A Clinical Study On The Treatment Of Knee Osteoarthritis Synovial Lesions Based On The Oral Administration Of Traditional Chinese Medicine Based On B-ultrasound Evaluation

[Background and purpose]Knee osteoarthritis(KOA),also known as degenerative osteoarthritis and proliferat ive arthritis of the knee,is characterized by primary or secondary degeneration and str uctural disorders of the knee cartilage,accompanied by subchondral osteoporosis and s clerosis,cartilage exfoliation and aseptic inflammation of the synovium,which graduall y destroys and deforms the joints and ultimately leads to a degeneration of knee joint dysfunction.Sexual diseases.The clinical manifestations were knee pain,swelling,stif fness and difficulty in movement.At present,it is generally believed that the occurren ce of knee osteoarthritis is mainly related to age,sex,obesity,joint injury,environme nt,heredity,diet and so on,among which age is the strongest pathogenic factor.Previ ous studies on the pathogenesis of osteoarthritis mainly focused on cartilage degenerati on,subchondral bone sclerosis,weakening of knee muscle strength,and neglected syn ovitis inflammatory lesions,even considered that it was only a secondary change in th e course of osteoarthritis.In recent years,a large number of studies at home and abro ad have pointed out that knee osteoarthritis is accompanied by the occurrence and dev elopment of synovitis from early to late.Synovitis lesions may be the primary manife station of knee osteoarthritis,and affect the progress of knee osteoarthritis.For this re ason,some scholars have proposed that synovitis as a starting point may be a new ta rget for the treatment of knee osteoarthritis.At present,the treatment methods for kne e osteoarthritis synovitis are mainly divided into drug and surgical treatment.The com monly used drugs are oral NSAIDs,protective articular cartilage drugs and intra-articul ar injection of sodium hyaluronate,glucocorticoid,etc.The surgical treatment includes joint cavity debridement,synovectomy,radiofrequency ablation,knee replacement,etc.These treatments are not ideal because of their large side effects,limited time or high cost.Comparatively speaking,TCM has certain advantages in alleviating inflammatory reaction of synovium,improving clinical symptoms and improving quality of life.Based on the changes of synovial membrane thickness in knee osteoarthritis detec ted by B-mode ultrasound,the clinical efficacy of Xiaozhongfang granule in the treat ment of knee osteoarthritis was observed,in order to provide clinical basis for the tre atment of knee osteoarthritis with traditional Chinese medicine.[Method]All the cases in this project come from the outpatient patients recruited by orthop aedics and massage department of DONG ZHI MEN Hospital.A total of 18 eligible patients,24knee joints,were collected.All cases were taken as self-control.Xiaozhong fang Granules were taken orally for 4 weeks,one dose a day.Before and after treatm ent,all patients were examined by B-mode ultrasonography to observe the changes of synovial membrane thickness.Visual analogue pain score VAS,Xi’an Ontario and Mc Master University Osteoarthritis Index score and Lequesne index score were collected before and after treatment.Nimodipine method was used to evaluate the efficacy.The final data were analyzed by SPASS22.0 statistical software.Measurement data are ex pressed by standard deviation(x±s).Using t test,paired t test was used to test the difference D of paired data in accordance with normal distribution,and non-parametric test was used to test the difference D of paired data in non-normal distribution.The test level is alpha=0.05.P<0.05 showed significant difference,P>0.05 showed no sig nificant difference.[Result]Eighteen patients with knee osteoarthritis were enrolled in this study,including 4 males and 14 females,aged 45-80 years,with an average age of 62 years;a total of 24knees,6 left knees,18 right knees,22 grade Ⅱ knees and 2 grade Ⅲ knees;the sh ortest course of disease was 4 months,the longest was 18 years,with an average cou rse of 6 years.After 4 weeks of treatment with Xiaozhongfang,the synovial thickness of the sub jects before and after treatment had statistical significance(P<0.05),indicating that aft er treatment with Xiaozhongfang,the synovial thickness decreased.After 4 weeks of t reatment with Xiaozhongfang,the WOMAC(pain,stiffness,difficulty in movement ev aluation),VAS and Lequesne index scores had statistical significance(P<0.05)compar ed with the self-control before and after treatment.It showed that after treatment with Xiaozhongfang,the WOMAC(pain,stiffness,difficulty in movement evaluation),VA S and Lequesne index scores decreased,indicating that Xiaozhongfang granules could i mprove knee osteoarthritis.Clinical symptoms.[Conclusion]Xiaozhongfang Granule can reduce the thickness of synovium,relieve pain and i mprove knee joint function by invigorating kidney and removing dampness and activat ing blood circulation and removing blood stasis in the treatment of knee osteoarthritis.