复重建外科杂志，2005(9): 685-686. [3]　雷志强，曾平，陈卫衡，等. 股骨头坏死流行病学特点分析[J]. 中医正骨，2020，32(1): 4-6. [4]　Palit A, Williams M A, Turley G A, et al. Femur first navigation can reduce impingement severity compared to traditional free hand total hip arthroplasty[J]. Scientific Reports, 2017, 7(1): 7238. [5]　Barrack R L. Economics of revision total hip arthroplasty [J]. Clinical Orthopaedics and Related Research, 1995, 319: 209-214. [6]　Weber M, Renkawitz T, Voellner F, et al. Revision surgery in total joint replacement is cost-intensive[J]. BioMed Research International, 2018, 2018: 8987104. [7]　Hawker G, Wright J, Coyte P, et al. Health-related quality of life after knee replacement[J]. Journal of Bone and Joint Surgery, 1998, 80(2): 163-173. [8]　王均玉，宋梦歌，高欢欢，等. 基于经筋理论探析股骨头坏死的病理机制[J]. 中医药学报，2021，49(9): 5-9. [9]　骆帝，梁学振，刘金豹，等. 不同病因股骨头坏死样本成骨与成血管相关指标蛋白表达的差异[J]. 中国组织工程研究，2022，26(11): 1641-1647. [10] 陈志伟. 基于经筋理论辨治股骨头坏死[J]. 中国中医药信息杂志，2021，28(9): 134-137. [11] 陈龙豪，周红海，张璇，等. 韦贵康运用手法配合中药内服外用治疗早中期股骨头缺血性坏死经验[J]. 中医杂志，2021，62(15): 1303-1307. [12] 韦贵康，王明杰，刘建航，等. 韦氏骨盆调衡法配合中药验方治疗股骨头缺血性坏死的临床观察[J]. 四川中医，2011，29(6): 93-95. [13] 吴涛，赵娟. 推拿手法治疗股骨头坏死研究浅探[J]. 中医临床研究，2012，4(14): 38-39. [14] 朱蜀云，马素英，杨康，等. 推拿加中药治疗由激素和酒精造成的中晚期股骨头坏死的临床观察[J]. 中国骨质疏松杂志，2015，21(4): 456-459. [15] 王威. 针灸与中药协同作用的合理性[J]. 中国针灸，2004(4): 76. [16] 白良川，何光远，姚长风，等. 电针对激素性股骨头坏死家兔局部组织血流量、骨钙素及超微结构影响的实验研究[J]. 中国中医骨伤科杂志，2011，19(9): 1-3. [17] 黄丽萍，王刚，高谦，等. 内热针治疗早期股骨头缺血性坏死的临床疗效观察[J]. 解放军医学院学报，2020，41(12): 1202-1205，1221. [18] 黄丽萍，王刚，高谦，等. 内热针治疗早期股骨头缺血性坏死的临床疗效观察[J]. 解放军医学院学报，2020，41(12): 1202-1205，1221. [19] 张天民，张强，曾垂秀，等. 针刀刀具及其作用原理[J].中国医药导报，2016，13(27): 163-166. [20] 王均玉，宋梦歌，何海军. 基于经筋理论探讨针刀治疗股骨头坏死[J]. 湖北中医药大学学报，2021，23(3): 56-60. [21] 李泰贤，颜炎，傅繁誉，等. 针刀治疗股骨头坏死的镇痛作用与神经递质关系的初步研究[J]. 中国中医骨伤科杂志，2021，29(3): 12-16. [22] 颜炎，李泰贤，傅繁誉，等. 针刀治疗股骨头坏死镇痛机制及血管舒缩因子表达的初步研究[J]. 湖南中医药大学学报，2021，41(2): 265-269. [23] 薛志鹏，李泰贤，孙继高，等. 针刀治疗股骨头坏死Meta分析[J]. 辽宁中医药大学学报，2020，22(5): 78-83. [24] 李泰贤，沈丹青，薛志鹏，等. 针刀疗法改善股骨头坏死关节功能的近期疗效观察[J]. 中国中医骨伤科杂志，2018，26(4): 24-28. [25] Vitorino C, Sousa J, Pais A. Overcoming the skin permeation barrier: challenges and opportunities[J]. Current Pharmaceutical Design, 2015, 21(20): 2698-2712. [26] Alkilani A Z, McCrudden M T, Donnelly R F. Transdermal drug delivery: innovative pharmaceutical developments based on disruption of the barrier properties of the stratum corneum[J]. Pharmaceutics, 201, 7(4): 438-470. [27] 叶建红，毛向东. 中药外敷和泡浴对股骨头缺血性坏死血液流变学的影响[J]. 中医外治杂志，2005(4): 12. [28] 庞晓晨，成睿珍，赵静，等. 中药透皮给药系统研究进展及其新剂型的应用[J]. 中国新药杂志，2019，28(3): 286-291. [29] 洪志楠，何伟，魏秋实，等. 股骨头坏死物理治疗的研究进展[J]. 中国矫形外科杂志，2017，25(23): 2160-2164. [30] Okazaki S, Nagoya S, Tateda K, et al. Weight bearing does not contribute to the development of osteonecrosis of the femoral head[J]. International Journal of Clinical and Experimental Pathology, 2012, 93(6): 458-462. [31] Mont M A, Carbone J J, Fairbank A C. Core decompression versus nonoperative management for osteonecrosis of the hip[J]. Clinical Orthopaedics and Related Research, 1996(324): 169-178. [32] Cross C E, Halliwell B, Borish E T, et al. Oxygen radicals and human disease[J]. Annals of Internal Medicine, 1987 Oct, 107(4): 526-545. [33] Nagatomo F, Gu N, Fujino H, et al. Effects of exposure to hyperbaric oxygen on oxidative stress in rats with type II collagen-induced arthritis[J]. Clinical and Experimental Medicine, 2010, 10(1): 7-13. [34] 刘冠虹，刘锦涛，姜宏. 