The Theoretical And Clinical Research On Kashin-Beck Disease Of Knee Joint With Tuina And Drug

Kashin-Beck Disease (KBD) is a systemic disease dominated by joint disease. The etiology and pathogenesis of it remain to be unclear so far. And there is no effective therapy at present. In this paper, treating KBD with Tuina and drug both in theoretical and clinical aspects is discussed and researched.Theoretical ResearchThis research analyses KBD from its epidemiology, Chinese medical literature, and modern medical literature. Simultaneously, explore and research "overall conditioning" KBD of TCM in ideological and theoretical basis-back theory of meridians and acupoints, and "Partial loosening" in ideological and theoretical basis-Theory of joint mobilization. On this basis, propose that the principle of treating KBD should be "treating Biao and Ben with the same therapeutic principle of joint and back Shu", of which is from the academic thought of "overall conditioning", "syndrome differentiation", "partial loosening" of the tutor Professor Luo Caigui. And combine it to the clinical practice of the old TCM doctor as well as basing on the pathogenesis of KBD and the characteristics of the main symptoms, to retain the useful part, select, integrate and develop a clinical treatment of KBD of knee joint by Tuina and drug therapy, to provide experimental basis for further research.Clinical ResearchObjective:To evaluate the efficacy and safety of Tuina combined with drug therapy and that of Western medicine combination therapy as the clinical treatment of KBD of knee joint under the principle in the treatment of "treating Biao and Ben with the same therapeutic principle of joint and back Shu".Methods:Take a randomized, single-blinded, and controlled trial, with 150 patients divided into two groups in which 75 cases in treatment group of Tuina and drug therapy (that is TG) and 75 cases in control group of Western medicine combination therapy (that is CG). Having the SF-MPQ Index, range of knee movement, quality of life index (QOLI) and knee X-ray score as the clinical observation indexes to observe the efficacy and safety of each group after treatment for three months. Simultaneously, observe the efficacy of stopping treatment after three months and six months.Results:1. Evaluation results of the observing indexes:(1)SF-MPQ index:â‘ Comparing it before treatment to three months after treatment within groups with FAS and PPS analysis, the difference of both groups was statistically significant (p<0.01). But when compared it between groups, the difference was not statistically significant (p> 0.05). It suggested that both groups have good analgesic effect.â‘¡When compared it three months after stopping treatment between groups with FAS and PPS analysis, the difference was statistically significant (p<0.01), which indicated that both groups have good analgesic effect, but TG is better than CG.â‘¢Comparing it six months after stopping treatment between groups with FAS and PPS analysis, the difference was statistically significant (p<0.01), which illustrated that both groups still have good analgesic effect, but TG is still superior to CG.(2)Range of knee movement:â‘ Comparing it before treatment to three months after treatment within groups with FAS and PPS analysis, the difference was statistically significant (p<0.01). But when compared both sides of knee flexion angle and the difference of flexion angle and extension angle of it between groups, the difference was statistically significant (p<0.05), while knee extension angle was not statistically significant (p> 0.05). The above implied that both groups play a good role in improving short-term knee function, but TG is better than CG in improving flexion function while their capabilities of improving knee extension function are comparable.â‘¡Comparing it three months after stopping treatment between groups with FAS and PPS analysis, the difference was statistically significant (p<0.01), which indicated that TG is better than CG in improving the function of knee joint of long-term efficacy.â‘¢Comparing it six months after stopping treatment between groups with FAS and PPS analysis, the difference was statistically significant (p<0.01). It suggested that TG maintains longer in long-term effect of improving the knee joint movement than (3)Quality of life index (QOLI):â‘ Comparing it before treatment to three months after treatment within and between groups with FAS and PPS analysis, the difference was statistically significant (p<0.01), suggesting that both groups can improve life quality of patients, but TG is better than CG.â‘¡Comparing it three months after stopping treatment between groups with FAS and PPS analysis, the difference was statistically significant (p<0.01). It implied that both groups can improve life quality of patients three months after stopping treatment, and TG is still superior to CG.â‘¢Comparing it six months after stopping treatment between groups with FAS and PPS analysis, the difference was statistically significant (p<0.01). It indicated that although both groups could improve life quality of patients six months after stopping treatment, TG is still superior to CG.(4)knee X-ray score:Comparing it before treatment to three months after treatment, three months after stopping treatment and six months after stopping treatment with FAS and PPS analysis, the difference was not statistically significant (p>0.05), indicating that both therapies have little efficacy in X-ray Change. 2. The results of the overall efficiency evaluation:(1)Three months after treatment, there was no statistically significant difference between two groups in the total effective rate (p>0.05) with FAS and PPS analysis, while cure rate between two groups was statistically significant (p<0.01), indicating that the cure rate in TG is better than CG.(2)Three months after stopping treatment, the difference of the total effective rate and the cure rate of TG and CG were statistically significant (p<0.01) with FAS and PPS analysis, indicating that both total effective rate and cure rate in TG are better than CG.(3)Six months after stopping treatment, the difference of the total effective rate and the cure rate of TG and CG were statistically significant (p<0.01) with FAS and PPS analysis, indicating that both total effective rate and cure rate in TG are better than CG.3. Safety evaluation results: 2 cases of adverse reaction occurred in TG, the adverse reaction rate was 2.70%; 9 cases of adverse reactions occurred in CG, the adverse reaction rate was 12.33%. Comparing the incidence of adverse reactions of the two groups, the difference was statistically significant (x2= 4.9186, P= 0.0266<0.05), which suggested that the safety of TG is better than CG.Conclusion:1. The principle in the treatment of "treating Biao and Ben with the same therapeutic principle of joint and back Shu" under the academic thought of "overall conditioning", "syndrome differentiation" and "partial loosening" is tenable to the efficacy of KBD of knee joint. 2. Both Tuina combined with drug therapy under the principle in the treatment of "treating Biao and Ben with the same therapeutic principle of joint and back Shu" and Western medicine combination therapy have good efficiency in treating knee KBD. When it comes to short-term cure rate, long-term clinical efficacy and safety, Tuina combined with drug therapy is superior to Western medicine combination therapy.