| Lumbar osteoarthritis refers to the osteoarthritis which takes place in the lumbar vertebras.It refers to the osteoarthritis caused by the narrowed and degenerative lumbar intervertebral ligament,the degeneration and hyperplasy of the vertebra body margin and the degeneration of the I-B minor joints and refers to a series of symptoms caused by them.Its main clinical symptoms are the chronic continuous or interrupted lower back pain.The Western Medicine therapy mainly adopts non-steroidal anti-inflammatory drug(NSAID) which inhibits the epoxidase' blocking the arachidonic acid metabolism and inhibits prostaglandin synthesis,so as to inhibit inflammation and pain and improve the clinical symptoms.At the same time,however,it can weaken the physiological protection of prostaglandin,cause serious impairment to stomach duodenum and kidney and damage the cartilage,especially among the aged population among whom lumbar osteoarthritis has high occurrence.At present safe and efficient medicine or therapies are not available.Lumbar osteoarthritis belongs to the category of arthromyodynia and lumbago of Chinese Medicine which has discussed this disease for a long time in history.Internal Classics notes that waist houses the kidney;if the waist can' t move around,the kidney will be exhausted.Standards for Diagnosis and Treatment wind,dampness,coldness,heat,sudden sprain and contusion, stagnated blood,obscure complexion and phlegm are all signs;the root is kidney deficiency.These indicate the close relationship between lumbar osteoarthritis and kidney and kidney deficiency is the key cause.Modern Chinese Medicine considers that this disease is asthenia in origin and sthenia in superficiality.The asthenia indicates the liver and kidney deficiency, tendons and bones' loss of nutrition;the sthenia refers to cold dampness, blood stagnation,meridians and collaterals and blood vessels not smooth.The treatment principles should be to reinforce liver and kidney,strengthen tendons and bones,disperse wind,coldness and dampness,smooth the blood and activate the collaterals.Angelicae Pubescentis and Loranthi Decoction comes from Valuable Prescriptions Worth A Thousand Gold which reinforces liver and kidney and disperse wind,coldness and dampness,and treat both signs and roots of diseases.It consists of prepared rhizome of rehmannia,achyranthis,eucommia bark and Chinese taxillus herb to reinforce liver and kidney,angelica, Szechwan lovage rhizome,paeonia,radix codonopsitis,hoelen and sweet root to replenish blood and qi and angelica tuhov,largeleaf gentian root, saposhnikoviae radix and asiasarum and ramulus cinnamoni to disperse wind, coldness and dampness evil factors.It' s the common prescription for the lumbar vertebra hyperosteogeny of the type of kidney deficiency.The current clinical researches on lumbar osteoarthritis with Chinese Medicine mainly focus on the efficacy observation of certain prescription or drug.These lack of scientific research methods,unified diagnosis standard and efficacy standard.In efficacy evaluation,these mainly adopt the traditional indexes like morbidity rate,attack rate,remission rate and effective power,etc.These indexes can' t truly reflect the patients' comprehensive response to treatment nor comprehensively evaluate the intervention effect and finally can't meet the population's new requirements for health.The research results can't fully reflect the drug's efficacy and is not useful for the promotion of lumbar osteoarthritis treatment with Chinese Medicine.Aim:based on the background mentioned above,we designed the trial plan of lumbar osteoarthritis treatment efficacy evaluation with Angelicae Pubescentis and Loranthi Decoction.By evaluating the patients' clinical symptom improvement and life quality improvement,we hope that accurate evaluation will be made on the lumbar osteoarthritis treatment efficacy evaluation with Angelicae Pubescentis and Loranthi Decoction.Methods:Collect 53 lumbar osteoarthritis patients who meet the diagnosis, inclusion and exclusion criteria,give treatment with Angelicae Pubescentis and Loranthi Decoction granules for 3 months,and at the period of before treatment,1 month after treatment,2 months after treatment and at the end of the treatment respectively observe patients' evaluation on efficacy, doctors' evaluation on efficacy,patients' evaluation on lumbar pain,lumbar pressing pain and lumbar movement difficulties with Visual Analogue Scale; research on the effect of Angelicae Pubescentis and Loranthi Decoction granules on the patients' life quality.Results:1.After one month' s treatment with Angelicae Pubescentis and Loranthi Decoction granules,the doctors' and patients' general evaluation on lumbar pain,accompanying symptoms,daily activities and work has improved;after 2 months,the general evaluation continuously improve and the difference has statistical significance compared with that 1 month after treatment;at the end of the treatment,the evaluation has obvious improvement compared with that before treatment and has statistical significant difference.2.After one month' s treatment with Angelicae Pubescentis and Loranthi Decoction granules,the patients' lumbar pain symptoms improve and the difference has statistical significance compared with that before treatment; after 2 months,the lumbar pain continuously improve and the difference has statistical significance compared with that before treatment;at the end of