It is wrong to say that the femoral head is necrotic. From the film, the musculoskeletal part has a shadow, which belongs to periosteum, and the blackened periosteum belongs to poor blood flow there. Kidney produces bone marrow, and bone marrow produces bone periosteum, especially like blood, flesh and skin, which can be sealed and healed. So as long as the kidney is full of qi and blood, the femoral head is naturally rejuvenated and the whole femoral head is not necrotic at all, what reason is there to replace the whole femoral head surgically?
caput femoris necrosis
Chen Yuqin ... Femoral head necrosis is actually insufficient blood supply to the femoral head. Why is there insufficient blood supply to femoral head? It is because the patient's liver has insufficient blood storage, and the liver corresponding to the femoral head is diseased, which makes the blood supply in this part worse than that in other places. To save him, the first thing to be solved is not to treat the femoral head, but simply to treat the femoral head, which will certainly have little effect and will not last long. Since he is your patient, you can meet him often. Observe the changes in the treatment process carefully. My suggestion is to keep the blood in the patient's body rising. To keep the blood rising, we must meet two requirements: one is to have hematopoietic substances, and the other is to have hematopoietic time. Generally speaking, there should be no problem with the food on the table. Most people lack qi and blood because of long-term malnutrition, so grasping the state of bile secretion is the primary task. If you have a good prescription, of course, you should use Chinese medicine, otherwise you can also use the method of knocking on the gallbladder meridian to force bile secretion. Knock on the outside of the thigh for five minutes every day, starting from the ass and knocking along the thigh to the knee. After doing this for two weeks, the color of the patient's palm will change. After a month of knocking, the blood vessels in the arm will change. The blood made by the human body begins to circulate outside the human body. When the blood accumulates to a certain amount, it will reach the liver. When the blood accumulates more and more, there will be more blood in the liver and the urine in the human body will be deeper. At this time, what we usually call liver fever will appear. In fact, because there is more blood in the liver, the workload of the liver will be greater. This is a good thing. I will ask my patients to knock on the liver meridian, because when the workload of the liver increases, the human body has not been able to fully adapt to the new workload, so it is often too late to rule out the body fluid in the meridians, and there is water in any meridian. As for the problem of femoral head, it will not be a problem by this time.
The strange thing about Dong Shi ... Femoral head necrosis.
Hello, Mr. Yue Ming, do you still remember the acupuncture prescription for treating femoral head necrosis that you taught me? I used it, shoulder six, wrist slippery, bone dense, wood dense. Three times, the patient is very happy to come today. She said it's been more than three years, and 80% will be better in three days. It doesn't hurt. Just have a good sleep and go. She will come again and dare to thank Yue Ming.
The classic case of Song Depei in Zhengzhou City, Henan Province is: 1992 10. Wu Jingzhi, the wife of Li (Li's father), the former head of the United Front Work Department, was hit by a tricycle, and was diagnosed with a femoral neck fracture by filming and treated by China Academy of Traditional Chinese Medicine. The fracture healed, but it hurt a year later. After examination, it was femoral head necrosis. Song Depei adopted F.
The medicine was treated by Wu Laozhi, and the pain was obviously relieved after three days of medication. Two months later, X-ray showed that the new bone grew obviously and its activity was basically normal.
? Supplementary explanation:
? Song Depei's treatment of ischemic osteonecrosis with traditional Chinese medicine was identified as a "national second-class scientific research project". After winning the "second prize of Henan Province's traditional Chinese medicine science and technology", some Japanese bought this achievement with a huge sum of 10 million yuan, which was decisively rejected by Song Depei.
Professor Peng Jian ... Mahuang Fuzi Asarum Decoction, Guizhi Fuling Pill, Baishan Pill and Yanghe Decoction treat femoral head necrosis.
Hu Mou, female, 65 years old, farmer, first diagnosed in June 2009 165438+ 10/0: She suffered from low back and leg pain for more than ten years. Since last year, the bone below her left hip has been painful and swollen, and she is limping and can't do anything. She takes a rest every ten steps, is afraid of the cold, and has a good diet and defecation. Western medicine diagnosed lumbar hyperosteogeny, disc herniation and left femoral head necrosis. Dark complexion, pale tongue and weak pulse. To add and subtract Mahuang Fuzi Asarum Decoction, Guizhi Fuling Pill, Baishen Pill and Yanghe Decoction:
Prescription: Herba Ephedrae10g, Radix Aconiti Lateralis Preparata10g, Asari 5g, Cortex Cinnamomi 3g, Cortex Moutan10g, Semen Persicae10g, Radix Paeoniae Rubra10g, Semen Sinapis Alba10g. Seven doses.
