[Clinical observation of jianpi bushen formula to prevent collapse of osteonecrosis of femoral head].

To observe the clinical effect of Jianpi Bushen formula to prevent the collapse of osteonecrosis of femoral head (ONFH) of type phlegm and blood stasis obstructing the collaterals. 50 cases (including 73 hips) of non-collapse ONFH (ARCO I, II, III a) were selected from the out-patient department of orthopedic in Guang'anmen Hospital attached to China Academy of Chinese Medical Science. All the cases fit for diagnostic criteria were given Jianpi Bushen formula and followed up. Staging criteria was ARCO classification. Harris score evaluated the hip function. The mean follow-up time was 4.2 years (3-5.4 years). After a mean of 4.2 years (3-5.4 years) followed-up, 12 hips collapse occurred while 61 hips not (the non-collapse rate was 83.56%). Collapse did not occurred among the all 7 hips at stage ARCO I (the non-collapse rate was 100%). Among the 49 hips at stage ARCO II, 9 hips collapse occurred while 40 hips not (the non-collapse rate was 81.63%). Among the 17 hips at stage ARCO III a, 3 hips collapse occurred while 14 hips not (the non-collapse rate was 82.35%). Kaplan-Meier analysis showed the average survival time of non-collapse was 5 years (4. 8-5.2 years). The 3 year survival rate of non-collapse was 92.5%. The 4 year survival rate was 74% and the condition tended to be stability trend. The Harris score was 71.93 +/- 11.25 before treatment and 81.63 +/- 12.16 after treatment, significantly different. These results suggest that: Jianpi Bushen formula is an effective method for treating ONFH of type phlegm and blood stasis obstructing the collaterals. It can delay or prevent the collapse of femoral head and significantly improve the hip function.

[Research on the distribution difference of MRI signals in osteonecrosis of the femoral head patients of different TCM syndrome types].

OBJECTIVE: To observe the distribution difference of magnetic resonance imaging (MRI) signals in osteonecrosis of the femoral head (ONFH) patients of different TCM syndrome types. METHODS: Recruited 29 ONFH patients were assigned to the tendon and vessel stagnation group (14 cases) and the Gan-Shen deficiency group (15 cases) according to TCM syndrome typing. The distribution difference of their MRI signals of MRIT1WI, T2WI + fs, T1 and T2 combined signal were compared. RESULTS: There was statistical difference in T1W1 signal distribution between the two TCM syndrome types (P = 0.04). There was no statistical difference in T2WI + fs or T1 and T2 combined signal between the two TCM syndrome types (P = 0.42, P = 0.15). MRI signals in the tendon and vessel stagnation group were mainly manifested as fat-like signals,while they were mainly manifested as mixed signals in the Gan-Shen deficiency group. CONCLUSION: Distribution difference of MRI signals exists between ONFH patients of different TCM syndrome types.

A study on the correlativity of MRI signal classifications with TCM syndromes in femoral head necrosis patients.

OBJECTIVE: To probe into the relation between magnetic resonance imaging (MRI) signal classifications and TCM syndromes in femoral head necrosis patients, so as to provide reference for TCM diagnosis of this disease. METHODS: Refering to the criteria for TCM syndrome types of necrosis of the femoral head described in "The Guiding Principles of Clinical Studies of New Chinese Drugs" and Shimizu and Mitchell's MRI signal classifications, MRI signal classifications between different TCM syndrome types were compared. RESULTS: The Shimizu signal classification of different TCM syndrome types had statistically significant difference (P = 0.04); Both T2WI+fs and Mitchell signal classifications of different TCM syndrome types had no statistical by significant differences (P = 0.42 or P = 0.15). CONCLUSION: There is a certain correlativity of TCM syndrome types of necrosis of the femoral head with T1WI signal classification of MRI. MRI signal classification may contribute to objectivity in TCM syndrome typing of this disease.