A, Chinese medicine on the understanding of femoral head necrosis Femoral head necrosis belongs to Chinese medicine “bone erosion”, “bone paralysis”, “bone pole”, “bone category “Bone. For example, in Su Wen? The long thorn in the body says that “the disease is in the bone, the bone is heavy and cannot be lifted, the bone and hip are sore, and the cold is to the name of bone paralysis.” Chinese medicine has the feasibility and superiority in treating ischemic necrosis of the femoral head. Oral treatment is given to tonify the qi, activate the blood, strengthen the tendons and bones, nourish the liver and kidneys, and activate the blood vessels. According to TCM, the causes of disease are divided into internal and external causes, and they interact with each other. The internal cause is the root of the disease, and the external cause works through the internal cause, which is the loss of balance of yin and yang in the body and the poor functioning of qi and blood. Congenital deficiency, acquired loss of nourishment, strain, trauma, mismanagement can cause the occurrence of the disease. 1, caused by trauma, fall, flash, or encounter external violence, or broken tendons and bones, or stagnation of the meridians, or joint dislocation, can make the hip qi and blood flow is not smooth and stagnant, the meridians and veins are not blocked, the bone is not nourished and the thigh pivot paralysis, bone impotence. In the Treatise on the Origin of Diseases, it is said that “blood and qi are isolated and cannot circulate. After the hip is damaged, improper treatment or poor repositioning or fixation will further aggravate the damage to the hip meridians, stasis of blood, or injury to the qi of the five organs and cause the disease. 2, the six lethargy invasion Six lethargy in the wind, cold and damp evil is most likely to invade the human body, especially the cold evil is the most important. Cold is a Yin evil easy to hurt Yang Qi, cold stagnation and collection, wind and cold evil invasion of the hip meridians, blood and Qi stagnation, blood stasis, loss of warmth of tendons and bones, tendons and veins contracted, flexion and extension is not conducive to this disease. 3. External attack of evil and poison External attack of evil and poison on the human body, redness, swelling, heat, pain, pain contracture, flexion and extension is unfavorable, and the disease occurs after a long time. 4, the deficiency of the righteousness of the innate essence of the kidneys, the kidneys collect the essence of the marrow, the main bone, liver, tendons. The spleen and the stomach are the origin of the latter, the main transport of water and grain and the source of biochemical energy and blood. If the spleen and stomach are not able to transport water and grain, the liver and kidney will be deficient and the marrow will be empty, so the kidney will not be able to produce marrow for the bones and the marrow will not be able to nourish the bones and the liver blood will not be able to honor the tendons. Femoral epiphysis dysplasia or acetabular dysplasia, congenital dislocation of the hip joint, can lead to this disease. 5, phlegm and dampness blocking the lane vegetative obesity, over-eating fatty, sweet, thick and greasy, or long-term heavy drinking, resulting in the spleen loss of health, water and dampness transportation and abnormal, dampness trapped in the spleen and earth, long heat and phlegm, and wine is the essence of grains born, the nature of the great heat toxic, long-term heavy drinking people, dampness and heat is also Sheng. Over time, this leads to phlegm and heat flowing into the joints, blood vessels do not flow, tendons and bones lost in the Ying Qi full nourishment, bone marrow empty and disease. 6, drug abuse long-term use of a large number of hormones, can cause qi deficiency and blood stagnation, injury to yin and yang or spleen and kidney yang deficiency leading to the loss of tendons and bones and the onset of disease. The Chinese medicine typology of femoral head necrosis 1, early (acute stage) pain in the affected hip, muscle spasm, hip joint movement is limited. x-ray: narrowing of the joint space, bone trabeculae of the femoral head is sparse. The duration is about 4 to 6 weeks. In the early stage, the main cause of the problem is evil, or Qi stagnation and blood stasis, or cold and damp paralysis. In the middle stage (necrosis stage), the pain and spasm of the affected hip increases, the limb flexes and retracts, and there is mild internal contraction, and symptoms of traumatic arthritis may appear. x-ray: the femoral head becomes denser, and the femoral neck becomes thicker and shorter with cystic changes. The duration is about 1 to 1.5 years. In the middle stage, there is a mixture of deficiency and reality, but the evil reality is still predominant. In the late stage (recovery period), the pain and spasm of the affected hip are relieved, but the limb is somewhat inward and shortened, and the walking limp. x-ray: the density of the femoral head is uniformly increased, and only some clear bone trabeculae can appear, and the femoral head is flattened and widened, and becomes myxoid. In the later stage, deficiency or liver and kidney deficiency or qi and blood deficiency is the main pathogenesis. Third, the signs and symptoms of femoral head necrosis: 1, pain. Early stage can have no clinical symptoms, the most common early symptom is hip or knee pain, pain can be continuous or intermittent, also pain at rest, aggravated by activity, pain can be hip tingling, dull pain or soreness and discomfort, etc.. The pain may be tingling, dull pain or soreness and discomfort in the hip. It radiates to the groin, posterior hip, lateral side, and knee. The pain is not severe in the early stage, but gradually increases. There is often a history of taking a lot of hormones, or a history of drinking a lot of alcohol for a long time. 2. Restricted activity. In the early stage, patients have normal or slight loss of hip joint activity, which is characterized by limited movement in a certain direction, especially internal rotation. And this feature is more obvious when the disease is aggravated. 3.Crippling. Intermittent claudication occurs due to increased pressure in the femoral head, increased pressure in the hip joint and ischemia, which improves after resting. In the late stage, the claudication increases due to flexion, external rotation and internal deformity. Signs: no swelling, deformity or heat in the hip joint, may have atrophy of the quadriceps and gluteus maximus muscles, and pressure pain in the groin area. Often limping gait, severe femoral head collapse may be accompanied by shortening of the affected limb. Early Thomas, double “4” test is positive. Chinese medicine treatment of femoral head necrosis: Using Chinese medicine treatment, activating blood circulation, filling the marrow, tonifying the kidney and strengthening the bone, especially for the early stage of femoral head necrosis without collapse has a better effect. Mechanism of action of Chinese herbal medicine for femoral head necrosis: improve microcirculation of bone, increase blood flow, lower intraosseous pressure, inhibit platelet aggregation, reduce the degree of osteonecrosis, promote osteonecrosis repair, and have the effect of promoting blood vessel growth and protecting microcirculation. Blood activation and blood stasis class can make the blood high viscosity state is improved, improve the serum calcium content and calcium and phosphorus deposition level, while reducing the loss of bone calcium, have the effect of protecting bone cells, osteoblasts, can reduce and improve the bone tissue ischemic condition. The tonic class can improve the endocrine level of the body and inhibit bone resorption to promote bone formation.