| ObjectiveKnee osteoarthritis (KOA) is one common chronic disease, which often occurson the middle-aged people. Main symptom of this kind of disease is the painof knee and graduallys articular dyskinesia of the knee. The cause of diseasemain is mainly connected to the age, the heredity, sex, obese, fleshwound,high-pressured in the bone, the oxygen free radical, the cell factor and thegrowth factor, autoimmunity and conduction disorder and so on. Its pathologicalcharacteristic is the primary or secondary change on the articular cartilage,which cause the articular cartilage degenerates, softens and graduallyvanishes; the bone under the cartilage formates ossification, then thesynovitis, contracture of joint, narrow of joint space, articular dyskinesiaand so on, which seriously affects people's normal life and the work. The methodof treatment on this disease of modern medicine are mainly depended on themethods of the medicine and the surgery.Chinese medicine relegate this disease to "rheumatism involvingbone". Its main cause and pathogenesis are the deficiency of liver and kidneyand the insufficient of the Qi and blood, belonging to asthenia in origin andasthenia in superficiality. Its main treatment method is tonify liver andkidney, aiding with promoting blood flow and stretching tendon or communicatewebs. In clinical, endotherapy method by determination of treatment based inpathogenesis obtained through differentiation of symptoms and signs were majorby means of invigorate the kidney, invigorate the kidney and promoting bloodflow, soft liver methods. External treatment methods include applicationmethod, fumigate and washing, heat smooth, intraarticular injection, Chinsesemedicine iontophoresis, little needle-knife matching with Chinsese medicine,acupuncture, massage and so on. Also having combine endotherapy method with external treatment method. Via many study and clinical research validation,Chinsese medicine can improve the nature of osteoarthritic articularcartilage, improve the function of chondrocyte, down-regulate the level ofhormone, remove redundant oxyradical and increase the ability of counteractingoxyradical on osteoarthritic treatment aspect.Currently, invigorate the kidney and promotingbiood flow methods areutilized on osteoarthritic treatment. It was confirmed that this method candecrease NO level of osteoarthritic animal mould in serum, articular cartilageand synovium. It could delay the histological course of osteoarthritis andinhibited the generation and development of OA. In clinical treatment thismethod had got satisfactory curative effect. According to "the kidney beingin charge of bone", "liver - kidney correlation" and "blood stasis view",our research group under my tutor guiding, to summarize clinical experienceon OA, we raised the major principle of treatment on OA that included reinforceliver-kidney, reinforcing QI and promoting blood. We also had manufacturedthe Chinses medicine named "gu yan ding". Via our previous clinical study,this Chinese medicine could ameliorate the pain, swelling and functionalimpairment of knee OA. It also could improve intraosseous pressure and bloodcirculation. Its curative effect was satisfactory.Although application of invigorate kidney and improve blood method ontreatment on OA had got satisfactory result and curative effect. But inclinical study, particular in evaluating clinical effect, researchers usuallyadopt subject feeling to assessment. When doctor formulating the standard ofcurative effect, they usually felt the standard was short of objective andstandard because Chinese medicine was short of precise magnitude index. Thestandard was short of delineation as for feeling and mentation. Also thestandard was short of reflection onsociality and correlaton factor. Survialquality scale will solve the fuzzification and chanciness of the Chinesemedicine standard of curative effect. It can settle the groundwork for theclinical study on invigorate the kidney and promoting blood flow method. KneeOA is a chronic disease with high mutilation rate. The goals of treatment areto relieve symptom and improve the acromegalic survival quality. When theprognosis of disease was only partly recovery, it was very significant toinspect the survival quality using with measuring scale.Method Our study's focal point was invest the improvement of acromegalicsurvival quality post-treatment. The object were all from the first affiliatedhospital of Guangzhou university of Chinses medicine who come to our hospitalfrom March 2005 to September 2006. We select 72 cases of knee OA, divided into2 groups randomly. The cases included 113 osteoarthritic knee joint, 41 caseswith double osteoarthritic knee, 31 cases with single osteoarthritic knee.Two groups had no significant difference in the aspects of age, the courseof disease, inhabited environment, culture level, occupation, marriage stateand so on (P＞0.05). The clinical study used "gu yan ding" to treat on kneeOA. We select celebrex as for control group. We invest the clinical symptom,James accumulated points and survival quality