目的:评价股骨近端防旋髓内钉(PFNA)与动力髋螺钉(DHS)治疗稳定型股骨粗隆间骨折的临床疗效.方法:将在我院治疗的稳定型股骨粗隆间骨折患者分为PFNA治疗组24例和DHS治疗组24例,观察并比较两组患者的手术时间、术中出血量、引流量及术后髋部疼痛VAS评分及 Harris髋关节功能评分、术后并发症.结果:43例患者术后获得随访,随访时间6个月～20个月.两组患者在手术时间、术中出血量、引流量、及术后不同时间点髋部疼痛VAS评分及Harris髋关节功能评分差异均无统计学意义(P＞0.05).PFNA组治疗过程中发生l例深静脉血栓形成及1例肺栓塞.结论:对于稳定型股骨转子间骨折,PFNA与DHS均可获得良好的临床疗效,但PFNA并发症相对较多.

膝关节骨性关节炎(Knee Osteoarthritis,KOA)是人类最为常见的慢性、退行性关节疾病,其在40岁以上人群中发病率高,较其他关节OA的发病率高[1].在进行的一项社区抽样调查中,膝关节病史阳性者650例(占21.5％),男性发病率为13.2％,女性发病率为28.3％[2].目前普遍认为:OA是由于原发性或继发性因素导致关节软骨出现退行性病变,继而出现软骨下骨质增生,使关节逐渐被破坏及产生畸形,进而出现膝关节疼痛,影响关节功能的退行性疾病.

目的为了解目前大学生颈椎健康状态,探讨颈椎生理曲度与颈椎病之间的关系。方法对成都两所高校480例大学生进行颈椎生理曲度及颈椎病调查研究。结果成都中医药大学组颈曲异常194例(80.8%),颈椎病76例(31.7%);成都体育学院颈曲异常165例(68.7%);颈椎病65例(27.1%)全部受试者颈曲异常的百分比为74.8%,颈椎病百分比为29.4%;两组受试者颈曲异常的差异具有统计学意义;两组受试者颈椎病发病率的差异无统计学意义。结论颈曲异常是颈椎病发病的早期表现及诊断依据之一,与颈椎病发病关系密切,且表现形式多样;在临床工作中加强对颈曲异常的认识具有重要意义。

遵循中医整体治疗观,运用改良卧位拉筋法结合推拿手法对45例颈椎病患者进行治疗,效果显著。本文介绍了临床诊疗过程,并总结笔者自身心得体会,提出"整体牵引","上病下治"等颈椎牵引的新认识,并对推拿手法提出均匀、柔和、深透、有力、持久的操作要求。

腰椎间盘突出症是骨科常见疾病,随着现代社会人们生活习惯的改变,其发病率逐年升高,并向年轻化、低龄化发展,严重威胁人们的健康.中医对于该病的理论认识归于"痹痛"范畴,相关论述较少;西医对该病的认识较之领先,腰椎、椎间盘退变及机械压迫神经学说是目前的普遍认识[1,2],但并不能圆满解释该病的发病机制,而且经手术治疗后出现腰椎手术失败综合征(FBSS)高达约30%的事实,也充分反映出其不足.

目的:观察钻孔减压加丹红注射液治疗退行性膝关节炎的疗效。方法:2002年5月~2006年10月将56例退行性膝关节炎患者行胫骨、股骨、髌骨钻孔减压加丹红注射液静脉滴注治疗。结果:随访4周~1年,总有效率83.9%~96.4%。结论:钻孔减压加丹红注射液静脉滴注治疗退行性膝关节炎,以休息痛为主要指征,止痛效果良好。

【Objective】To create a TCM quality of life(QOL)scale for knee osteoarthritis(OA)and to evaluate QOL of knee OA patients treated by warming collaterals and activating blood therapy.【Methods】QOL of 32 patients with knee OA was evaluated by the created TCM QOL scale and SF-36 questionnaire respectively before and after collaterals-warming and blood-activating treatment by Jingu Tongxiao Pill.【Results】The scoring results of TCM QOL scale showed that syndrome manifestation scoring,activities of daily life(ADL)scoring and comprehensive scoring were decreased after treatment(P0.01 compared with those before treatment),indicating that symptoms and ADL were obviously improved.The scoring results of SF-36 questionnaire showed that the 8-dimension items of physical function(PF),role function physical(RP),bodily pain(BP),general health(GH),vitality(VT),social function(SF),role function emotional(RE),mental health(MH)were much improved after treatment(P0.01 compared with those before treatment),and the comprehensive scoring also was increased(P0.01).【Conclusion】The evaluation result by applying the created TCM QOL scale and SF-36 questionnaire is similar in evaluating the effect of collaterals-warming and blood-activating therapy for the treatment of knee OA,indicating that the therapy can improve the QOL of patients with knee OA.Meanwhile,it is indicated that the created TCM QOL scale can give an objective evaluation for the clinical manifestations of knee OA and reflects the characteristics of Chinese culture and traditional Chinese medicine,and this will serve as a reference for the establishment of TCM QOL criteria.