【摘要】 目的 探讨活血益肾汤治疗酒精性股骨头坏死对患者髋关节功能、影像学表现等的改善效果。方法 选取2020年6月-2024年3月在广州中医药大学第一附属医院接受治疗的113例酒精性股骨头坏死患者，按随机数字表法分为A组(57例)和B组(56例)，治疗期间A组脱落2例，B组脱落1例，最终每组55例。A组给予常规西医治疗；B组在A组基础上联合活血益肾汤治疗，2组均治疗9个月。比较2组临床疗效、影像学表现结果及髋关节功能评分、血液流变学指标、骨代谢指标，并观察治疗期间安全性。结果 治疗9个月后，B组总有效率、影像学有效率较A组更高(P<0.05)；治疗9个月后，2组行走距离、关节活动度、生活能力、疼痛评分及血清骨特异性碱性磷酸酶(BALP)、骨保护素(OPG)水平高于治疗前，且B组较A组更高(P<0.05)，2组红细胞聚集指数、红细胞压积、血浆黏度及血清Ⅰ型前胶原氨基端前肽(PⅠNP)、Ⅰ型胶原C端肽(CTX)水平低于治疗前，且B组较A组更低(P<0.05)。结论 活血益肾汤辅助西医治疗酒精性股骨头坏死可改善其髋关节功能、影像学表现、血液流变学及骨代谢，进而提高临床疗效，且安全性良好。更多还原

【Abstract】 Objective To explore the improvement effects of Huoxue Yishen decoction on hip joint function and imaging manifestations of patients with alcoholic femoral head necrosis.Methods 113 patients with alcoholic femoral head necrosis treated in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from June 2020 to March 2024were selected and divided into group A(57 cases) and group B(56 cases) according to random number table method.During the treatment,2 cases fell off in group A and 1 case fell off in group B,resulting in 55 cases in each group.Group A received routine Western medicine treatment,and group B received Huoxue Yishen decoction on the basis of the treatment of group A.Both groups were treated for 9 months.The clinical efficacy,imaging findings,hip function scores,hemorheology indexes and bone metabolism indexes were compared between two groups,and the safety during treatment was observed.Results After 9 months of treatment,the total effective rate and imaging effective rate of group B were higher than those of group A(P<0.05).After 9 months of treatment,the walking distance,joint activity,living ability,pain score,and serum levels of bone-specific alkaline phosphatase(BALP) and osteoprotegerin(OPG) of two groups were higher than those before treatment,and group B was higher than group A(P<0.05);The erythrocyte aggregation index,hematocrit,plasma viscosity,and serum levels of type I procollagen amino-terminal propeptide(PINP) and type I collagen C-terminal peptide(CTX) of two groups were lower than those before treatment,and group B was even lower than group A(P<0.05).Conclusion Huoxue Yishen decoction,when used as an adjunct to Western medicine in the treatment of alcoholic femoral head necrosis,can improve the hip joint function,imaging manifestations,hemorheology and bone metabolism.This therapy has good safety.更多还原