2009-165438+1October 20th: After taking it from above, the curative effect is remarkable, the pain basically disappears, and the pain is slightly relieved. The original prescription was honey pills.
Prescription: Herba Ephedrae10g, Radix Aconiti Lateralis15g, Asari 5g, Cortex Cinnamomi 5g, Cortex Moutan10g, Semen Persicae10g, Radix Paeoniae Rubra10g, Poria10g, and dried. Radix Dipsaci 15g, Fructus Psoraleae 15g, Cortex Eucommiae 10g, Rhizoma Drynariae 10g, Caulis Spatholobi 15g, Carapax Trionycis 10g, Semen Sinapis Albae 10g, and Rhizoma Spatholobi. Pyrite 15g, earthworm 15g, tortoise plastron glue 15g, small hippocampus 15g. ?
Two doses, honey pills, twice a day, each time 10g, can be taken for about two months.
201February 12 third visit: after taking the above materials, the pain was greatly relieved, the limping was not obvious, and the legs and feet were much stronger, and they could walk for hundreds of meters. In recent days, the weather has become warmer and wetter, and my waist and legs feel a little sore. It is planned to add Atractylodes lancea 15g and Phellodendron amurense 15g in the original honey pill formula. After a year's follow-up, the condition was stable and he walked freely, and he did not continue to check.
Attachment: On June 5438+1October 29th, 2009, I was invited to Shanghai to entertain the writer Pan Xiaojue. Ms. Pan suffered from stage ⅳ necrosis of bilateral femoral heads and had to take a wheelchair. While taking traditional Chinese medicine, she insisted on massage and moxibustion, and actively explored dietotherapy, nutrition and various methods of self-care. After more than a year of comprehensive conditioning, she finally got a clinical cure and was able to walk freely. It was confirmed by photos that she had been depressed. She wrote a book about the real process of seeking medical advice and self-diagnosis: Who should we give ourselves to (Fudan University Press, 20 1 1 year, 1 month), which contains the first prescription I gave her:
Radix Rehmanniae Preparata10g, Colla Cornu Cervi10g, Rhizoma Zingiberis, Ramulus Cinnamomi10g, Semen Sinapis Albae10g, Caulis Spatholobi15g, Radix Rhodiolae10g, and Radix Glycyrrhizae Preparata/kloc.
Interpretation of prescription and medicine: Mahuang Fuzi Asarum Decoction warms yang to dispel cold, dredge collaterals, Guizhi Fuling Pill dredge yang to promote blood circulation and dredge collaterals. The combination of the two methods often has a good effect on limb pain caused by cold meridians, blocked yang and blocked blood vessels. However, it is different to rely solely on the strength of the above two parties for this stubborn disease of necrosis of femoral head due to cold to bone, or due to traumatic injury, phlegm and blood stasis, and lack of nourishment.
I got a "hundred-year-old pill" from Pufuzhou Medical Laboratory. According to Pu Lao, "This prescription was dictated by an old Chinese doctor. I have known this prescription for more than 60 years, and it has been used to treat traumatic injuries, regardless of internal injuries of viscera, injuries of bones and muscles, and injuries of meridians. It also treats nocturnal emission, soft feet, soreness of waist and knees, and various physical weakness and daily damage. Take it for a long time. Gong specializes in nourishing liver and kidney, strengthening tendons and bones, promoting blood circulation and removing blood stasis, breaking wounds and replenishing marrow, and is purely based on communication without stagnation. "
From my clinical experience, the suitable pathogenesis of this prescription should be deficiency caused by blood stasis, deficiency caused by blood stasis, and deficiency with blood stasis, especially for degenerative diseases of bones. The original prescription is taken from the famous "Qing 'e Pill", supplemented with Psoralea corylifolia, Rhizoma Drynariae, Eucommiae Cortex, Radix Dipsaci and Cistanchis Herba. Angelica sinensis, black beans, Spatholobus suberectus, and Radix Cyathulae enrich blood, dredge meridians, and benefit waist and knees; Lignum Aquilariae Resinatum regulates qi, and Radix Notoginseng, Sanguis Draxonis and Amber promote blood circulation and relieve pain. The whole prescription is both tonic and consumptive, and its medicinal properties are peaceful. I learned from Mr. Zhu Liangchun's experience in using animal drugs, and even added hippocampus, scorpion, ground beetle, antler cream and so on. Put it in the prescription. Over the years, I have used it to treat degenerative bone diseases of the waist and legs of middle-aged and elderly people, and achieved universal curative effect. In this case, I tried to combine the warming and tonifying effects of two classic prescriptions with the effect of this prescription on bone diseases, and initially accumulated some experience in treating femoral head necrosis.
