| [Background]Most of the knee osteoarthritis in the early and middle stages is mainly the degeneration of the medial knee joint,but these patients may have different degrees of anterior knee pain or patellofemoral arthritis.Surgical treatment is widely used in clinic,such as single condylar replacement,and some scholars have proposed traditional Chinese medicine treatment,but the curative effect is limited.The treatment of such patients has not yet formed a unified standard.How to delay degeneration,relieve anterior knee pain and improve knee joint function has become an urgent task.After previous studies,it is found that the method of warming yang and tonifying marrow has achieved a good clinical effect in the treatment of knee osteoarthritis,and single condylar replacement is generally accepted,whether the combination of the two can effectively treat patients with medial knee osteoarthritis complicated with anterior knee pain,its clinical efficacy still needs to be further verified,and the specific mechanism also needs to be further discussed and studied.[Objective]The purpose of this study is to evaluate WenYangYi decoction and promoting blood circulation to remove blood stasis method to treat the clinical curative effect of single condylar knee pain after replacement,and to provide strong support for the development of the theory of warming yang and tonifying marrow.It also provides a new idea and effective method for the treatment of knee joint double compartment osteoarthritis.[Methods]In this study,40 patients with knee joint double compartment osteoarthritis were randomly divided into two groups:the experimental group(n=20)and control group(n=20).The experimental group received treatment with medial unicondylar replacement and Chinese medicine granules.The second day after operation,oral Chinese medicine,200mL warm water flushing,2 times a day,once in the morning and once in the evening,continuous treatment for 2 weeks as a course of treatment,a total of two courses.The control group received treatment with medial single condylar replacement only.During the period of postoperative observation,two groups of patients in postoperative treatment were the same,and the basis of the function of health education and rehabilitation exercise at the same time.The adverse reactions of traditional Chinese medicine were recorded by comparing the scores of VAS、WOMAC and traditional Chinese medicine clinical symptoms before the operation,14 days and 1 month after operation,as well as the changes of IL-1β and TGF-β1 in serum,and the effect of traditional Chinese medicine treatment was analyzed using statistical data analysis.[Results]① There were no significant differences in age,gender,BMI and affected limb between the experimental group and the control group(P>0.05).Before the beginning of treatment,there was no significant difference in VAS scores,WOMAC index scores,TCM clinical symptom scores and serum levels of IL-1β and TGF-β1 between the two groups.②One month after operation,the pain degree of all patients was relieved,and the degree of relief in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).③14 days after operation and 1 month after operation,the pain was significantly relieved,the function of knee joint was improved,and the ability of daily activity was also enhanced.There was statistically significant difference in WOMAC index scores and TCM clinical symptom score between the two groups(P<0.05).④The content of serum IL-1βdecreased significantly between the two groups at 14 days and 1 month after operation,especially in the experimental group,and the difference was statistically significant(P<0.05).⑤The level of TGF-1 increased significantly in both groups within 14 days after operation,but decreased one month later.Especially in the experimental group,this change is more prominent,and the change has statistical value(P<0.05).⑥The results of postoperative treatment showed that satisfactory results were obtained in both groups,in which the therapeutic effect of the experimental group was more prominent and the functional activity was also improved.And without any serious side effects,the safety factor is extremely high.[Conclusion]WenYangYi decoction and promoting blood circulation to remove blood stasis method is an effective method for the treatment of single condylar knee pain after replacement,which can significantly reduce the anterior knee pain and reduce the surgical indications,with few adverse reactions and remarkable curative effect,so it is worth popularizing in clinical practice. |
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