the treatment,the lumbar pain has obvious improvement and has statistical significant difference.3.After one month' s treatment with Angelicae Pubescentis and Loranthi Decoction granules,the patients' PF,RP,BP,GH,VT,ST,RE,MH improve and the difference has no statistical significance;after 2 months,the PF, BP,GS and SF obviously improve and the difference has statistical significance compared with that before treatment;after 3 months' treatment,the PF,BP, GS and SF has continuous improvement and has statistical significant difference compared with that before treatment,but the RP,VT,RE and MH still haven't statistical difference though has improvement at certain level.Conclusion:1.Obvious efficacy occurs after 2 months' treatmetn with Angelicae Pubescentis and Loranthi Decoction granulesLumbar osteoarthritis belongs to the category of arthromyodynia and lumbar pain in Chinese Medicine which considers that waist houses the kidney and kidney supports bones.According to position of the meridians and collaterals' circulation,lumbar belongs to the circulation part of Du-meridian.Foot-taiyang Urinary Bladder Meridians move on both sides of lumbar and form the interior and exterior relationship with Kidney Meridian of Foot-shaoyin.Therefore,kidney qi,Du-meridian and Urinary Bladder Meridian qi maintain the normal function of waist.When people reach middle age,the kidney qi gradually loses,muscle and viscus are void,wind,cold and dampness evils enter,blood vessels stagnate,arthralgia spasm occurs to Du-meridian and pain is caused.Angelicae Pubescentis and Loranthi Decoction comes from Valuable Prescriptions Worth A Thousand Gold which reinforces liver and kidney and disperse wind,coldness and dampness,and treat both signs and roots of diseases.It consists of prepared rhizome of rehmannia,achyranthis, eucommia bark and Chinese taxillus herb to reinforce liver and kidney,angelica, Szechwan lovage rhizome,paeonia,radix codonopsitis,hoelen and sweet root to replenish blood and qi and angelica tuhov,largeleaf gentian root, saposhnikoviae radix and asiasarum and ramulus cinnamoni to disperse wind, coldness and dampness evil factors.This prescription takes into consideration of the etiology and pathogenesis of lumbar osteoarthritis,therefore after treatment,the doctors' and patients' general evaluation on lumbar pain, accompanying symptoms,daily activity and work improve remarkably.As the formation of lumbar osteoarthritis is a long time and patients coming for treatment generally have long disease course whose kidney deficiency is more serious and difficult to support the healthy qi and diminish the evil after unsatisfactory treatment,so the treatment will take a long time.2.After 1 month' s treatment with Angelicae Pubescentis and Loranthi Decoction granules,the lumbar pain is obviously relieved and after 2 months the lumbar pain and lumbar movement difficulties are relievedCompared with treatment of lumbar pressing pain and lumbar movement difficulties,Angelicae Pubescentis and Loranthi Decoction has quicker effect on lumbar pain.After 1 month' s treatment,the lumbar pain obviously improves and has statistical difference while the lumbar pressing pain and lumbar movement difficulties need two months on average to have the efficacy of statistical difference.It may have association with medication dosage form, besides the other factors like the disease course is long,the kidney deficiency is getting serious,the healthy qi is hard to reinforce,etc. Decoction can diminish evil qi more quickly.Angelicae Pubescentis and Loranthi Decoction granules are equivalent to pills and powder and the drug action is slow.However,to the disease deep at bones and joints,decoction must be used.The treatment takes long time,so making decoction is not convenient,especially in the quick-rhythm modern society,therefore granules are more practical.3.Angelicae Pubescentis and Loranthi Decoction granules can improve patients' life qualityAfter treatment,the patients' physiological function improves with the release of symptoms and improvement of activity ability;body pain is obviously relieved which is consistent with clinical observation;the general health obviously improves,and the recovery of lumbar pain brings the improvement of activity difficulty as lumbar is the major weight loading and activity part; as the recovery of pain,the improvement of movement ability and the increase of movement range,the social function of patients improves;the ability of housework and daily work improvement is very helpful for the improvement of patients' life quality.However,the research shows that there' s no statistical difference in the improvement of RP,VT,RE and MH.It indicates that though after 3 months' treatment,the clinical symptoms obviously improve;patients' mental and physiological health is affected more or less as the disease can only be controlled but not cured.Whether the further treatment can improve the patients' life quality is worth of further research.The research results above fully demonstrate the confirmed efficacy of Angelicae Pubescentis and Loranthi Decoction granules on the treatment of lumber vertebra arthritis which can significantly improve the patients' clinical symptoms and improve their life quality.This research provides evidence for the clinical efficacy of Chinese Medicine in the treatment of bone joint regressive diseases. |
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