早中期股骨头坏死保守治疗若干进展[J]. 中国中医骨伤科杂志，2012，20(4): 64-66. [35] Koren L, Ginesin E, Melamed Y, et al. Hyperbaric oxygen for stage I and II femoral head osteonecrosis[J]. Orthopedics, 2015, 38(3): e200-e205. [36] Salameh M, Moghamis I S, Kokash O, et al. Hyperbaric oxygen therapy for the treatment of Steinberg I and II avascular necrosis of the femoral head: a report of fifteen cases and literature review[J]. International Orthopaedics, 2021, 45(10): 2519-2523. [37] Wang C J, Cheng J H, Huang C C, et al. Extracorporeal shockwave therapy for avascular necrosis of femoral head[J]. International Journal of Surgery, 2015, 24(Pt B): 184-187. [38] Wang C J, Wang F S, Ko J Y, et al. Extracorporeal shockwave therapy shows regeneration in hip necrosis[J]. Rheumatology, 2008, 47(4): 542-546. [39] Yin T C, Wang C J, Yang K D, et al. Shockwaves enhance the osteogenetic gene expression in marrow stromal cells from hips with osteonecrosis[J]. Chang Gung Medical Journal, 2011, 34(4): 367-374. [40] Algarni A D, Moallem H M. Clinical and radiological outcomes of extracorporeal shock wave therapy in early-stage femoral head osteonecrosis[J]. Advances in Orthopedics, 2018, 2018: 7410246. [41] Han Y, Lee J K, Lee B Y, et al. Effectiveness of lower energy density extracorporeal shock wave therapy in the early stage of avascular necrosis of the femoral head[J]. Annals of Rehabilitation Medicine, 2016, 40(5): 871-877. [42] Kong F R, Liang Y J, Qin S G, et al. Clinical application of extracorporeal shock wave to repair and reconstruct osseous tissue framework in the treatment of avascular necrosis of the femoral head (ANFH)[J]. China Journal of Orthopaedics and Traumatology, 2010, 23(1): 12-15. [43] 任茜，周建，王鸣刚，等. 脉冲电磁场促进成骨细胞成熟分化依赖于初级纤毛-PI3K/AKT途径[J]. 北京大学学报(医学版)，2019，51(2): 245-251. [44] Leo M, Milena F, Ruggero C, et al. Biophysical stimulation in osteonecrosis of the femoral head[J]. Indian Journal of Orthopaedics, 2009, 43(1): 17-21. [45] Ding S, Peng H, Fang H S, et al. Pulsed electromagnetic fields stimulation prevents steroid- induced osteonecrosis in rats[J]. BMC Musculoskeletal Disorders, 2011, 12: 215. [46] Li J P, Chen S, Peng H, et al. Pulsed electromagnetic fields protect the balance between adipogenesis and osteogenesis on steroid-induced osteonecrosis of femoral head at the pre-collapse stage in rats[J]. Bioelectromagnetics, 2014, 35(3):170-180. [47] Ikegami A, Ueshima K, Saito M, et al. Femoral perfusion after pulsed electromagnetic field stimulation in a steroid - induced osteonecrosis model[J]. Bioelectromagnetics, 2015, 36(5): 349-357.

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备注/Memo

备注/Memo:
【收稿日期】2022-02-25 【作者简介】刘广（1996－），男，江西赣州人，广西中医药大学研究生院在读硕士研究生，研究方向为骨关节疾病、创伤修复及足踝外科疾病。 【通信作者】丰哲（1968－），男，湖南岳阳人，广西中医药大学附属瑞康医院主任医师，教授，博士研究生导师，博士，研究方向为骨关节疾病、创伤修复及足踝外科疾病。
更新日期/Last Update: 2022-07-18