Zhu Changgeng's Experience in Treating Femoral Head Necrosis (Attached Treatment Prescription)
Li Xingzhi Institute of Traditional Chinese Medicine? today
Professor Zhu Changgeng used to be a member of the National Professional Committee for Avascular Necrosis of Femoral Head, director of the Department of Orthopaedics of Shaanxi College of Traditional Chinese Medicine and director of the Department of Orthopaedics of the Affiliated Hospital of Shaanxi College of Traditional Chinese Medicine. I have accumulated rich experience in treating femoral head necrosis with traditional Chinese medicine, which is introduced as follows:
Pathogenesis of femoral head necrosis in traditional Chinese medicine
Necrosis of femoral head refers to the pathological process of necrosis of living bone tissue of femoral head for some reason. Because its pathological mechanism is mostly caused by blood supply disorder of bone, it is also called avascular necrosis of femoral head. Traditional Chinese medicine divides it into "bone erosion" and "bone arthralgia" according to its location, syndrome characteristics and pathological mechanism. According to Hao Yuan's "The Discharges of Ling Shu Zhen", "Deficiency and evil go deep into the body, and cold and heat contend. If the cold is better than the heat, the bone aches and the flesh dries up, if the heat is better than the cold, the rotten meat will become pus, and the internal injured bone will become eroded bone. " It's called "bone erosion" According to Liu Bailing's statement that "kidney fat is not long, marrow is dry and qi is not good, and cold is blocked in bones" and "arthralgia is blocked but impassable" in the General Record of Shengji, Liu Bailing thinks that cold pathogen hurts kidney yang, causing qi stagnation and blood stasis to form blood stasis, and the disease is located in buttocks, so it is called "hip arthralgia". According to years of clinical experience, Zhu Changgeng believes that avascular necrosis of femoral head is caused by deficiency of liver and kidney, stagnation of qi and blood, obstruction of meridians and joints, and lack of nutrition.
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Treatment of femoral head necrosis with traditional Chinese medicine
Zhu Changgeng proposed to treat avascular necrosis of femoral head by tonifying kidney and promoting blood circulation and promoting bone formation, and achieved satisfactory clinical results.
The prescription comprises 30g of Radix Astragali, 8g of Radix Salviae Miltiorrhizae15g, 0g of Radix Notoginseng15g, 0g of Eupolyphaga Seu Steleophaga10g, 0g of colla cornus Cervi10g, 8g of Achyranthes bidentata and 6g of raw licorice.
Fang Jie: Astragalus membranaceus has the functions of invigorating spleen and lung, benefiting qi and generating blood, and is a monarch drug. Salvia miltiorrhiza promotes blood circulation to remove blood stasis, promotes qi circulation to relieve pain, and notoginseng promotes blood circulation to remove blood stasis, reducing swelling and relieving pain. Colla cornus Cervi has the functions of warming liver and kidney, strengthening bones and muscles, promoting blood circulation to reduce swelling and regulating du meridian. It is a kind of flesh-and-blood product, salty and warm in taste, entering the liver and kidney meridians, and the three flavors are ministerial drugs. Eupolyphaga Seu Steleophaga can break blood, remove blood stasis, join bones and continue tendons, which is an adjuvant medicine. Achyranthes bidentata governs the blood circulation of lower energizer, is good at promoting blood circulation and dredging veins, and induces blood to be used as medicine. Licorice. Tonifying qi, harmonizing middle energizer and harmonizing various medicines are medicines.
Usage: grind the powder and make capsules, taking 1.2g each time, three times a day. Each course of treatment 10 day.
Scope of application: stage ⅰ and ⅱ femoral head necrosis.
