| BackgroundNowadays more and more studies have shown an increasing incidence rate of osteoarthritis with the extension of average life expectancy, which consequently has caused wide attention within the medical field. The scientific research team of Professor Lorig KR did a series of management researches in1970s, which indicated that osteoarthritis health management can effectively relieve pain, reduce the number of medical treatment and save the cost of treatment and rehabilitation. In China, due to the imperfect construction of the medical system and the masses of ordinary knowledge level constraints, the development of health management in China in ten years is not good. The Constitution Theory of Traditional Chinese Medicine (TCM) plays an important role in the prevention and treatment of diseases and has a prominent role in the chronic health management aspects, but neither the studies of degenerative osteoarthritis nor the health management studies are seldom carried out and not deep enough.ObjectiveTo review the related TCM constitution and disease research progress, degenerative osteoarthritis epidemiological research on degenerative osteoarthritis and to construct the application research on theory and application of degenerative osteoarthritis of TCM health management mode. With questionnaire survey common factors and physicals of degenerative osteoarthritis, the correlation between common factors and degenerative osteoarthritis and the degenerative osteoarthritis and TCM physical were explored. By Discussing the TCM Health Management System based on tertiary prevention, the system based on physique theory of TCM was established. For intervene degenerative osteoarthritis patients, the TCM Health Management System of degenerative osteoarthritis were used and the intervention effects were observed while optimizing the systems.Methods1literature review and theoretical study:By reviewing the papers of domestic and foreign research progress, it was focused on research status of osteoarthritis health management. By understanding research situation about the relationship between physique and disease, it was focused on research status the relationship between physique and disease. By understanding research progress of TCM and western medicine treatment of degenerative osteoarthritis, it was explored the integrative method about disease and health management of TCM based on the current treatment situation.2Clinical Research ⅠThe correlation study about degenerative osteoarthritis influence factors and physique. In the disease group were the124osteoarthritis senile patients selected from Guangdong Second Provincial TCM Hospital and diagnosed as degenerative osteoarthritis. In the control group were the124volunteers with senile osteoarthritis that were not in the bone joints. A cross-sectional on-the-spot investigation was taken to all these patients with the " Traditional Chinese Medicine Physical Scale " and " Degenerative Osteoarthritis Influencing Factors Questionnaires". By collecting physical factors and affecting the physique distribution data, the questionnaires were applied and the influence factors by statistics were assessed by single factor analysis, then based on single factor analysis, the risk factors and protect factors of the degenerative osteoarthritis infection were analyzed by multi-factorial logistic regression. For the physical distribution data of osteoarthritis, normal type as control, the physical distribution data of the degenerative osteoarthritis infection were analyzed by multi-factorial logistic regression.3Clinical research ⅡClinical research on liver and kidney deficiency type knee osteoarthritis Chinese medicine health management mode:the choice of treatment in our hospital outpatient Professor Xu Xuemeng syndrome of deficiency of liver and kidney.in patients with knee osteoarthritis in72cases, using random number table, through random control method, the patients were divided into test group and control group. The two groups were received "bone muscle" and characteristic treatment, while giving the Chinese medicine health management intervention trial group."Bone muscle" and characteristic therapy including oral medicine, acupuncture point injection, five seeds scattered outside the ironing and functional exercise; according to deficiency of the liver and kidney the knee osteoarthritis Chinese medicine health management program clinical study results for.Results1Clinical Research IClinical investigation:In our hospital, elderly patients with degenerative osteoarthritis of knee joint prevalence rate is the highest, accounting for45.97%of all patients, followed by the rest of the lumbar, cervical vertebra, hip joint, ankle is39.52%,8.87%,4.03%,1.61%. Effect of different factors on degenerative osteoarthritis, chi-square test was used for univariate analysis, the analysis results found that age, sex, body mass index (BMI), work posture, labor type, family history, joint trauma history, squatting defecation habit, alcohol drinking, insomnia and anxiety, living storey, edible fruit, physical exercise, sport form, health knowledge obtained form, they are all factors that influence the degenerative osteoarthritis. The Logistic regression multivariate analysis of factors associated with screening out single factor analysis (screening method:variable Forward:LR, variable selection criteria=0.05, excluding standard is0.1), related risk factors of bone and joint inflammation. The related factors of degenerative osteoarthritis include sex, body mass index (BMI), squatting defecation habit, sport form and health knowledge acquisition. Concrete manifestation:men to lower the risk of female osteoarthritis (OR=0.955,95%CI:0.920-0.991, P=0.014); a higher BMI (more obesity risk of osteoarthritis) were higher (0R=1.252,95%CI:1.080-1.452, P=0.004); a squatting defecation habits are higher than the risk of not squatting defecation habit bone arthritis (OR=1.525,95%CI:1.357-1.713, P=0.001); weight-bearing exercise is higher risk than stretching and strength exercises(OR=0.549,95%CI:0.325-0.928, P=0.025) active access health knowledge to lower risk than passively acquired knowledge of osteoarthritis (OR=0.047,95%CI:0.006-0.363, P=0.005). By multiple factor Logistic regression analysis:compared with the mild physical, deficiency of Yang (P=0.002) risk groups of patients with osteoarthritis were significantly higher (OR=1.329,95%CI:1.109～1.593); compared with the mild physical, blood stasis constitution (P=0.029) risk of people suffering from osteoarthritis was significantly increased (OR value2.755,95%CI:1.1106.836).(2) Construction degenerative osteoarthritis of the TCM system of degenerative osteoarthritis:through the research of degenerative osteoarthritis and physique, influence factors of the relationship between the two, three levels of prevention based on the theory of traditional Chinese medicine health management plan, formulated the degenerative osteoarthritis. The scheme includes physical nursing plan and degenerative osteoarthritis disease health management program in two parts. According to the risk constitution of degenerative osteoarthritis of Yang deficiency and blood stasis, formulate the constitution adjustment scheme, the concrete content includes six aspects of environmental living, physical movement, mental adjustment, diet, drug therapy, music and other measures; the specific content of degenerative osteoarthritis disease health management program includes five a part of food management, sports management, personal management, disease management and weight management. According to the three levels of prevention theory, primary prevention is the main way of life management, the purpose is to adjust biased physique, monitoring disease, suitable physical nursing program; two levels of prevention mainly for physical and dangerous risk factors, the risk of physical intervention to change into peace constitution, by avoiding risk factors to reduce risk, joint program of health management for physical adjustment scheme of+0A special diseases health management scheme; three levels of prevention for clinical assistant, mainly take active treatment according to the condition of patients to prevent disease development and transfer, joint plan of health management for clinical treatment of health nursing program+0A special diseases health management scheme.2Clinical research ⅡConstitution of deficiency liver and kidney knee osteoarthritis, Yang deficiency accounted for the larger proportion, the test group and the control group were25cases,27cases, no significant difference in total physical distribution (X2=1.021,P=0.796), the test group and the control group, the main risk factors-gender, whether to use squatting defecation, body mass index, no significant difference. The patients in the two groups three months after curative effect evaluation, two cases were no shedding, no suspension of clinical test situation. Clinical evaluation of test results for:6cases of clinical control,21cases markedly effective, effective7cases, invalid2cases, the total efficiency of94.4%; control group curative effect evaluation result is:3cases of clinical control,13cases markedly effective, effective13cases, invalid7cases, the total efficiency of80.6%; the results of two groups Ridit analysis, the results were statistically significant (chi-square=7.460P=0.009<0.05), rank mean test group was30.47, control rank mean group was42.53, suggesting the test group3months after treatment the curative effect is better than that of the control group.Conclusion1.The correlation study about degenerative osteoarthritis influencing factors and constitution, we found that yang deficiency and blood stasis were dangerous constitutions, gender、BMI、squat-defecation habits were dangerous factors, protect factors were stretching and strength exercises、active healthy information acquisition. Enrich the pathogenesis theory of degenerative osteoarthritis, provides new theoretical for "correlation of constitution and disease" argument.2. Based on discussion and investigation on the theory and research, construct the degenerative osteoarthritis of TCM health management mode, can management the healthy people、high-risk people and patients, to satisfy the need of clinical prevention, treatment, rehabilitation of three aspects.3. Construct chronic disease health management mode use constitution of TCM regulating scheme and special diseases health management scheme. Can be adjusted according to the actual situation, to meet the individual needs, simple and easy. |
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