Clinical Study On Treatment Of Knee Osteoarthritis With Blood Stasis And Resolving Collateral By Tongluo External Therapy

Objective:This study is to observe the clinical efficacy and safety of Tongluo External Therapy in the treatment of stagnation of blood stasis type knee osteoarthritis(KOA),and provide new ideas and methods for Chinese medicine treatment of KOA.Methods:This study strictly abides by the diagnostic criteria and standard of Chinese medicine and Western medicine.According to the Kellgren-Lawrence classification standard,the Department of Rheumatology in Hebei Provincial Hospital of Traditional Chinese Medicine collects the requirements of the classification,which is graded from 0 to II.The 90 patients were divided into TCM group,Western medicine group and combination group according to the principle of randomized control,30 cases in each group.The traditional Chinese medicine group was treated with Tongluo external treatment,namely,external application of traditional Chinese medicine hot sputum,puncture and bloodletting combined with local beat;Western medicine group was given oral glucosamine sulfate capsule;combined group wascombined with external collateral treatment on the basis of conventional western medicine treatment.The course of treatment was 6 weeks,and the total clinical effective rate,VAS,WOMAC,ESR,CRP,changes in joint color ultrasonography,and blood routine,liver and kidney function,and electrocardiogram were monitored in three groups.Finally,thedata was summarized and statistical analysis was performed using SPSS 19.0 software.Results:1.After6 weeks of treatment,the total effective rate of the traditional Chinese medicine group was 93.33%,and that of the western medicine group was 86.67%.There was no significant difference between the two groups(P>0.05).The total effective rate of the combined group was 96.67%,which was higher than that of the traditional Chinese medicine group and the western medicine group,statistically significant(P<0.05).However,at the third week of treatment,the total effective rate of the Chinese medicine group was52.7%,that of the Western medicine group was 37.5%,and that of the combined group was 60.3%.There was no significant difference between the Chinese medicine group and the combined group(P>0.05),compared with the Western medicine group.The efficiency was high and there was a statistical difference(P<0.05).2.After 6 weeks of treatment,the VAS and WOMAC scores of the three groups were significantly lower than those before treatment(P<0.05).There was no significant difference between the Chinese medicine group and the Western medicine group(P>0.05).The VAS and WOMAC scores of the combination groupwere significantly lower than other two groups,and the difference was statistically significant(P<0.05).At the third week of treatment,the above indexes of the TCM groupand the combination groupwere all decreased,which was statistically significant(P<0.05),and there was no significant difference in the Western medicine group(P>0.05).3.Among the 3 groups,13 patients in the traditional Chinese medicine group with synovitis showed,11 cases in the western medicine group,16 in the combined group.After 6 weeks of treatment,the joint effusion or synovial thickening improved.4.The ESR and CRP levels of the three groups were observed.Only 6 of the 90 patients before treatment had a slight elevation of ESR.After treatment,theESR decreased to normal level,there was no difference in serum levels before and after treatment(P>0.05).There were no obvious abnormal changes in ESR、CRP,liver and kidney function and electrocardiogram before and after treatment in the three groups.5.In the course of treatment,there were 1 case of side reaction in the Chinese medicine group,the incidence rate was 3.33%;in the Western medicine group and the combination group,each group had 2 cases occurred,the incidence rate was 6.67%.Conclusions:1.Tongluo external treatment can improve the VAS score,WOMAC score and synovitis joint color ultrasonography of knee osteoarthritis.The curative effect is comparable to that of glucosamine sulfate capsule alone,and the effect is faster,the incidence of side reactions is low,and the safety is high.The combined effect of the two is significantly better than the single treatment.2.Under the guidance of collateral disease theory,patients with phlegm and blood stasis type knee osteoarthritis can be treated with Tongluo external treatment to achieve the purpose of activating blood circulation,removing phlegm and relieving pain and relieving the disease.