at one week before beginningtreatment. The all cases overdose for 6 weeks. After 6 weeks we investedclinical curative effect and invested James accumulated points and thesurvival quality scale after 6 weeks and 10 weeks. Then we analyzed the findingsof survival quality scale. Also we analyzed the study's findings contrastingwith the findings of Guangzhou community of old people.ResultAfter 6 weeks post-treatment, western medicine group had 3 cases exitedfrom the study because of gastrointestinal tract reaction. Chinse medicinegroup had one case losing. The study had 72 cases completing the study. Atthe aspect of curative effect, Chinese group's total effective rate was 77.1%, the other group was 81.1%, with no significant difference(P＞0.05). Itillustrated Chinsese medicine had the similar curative effect to westernmedicine. The two groups had no significant difference(P＞0.05) in Jamesaccumulated points after 6 and 10 weeks post-treatmet. It illustrated thatthe two methods could markedly improve James points, relieve the state of OAand improve the activity of daily living. The James points in the two groupsdecreased a little after 10 weeks, but having no significant difference tocompare with after 6 weeks. It illustrated that the symptom didn't obviouslyrepeat after withdrawl for 4 weeks. The prostecditive efficacy of Chinesemedicine was similar to celebrex. The two groups had significant differenceat the aspects of role-physical and bodily pain between pretherapy andposttherapy. But between Chinese medicine group and western medicine groupwith no significant difference(P＞0.05), It illustrated the efficacy ofChinses medicine was similar to western medicine at the aspects of role-physical and bodily pain. In the aspects of physiological functions,Chinese medicine group had significant difference between pretherapy andposttherapy. It had no significant difference between after 6 weeks and after10 weeks(P＞0.05). It illustrated that Chinese medicine could improverole-physical. Western medicine group had no significant difference betweenpretherapy and posttherapy(P＞0.05). Between Chinese medicine group andwestern group, Chinese group had better effect than western medicine groupat the aspect of role-physical. At the aspect of vitality, Chinese medicinegroup had significant difference between pretherapyand postherapy(P＜0.05).It illustrated that Chinese medicine could improve vitality. At the aspectsof sentiment and functional authority, the two groups had significantdifference(P＜0.01). It illustrated that Chinses medicine had better effectson sentiment and functional afthority than western medicine. Contrasted withthe findings of quality of life scale of Guangzhou healthy middle and agedpeople, the two groups had obviously lower than the level of the same age healthypeople's. Because of pain, It cause that knee osteoarthritic people decreasedtheir physical training and exercise. The symptom such as pain had someremittance After therapy, but it didn't come to the level of health adult.So at three latitudinal aspects, the two groups should be lower than healthypeople's. At the bodily pain latitudinal aspects, the two groups had higherpoints posttherapy than pretherapy, but they were lower than healthypeople's. It illustrated that treatment on knee OA is a long-term andpersistent course.In the others contrast, Chinese medicine group had similar to healthypeople's. At the aspect of social functioning and sentiment role emotional,Chinese medicine had little higher lever than healthy people's. It confirmedthat Chinese medicine treat disease based on whole concept and determinationof treatment based in pathogenesis obtained through differentiation ofsymptoms and signs. The two groups had no significant difference between after6 weeks and 10 weeks. The two groups had no obvious rebound phenomenon. Itillustrated that the two methods had better long-term effect, but we shouldtake into further long-term survey.ConclusionThe study confirm that the effect of Chinese medicine named "gu yam ding"was similar to celebrex at aspect of clinical curative effect, James accumulated points. At aspect of improvement of survival quality scale, thetwo groups has similar effect by means of bodily pain. At the aspect of physicalfunctioning, vitality and sentiment role-emotional, Chinese medicine hasbetter effect than celebrex. The two groups contrasted with the findings ofhealthy middle and aged people in Guangzhou at the aspect of physicalfunctioning, role-physical and Vitality, the two groups have lower lever. Atother items, Chinese medicine is similar to healthy people's. At the aspectof social function and sentiment functional authority, Chinese medicine islittle higher than normal healthy people's. Contrasted with western medicine,Chinese medicine have some good quality such as widespread application,hypotoxicity, low side reaction, cheap, caplendus conveniently and so on. Itembodies the superiority of Chinsese medicine thoroughly with holism anddifferentiaton of symptoms and signs.
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