| Objective: Inheriting and carrying forward the academic thought of "treating both muscles and bones",and combining with the years of clinical treatment experience of Professor Lu Min,a famous Chinese medicine expert in China,the research group proposed the clinical six-type theory and corresponding treatment plan for knee osteoarthritis.Methods :(1)Taking inpatients in the Department of Limb and Arthrology of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 1,2021 to December 31,2022 as the research object,through case review and medical record screening,basic information such as patient name,sex,age,occupation,height,weight,symptoms,signs,etc.was extracted,and a database of knee osteoarthritis was established to analyze the data obtained from the investigation and statistics,SPSS25.0 statistical software was used to carry out statistical analysis on the data obtained,and preliminarily explore the frequency of KOA clinical six types and the distribution law of each syndrome type.At the same time,investigate the statistical distribution level between the gender,age,weight,etc.of all types of patients.(2)From January 2022 to December 2022,the patients with knee osteoarthritis in the Knee Pain Clinic of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine were selected as the study subjects.Among them,100 patients with clinical type of qi stagnation and blood stasis(local tendon knot)were selected,and treated with divergent shock wave acupoint selection along the meridian,and the VAS score and TCM syndrome score before and after treatment were recorded,To preliminarily verify the feasibility of shock wave acupoint selection along the meridian to treat KOA of qi stagnation and blood stasis(local tendon knot)type.Results:(1)The total number of cases screened was 2463.A total of874 cases met the requirements.Among them,813(93%)were valid medical records.Among 813 cases of KOA,32 were male 23%(26.2/8.13),women account for 67 8(551 /813),male/female ratio 1:210.The patients over 50 years old accounted for 77.9%(633 /813),29% of patients over 60 years old 3%(23.8 /8.13),11% of patients over70 years old 9 %(97 / 813).Overall body mass index B MI 26.5,male average 22.3.The average female is 27.8.Among them,work intensity grade 1 accounts for 21 1.6%(172/813),level 2 accounting for 44.03%(358 /813),level 3 accounts for 22.88%(186 /813),level 4 accounts for9.10%(74 /813),level 5 accounts for 2.83 %(23/81 3)。 Among the causes of onset or aggravation,423 people were affected by cold,208 people were tired,and the remaining 18.2 people did not complain of obvious causes.Overall average course of disease 23 years.Local tendon type accounts for 22% 0.2%(17.9 /8.13),muscle weakness type accounted for 13 78%(1.12 /8.13),and 39% of them were skeletal degeneration 60%(89/813),free and 4 55%(37/813),and 910%(74/813),which is in line with the epidemiological distribution of KOA and has guiding significance for clinical syndrome differentiation and classification of KOA.(2)Through observing the treatment of 100 patients with qi stagnation and blood stasis(local tendon knot)type with shock wave along the meridian,and using oral glucosamine sulfate capsule and divergent extracorporeal shock wave for intervention,all patients’ VAS pain score and TCM syndrome score were significantly lower than before treatment,with a statistically significant difference(P<0.05),indicating that this treatment scheme can effectively relieve the symptoms of early local tendon knot KOA patients,It provides a new idea for the clinical treatment of KOA.Conclusion:(1)The system summarizes the national traditional Chinese medicine expert professor lu clinical experience,KOA can be divided into local knots,muscle weakness,muscle degeneration,free compression,muscle deformity and synovial swelling,and designed for each type the corresponding treatment,intended for clinical KOA treatment to provide more simple and effective treatment.(2)According to data statistical survey,local tendon accounted for 22.02%,muscle weakness for 13.78%,muscle degeneration for 39.60%,free tendon compression for 10.95%,muscle deformity for 4.55%,synovial swelling for 9.10%,the incidence of patients over 50 years old 10%,77.9%,the number of female patients is 2.1 times that of male patients,which conforms to the epidemiological distribution law of KOA,and has certain guiding significance of syndrome differentiation and classification.(3)The effectiveness of divergent shock wave and xunmeridian acupuncture point in treating qi stagnation and blood stasis(local tendon knot)KOA is preliminarily confirmed,which provides a reference for the clinical treatment of KOA. |
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