External prescription:
Zhu Changgeng often cooperated with external application of traditional Chinese medicine in clinic, which obviously enhanced the therapeutic effect.
Prescription: Hot compress powder (experience prescription of affiliated hospital of Shaanxi College of Traditional Chinese Medicine)
Formula: Liu Yinv 12g, Radix Angelicae Pubescentis 12g, Radix Saposhnikoviae 12g, Radix Gentianae Macrophyllae 12g, Carthami Flos 9g, Folium Artemisiae Argyi 9g, Ramulus Mori 30g, Radix Paeoniae Rubra 15g, Zanthoxylum bungeanum 9g, Rhizoma Chuanxiong 9g, etc. Soak the medicinal vinegar, wrap it with gauze, and steam the affected area 2-3 times a day for 40 minutes each time.
Indications: It is suitable for patients with severe pain in the affected area of femoral head necrosis.
clinical experience
The therapeutic effect of this disease is closely related to the degree of avascular necrosis of the femoral head, whether the femoral head collapses and the degree of collapse, and the time for patients to receive treatment. For stage ⅰ and ⅱ avascular necrosis of femoral head, satisfactory results have been achieved through the treatment of integrated traditional Chinese and western medicine. For patients with stage III or above, the femoral head has collapsed, and if it is not treated correctly in time, most patients will have a further development trend. Therefore, early treatment is urgent and should be combined with other conservative treatment methods.
This article is taken from China journal of traditional chinese medicine No.3233, No.2010-0/-13. Author/Yuan Puwei
Wang Sanhu's medical record-sciatica
Chinese medicine? Wang Sanhu? 20 18-03-08
2018 February 14 became a micro-friend seeking medical treatment. "I have sciatica for more than 70 days. After taking medicine for 50 days, it didn't get better. I also did acupuncture for four days in a row and it didn't work. Please help me with the treatment, and I will pay for it. Now the pain from the ass to the knee is normal. "
According to the dark red tongue and thin yellow fur, I take Duhuo Jisheng decoction as the main prescription: Duhuo Jisheng decoction 12g, Taxilli 12g, Gentiana macrophylla 12g, Saposhnikovia divaricata 12g, Asari 6g. Achyranthes bidentata 15g, Codonopsis pilosula 12g, Radix Glycyrrhizae Preparata 12g, Carapax et Plastrum Testudinis 20g, Rhizoma Drynariae 30g, and cornu Cervi degelatinatum 10g. 10 dose. Q&A: How long do you think I need treatment? Take 10 first. Is it a month or two months? The doctor said that the sciatic nerve is a bit difficult to treat, right? Yes I also have avascular necrosis of femoral head. This prescription is also effective.
2065438+2 12008 Q&A: I have taken five doses of the medicine you prescribed. Why is it still not good? Generally speaking, taking medicine for this disease has a process. How many drugs do you usually take to feel? Two weeks. February 25th: Hello, Dr. Wang. After taking ten doses of medicine you prescribed today, I still feel a little pain in my feet. The stool is different these days, and the urine looks a little hot. Mainly afraid to squat and defecate. If I squat down and walk about 50 meters after defecation, my ass and feet will hurt. I have defecated three times a day these three days. Please write a prescription now. According to the evidence, I have the image of damp-heat, and add the products for clearing damp-heat: Radix Angelicae Pubescentis 12g, Herba Taxilli 12g, Radix Gentianae Macrophyllae 12g, Radix Saposhnikoviae 12g, Asari 6g, Rhizoma Chuanxiong 12g, and Radix Angelicae Sinensis/kloc. 10 dose.
2065438+March 2, 2008 WeChat said: I have been taking medicine for two weeks now, and my buttocks and feet still hurt these days. Will sciatic nerve be treated after all? Please tell me the reason. Answer: no illness is absolute, the degree is different, the treatment method is not necessarily, and I dare not boast of catching a cold. He had the following words: "Do you think I should continue taking those pills now? Consultation fee 2 10 times. I thought you were really good at it, but it turned out to be a hollow reputation. This is pure cheating. I am disabled, only 2000 yuan a month, and I was cheated by you for 400 consultations. I have nothing to say.
