The influence of traditional Chinese medicine constitutions on the potential repair capacity after osteonecrosis of the femoral head.

OBJECTIVES: To explore the effects of traditional Chinese medicine (TCM) constitutions on repair capacity after osteonecrosis of the femoral head (ONFH).

DESIGN AND SETTING: Ninety-six patients with TCM constitutions of yang-deficiency, dampness-heat and/or blood-stasis were recruited from the orthopedic outpatient clinic of the Guang'anmen Hospital of the China Academy of Chinese Medical Science. Each patient underwent computed tomography (CT) examination of the hips, and CAD software was used to estimate proximal sclerosis ratios based on the CT images.

MAIN OUTCOME MEASURES: The proximal sclerosis ratios of subjects with different TCM constitutions were found to be significantly different (P=0.046): the ratios of subjects with the yang-deficiency, dampness-heat, blood-stasis, yang-deficiency plus dampness-heat, yang-deficiency plus blood-stasis, and dampness-heat plus blood-stasis constitutions were, respectively, 0.20±0.25, 0.24±0.25, 0.39±0.29, 0.29±0.37, 0.35±0.29, and 0.42±0.28. Differences among the three types of single, uneven constitutions were also observed (P=0.042).

RESULTS: For each pairwise comparison, the yang-deficiency constitution was different from the blood-stasis constitution (P=0.02) and dampness-heat plus blood-stasis constitution (p=0.02). The proximal sclerosis ratio was lower in the yang-deficiency constitution group but higher in the blood-stasis constitution group.

CONCLUSIONS: TCM constitutions influence the capacity for ONFH repair. The blood-stasis constitution has a strong repair ability, but the yang-deficiency constitution has a poor repair ability and tends to collapse and require positive treatment. Furthermore, important therapeutic principles should reinforce the kidney and strengthen the spleen.