Therapeutic Mechanism of Taohong Siwu Decoction in Recovering Joint Muscle Strength and Bone Mineral Density of Patients After Hip Preservation Surgery for Osteonecrosis of the Femoral Head
10.13359/j.cnki.gzxbtcm.2025.08.009
- VernacularTitle:桃红四物汤对股骨头坏死保髋术后关节肌力、骨密度恢复的疗效机制
- Author:
Xin ZHANG
1
;
Meng ZHANG
;
Jian LIU
;
Haijun HE
Author Information
1. 中国中医科学院广安门医院保定医院,河北 保定 071000
- Keywords:
Taohong Siwu Decoction;
osteonecrosis of the femoral head;
post-hip preservation surgery;
joint muscle strength;
bone mineral density;
alkaline phosphatase;
osteocalcin;
bone morphogenetic protein 2
- From:
Journal of Guangzhou University of Traditional Chinese Medicine
2025;42(8):1890-1897
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the mechanism of Taohong Siwu Decoction in recovering joint muscle strength and bone mineral density(BMD)in patients after hip preservation surgery for osteonecrosis of the femoral head(ONFH).Methods A total of 110 ONFH patients admitted to Guang'anmen Hospital Baoding Branch,China Academy of Chinese Medical Sciences from April 2022 to April 2024 were enrolled.The patients were equally randomized into a control group and a study group using a random number table,with 55 cases in each group.All patients underwent core decompression surgery and then were given postoperative conventional western medical treatment,and the study group received additional modified Taohong Siwu Decoction.The course of treatment lasted for 8 weeks.Before and after treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,Visual Analogue Scale(VAS)score for pain,Harris hip score,joint muscle strength,bone mineral density(BMD),hemorheological parameters(including plasma viscosity,whole blood high-shear viscosity,and whole blood low-shear viscosity),and bone metabolism markers[including alkaline phosphatase(ALP),osteocalcin(BGP),and bone morphogenetic protein 2(BMP-2)].After treatment,the clinical efficacy was evaluated between groups.Results(1)After 8 weeks of treatment,the total effective rate in the study group was 92.73%(51/55),which was significantly higher than that in the control group(72.73%,40/55).The intergroup comparison showed a statistically significant difference(χ2=7.698,P＜0.01).(2)After treatment,scores for hip pain,soreness and weakness of the lower back and knees,mental fatigue,and deep-thin-choppy pulse decreased in both groups compared with those before treatment(P＜0.05).Moreover,the magnitude of reduction in all these scores was significantly greater in the study group than that in the control group(P＜0.01).(3)After treatment,the VAS scores for pain severity decreased in both groups compared with baseline(P＜0.05),while the Harris scores for joint function increased in both groups(P＜0.05).Furthermore,the magnitude of reduction in VAS scores and the magnitude of improvement in Harris scores were both significantly greater in the study group than those in the control group(P＜0.01).(4)After treatment,plasma viscosity,high-shear whole blood viscosity,and low-shear whole blood viscosity decreased in both groups compared with those before treatment(P＜0.05).Additionally,the reductions in all these parameters were significantly more pronounced in the study group than in the control group(P＜0.01).(5)After treatment,serum alkaline phosphatase(ALP)levels decreased in both groups(P＜0.05),while serum osteocalcin(BGP)and bone morphogenetic protein-2(BMP-2)levels increased in both groups(P＜0.05).Crucially,the magnitude of reduction in serum ALP levels and the magnitude of elevation in serum BGP and BMP-2 levels were all significantly greater in the study group than those in the control group(P＜0.01).(6)After treatment,in the study group,the number of patients with Grade 3 muscle strength significantly decreased while the number with Grade 4 muscle strength significantly increased compared with those before treatment(P＜0.05).In contrast,although the control group showed some improvement in joint muscle strength,the changes were not statistically significant(P＞0.05).After treatment,the intergroup comparisons showed that the study group had a significantly smaller number of patients with Grade 3 muscle strength and a significantly larger number with Grade 4 muscle strength than the control group(P＜0.01).(7)After treatment,both local femoral head BMD and average BMD increased in both groups compared with those before treatment(P＜0.05).The magnitude of increase in both local and average BMD was significantly greater in the study group than that in the control group(P＜0.01).Conclusion The application of Taohong Siwu Decoction in the treatment of in patients after hip preservation surgery for ONFH is effective on reducing TCM syndrome scores,alleviating pain,improving joint function and hemorheology,and restoring BMD and bone metabolism indicators,which enhances the overall clinical efficacy for the patients.
