股骨头坏死中西医结合诊疗专家共识(1)

世界中医药2023年4月第18卷第7期·901·股骨头坏死中西医结合诊疗专家共识世界中医药学会联合会骨质疏松专业委员会上海中医药大学附属龙华医院中日友好医院教育部筋骨理论与治法重点实验室摘要股骨头坏死(FHN)又称股骨头缺血性坏死(AVN),是骨科领城常见的难治性疾病，其发病机制尚未完全阐明。为规范残病诊断体系并捉高临床疗效，通过组织全国多个省、直辖市中医和西医领城相关专家进行多次讨论和修改，共同制定《股骨头坏死中西医结合珍诊疗专家共识》（以下简称共识）。共识中西医并重，参考股骨头坏死等相关诊断标准制定股骨头坏死中西医结合珍治的专家共识：同时参考中医骨痹、骨蚀等相关中医珍断标准制定股骨头坏死中医辨证珍断体系和辨证论治的专家共识，并针对残病各期采取不同的中西医结合治疗方法，有确切的临床优势且安全性较高，可供临床医师参考应用。关键词股骨头坏死：中西医结合：辨证诊疗：专家共识Expert Consensus on the Diagnosis and Treatment of Femoral Head Necrosiswith Integrated Traditional Chinese and Western MedicineOsteopomosis Professional Committee of the World Federation of Chinese Medicine Societies,Longhua HospitalShanghai University of Traditional Chinese Medicine,China-Japan Friendship Hospital,Key Laboratoryof Muscle and Bone Theory and Treatment of Ministry of EducationAbstract Femoral head necrosis(FHN),also known as avascular necrosis(AVN),is a common and refractory disease in ortho-pedics,and its pathogenesis is not yet fully elucidated.In order to standardize the disease diagnosis system and improve clinicalefficacy,the Expert Consensus on the Diagnosis and Treatment of Femoral Head Necmsis with Integrated Traditional Chinese andWestern Medicine(hereinafter referred to as Consensus)has been jointly formulated by organizing experts in the fields of tradi-tional Chinese medicine(TCM)and western medicine in many provinces and municipalities in China for many rounds of discus-sions and modifications.In the Consensus,both TCM and westem medicine are attached equal importance,and the Consensus isestablished by consulting relevant diagnostic standards such as FHN.At the same time,the expert consensus on TCM diagnosissystem and treatment based on syndrome differentiation of FHN is established by consulting the relevant TCM diagnostic standardsof bone arthralgia and bone erosion,and different integrated traditional Chinese and western medicine treatment methods are a-dopted for the disease in different stages.It has definite clinical advantages and high safety,which can be used for references andapplication for clinicians.Keywords Femoral head necrosis;Integrated traditional Chinese and western medicine;Diagnosis and treatment based on syn-drome differentiation;Expert consensus中图分类号：R274文献标识码：Adot:10.3969/i.isn.1673-7202.2023.07.003为明确中西医结合在股骨头坏死(Femoral Head本共识在充分考虑专家临床经验和患者意愿的Necrosis,FHN)诊疗中的作用，提高中西医结合诊疗基础上，遵循规范程序，针对前期来自临床一线调查水平，世界中医药学会联合会骨质疏松专业委员会总结的临床问题，开展循证评价。通过名义组法组织专家根据近年来HN最新诊疗进展，参考国内(Nominal Group Technique,NGT)形成本共识的推荐外指南和最新循证医学证据，结合临床经验，经过多意见或共识建议。专家共识意见的形成主要考虑证次讨论给出推荐意见，制定本共识。据质量、经济学、疗效、不良反应、患者可接受性以及基金项目：国家自然科学基金项目(81730107,81930116,81873321)：国家中医药“传承创新团队“计划项目(ZYYCXID-C-202202):国家科技部重点领域“创新团队”计划项目(2015RA4002):回家教育部“创新团队”计划项目(1RT270):上海市市级科技重大专项(2017SH☑☑X01):上海市重中之重研究中心建设项目(2022☑01009)：上海市促进市级医院临床技能与临床创新三年行动计划重大临床研究项目(SHD2020CR1010A):上海市长宁区卫生与计划生有委员会光华卓越PI工程(201601,2016-06)通信作者：阁小神(1945.08一)，女，本科，主任医师，教授，全回名中医，首都回医名师，研究方向：中西医结合治疗关节炎等风湿免疫疾病的临床研究，E-mal:yanxiaopingl688@126.m:王拥军(1965.09一)，男，博士，主任医师，教授，研究员，研究方向：中医药防治慢性筋骨病基确与临床研究，E-mail:y