On March 8, 20 18, WeChat said, "Hello, Dr. Wang. I shouldn't have said that about you. I'm really sorry. Please forgive me! I have taken all your medicines. On the seventeenth day, the pain from butt to toe was not so obvious, really. I was wrong about you before. Sorry, please forgive me! I have loose bowels from yesterday to now, my waist hurts a little from yesterday to today, and my stomach is a little uncomfortable today. Please write a prescription now. And I have avascular necrosis of the femoral head, please treat it. " Is to enhance the power of promoting blood circulation and removing blood stasis: Radix Angelicae Pubescentis 12g, Herba Taxilli 12g, Radix Gentianae Macrophyllae 12g, Radix Saposhnikoviae 12g, Asari 6g, Rhizoma Chuanxiong 12g, Radix Angelicae Sinensis 12g, and Radix Rehmanniae. Radix Glycyrrhizae Preparata 12g, Carapax et Plastrum Testudinis 30g, Rhizoma Drynariae 30g, Talcum 15g, Rhizoma Atractylodis 12g, Semen Persicae 12g, Flos Carthami 12g and Coicis Semen 30g. 10 dose.
Note: It is difficult to be a doctor, and it is even more difficult to be a famous doctor. It's even harder to be humiliated and forget the past.
Aseptic necrosis of femoral head
Huoxue Yanggu Decoction (Hetianxiang)
(Composition) Radix Angelicae Sinensis 10g Rhizoma Corydalis 10g Pericarpium Citri Reticulatae 10g Radix Curcumae 10g.
Radix Angelicae Pubescentis15g Radix Angelicae Dahuricae10g Cortex Cinnamomi10g Rhizoma Drynariae15g Radix Dipsaci10g Rhizoma Cibotii15g Radix Achyranthis Bidentatae 6g Herba speranskiae tuberculatae10g.
【 Efficacy 】 Promoting blood circulation and regulating qi, dispelling cold and removing dampness, warming meridians and dredging collaterals, and strengthening tendons and bones.
Indications: aseptic necrosis of femoral head epiphysis.
[Usage] This medicine can be taken by decoction, daily 1 dose, and taken in the morning and evening. It can also be ground into powder.
Refine honey into pills, each pill weighs 10g, and take 3 pills a day. 6 grams of frankincense and 6 grams of myrrh can be added.
Grind into fine powder and apply it to the pain with white wine.
【 Solution 】 Aseptic necrosis of femoral head epiphysis, also known as epiphyseal chondrosis of femoral head, or
Flat hip, due to the overload of hip joint, the epiphysis of femoral head has been damaged many times, qi stagnation and blood stasis,
Re-infection of pathogenic wind, cold and dampness leads to blocked blood supply, nutrient loss and diseases. Chinese medicine does not have this disease.
Name, but it was described in ancient medical books. For example, Jin Jian, a medical school in the Qing Dynasty, has a volume of 89 years: "Hip"
Bones, including hip bones and bones. Suffering from wind, cold, and dampness, injuries from falls, swelling and pain due to blood stasis.
Turn over, the feet can't walk straight, the toes with short tendons touch the ground, and the buttocks are inclined. ...
Symptoms are not obvious, hip pain is mild, and the pain disappears after rest, which is often easy to be missed and misdiagnosed.
This disease is not uncommon among teenagers. Radix Angelicae Sinensis, Rhizoma Corydalis, Olibanum and Myrrha are used for promoting blood circulation and removing blood stasis.
Pain: Pericarpium Citri Reticulatae, Radix Curcumae, relieving depression and promoting qi circulation: Rhizoma Drynariae, Radix Dipsaci, Cortex Cinnamomi, Rhizoma Cibotii, and Caulis et Folium Gaultheriae Yunnanensis are warm.
Reinforce yang and kidney, strengthen tendons and bones: Du Hua and Radix Angelicae Dahuricae dispel cold and remove dampness, reduce swelling and relieve pain. The whole prescription nourishes liver and kidney and benefits qi.
Tonify blood, dispel cold and dampness, warm channels and strengthen tendons.
When using this recipe, qi and blood stagnate: Eupolyphaga Seu Steleophaga and Sanguis Draxonis can be added for those with severe cold and dampness.
Rhizoma Atractylodis and Radix Clematidis can be added;
Radix Astragali, Rhizoma Atractylodis Macrocephalae and He Zi can be added for patients with long course of disease and weak constitution.
Car, in order to strengthen the spleen and eliminate dampness, tonify qi and blood.
[Note] Why is this prescription the basic prescription for aseptic necrosis of femoral head epiphysis? It has obvious curative effect.
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