The Clinical Study Of The Treatment On Knee Osteoarthritis By Om Package Of Chinese Medicine, Hyaluronic Acid

Osteoarthritis (Osteoarthritis, OA) is a kind of diseases that is characterized by degeneration and destruction of the articular cartilage,hyperosteogeny, and marked symptomatically especially by pain, motility disorders, or accompanied by heaviness, swelling, or even deformity, uselessness. It is also known as degenerative or proliferative osteoarthritis. The disease can affect multiple body joints, and involve the knee joints as the most commonly. The incidence of this disease increases with age growth, so it's otherwise called senile arthritis which is a common disease leading to reduced quality of life in the elderly. It is generally recognized that this disease is due to aging, strain, obesity, trauma, bone density, genetic and so on. It has expressions sucn as degeneration of the articular cartilage, sclerosis of the bone under the cartilage in pathologic and osteophyte formation, joint deformities in the late in radiographic. Because of the complicated construction of knees and pharmacological characteristics of drugs, traditional treatment that uses non-steroidal anti-inflammatory analgesic drugs can only temporarily alleviate symptoms, but it's unable to slow the progress of disease. Most patients generally subjective symptoms appear to be improved at short-term follow-up, but Long-term result responses are still unsatisfactory.The patients with OA admitted at the orthopedic in-patient department of Wuhan First Hospital since January 2009 to June 2009, were divided into two groups and respectively received two treatment. Group 1 were given om package external application of Chinese medicine and group 2 treated with om package external application of Chinese medicine and HA injection by arthrocentesis. on admission, two weeks after treatment (at discharge)and three months after treatment(post-discharge two Halfmoon), according to the standard the WOMAC scoring system, we evaluate and compare the clinical effects between the two therapeutic methods.Objective:the aim of the clinical study is to evaluate and compare the clinical effects and safety of the the two therapeutic methods: om package external application of Chinese medicine, om package external application of Chinese medicine and HA injection by arthrocentesis.Methods:In this study patients with OA had a total of 32 cases, all admitted at the orthopedic in-patient department of Wuhan First Hospital since January 2009 to June 2009 and divided into two groups and respectively received two treatment. Group 1 were given om package external application of Chinese medicine and group 2 treated with om package external application of Chinese medicine and HA injection by arthrocentesis. Before the therapy, the two group of patients were estimated according to the standard the WOMAC scoring system and were given some laboratory tests including blood routine, urine routine, liver and kidney function, electrolytes. The electrocardiogram and the X-ray films of AP view and lateral view of the knee joint were checked, too. On two weeks and three months after the treatment the WOMAC scores and clinical effects were evaluated againand and analyzed statistically. The evaluation standard of clinical effects is as follows, Clinical control: symptoms such as pain, swell etc vanish, the function of knee joint normal, the total scores of WOMAC decrease more than 90 percent; markedly effective:symptoms such as pain, swell etc disappear, the function of knee joint normal and the patients can take part in daily work, the total scores of WOMAC decrease more than 70 percent, effective:symptoms such as pain, swell etc disappear, the function of knee joint limited and the ability to take part in daily work improve, the total scores of WOMAC decrease more than 30 percent; invalid:symptoms such as pain, swell etc don't improve obviously, the total scores of WOMAC decrease less than 30 percent.【Note:The calculation formula:(the scores before treatment)-the scores after treatment/the scores before treatment* 100%】Results:1.Statistics of the WOMAC scores:The WOMAC scores of group 1:before treatment X±S=45.56±3.69, two weeks after treatment X±S=13.19±9.78, three months after treatment X±S=18.06±10.51.The scores of two weeks after treatment comparing with the scores before treatment were different significantly, p<0.01; the scores of three months after treatment comparing with the scores before treatment were difference significantly, p<0.01. the scores of three months after treatment comparing with the scores of two weeks after treatment were different significantly, too, p<0.05.The WOMAC scores of group 2:before treatment X±S=45.13±4.54, two weeks after treatment X±S=13.75±9.56 three months after treatment X±S=12.50±10.25. The scores of two weeks after treatment comparing with the scores before treatment were different significantly, p<0.01; the scores of three months after treatment comparing with the scores before treatment were different significantly, p<0.01; The scores of three months after treatment comparing with the scores of two weeks after treatment were no significant difference, p>0.05.Between the WOMAC scoresof the two groups, there was no significant difference after treatment on two weeks, but had difference significantly after treatment on three months.2.Evaluation and Statistics of the clinical effects:The clinical effects of group 1:two weeks after treatment,2 cases were achieved clinical control,9 as markedly effective,4 as effective and 1 as invalid, the effective rate was 93.75%; three months after treatment,1 case was achieved clinical control,6 as markedly effective,6 as effective and 3 as invalid, the effective rate was 81.25%. Compared with the effective rate after treatment on two weeks, there had difference significantly, P<0.05.The clinical effects of group 2:two weeks after treatment,2 cases were achieved clinical control,10 as markedly effective,3 as effective and 1 as invalid, the effective rate was 93.75%; three months after treatment 2 cases were achieved clinical control,9 as markedly effective,4 as effective and 1 as invalid, the effective rate was 93.75%. Compared with the effective rate after treatment on two weeks, there was no significant difference, P>0.05.Between the clinical effects of the two groups, there was no significant difference after treatment on two weeks, but had significant difference after treatment on three months.Conclusion:Two weeks after treatment, the WOMAC scores and the clinical effective rate of the two groups were different significantly comparing with the treatment before, and there had significant difference between the two groups. The results show that both of the two methods have obvious effects in clinical treatment of knee osteoarthritis.Three months after treatment, the WOMAC scores and the clinical effective rate of the two groups were different significantly comparing with the treatment before, and there had significant difference between the two groups. The data of group 1 after treatment on three months were different significantly comparing with those after treatment on two weeks, but there had no significant difference in group 2. and there were different significantly between the two groups after treatment on three months. Results show that the effects of both the two methods have good durability, while the method with om package external application of Chinese medicine and HA injection by arthrocentesis has more lasting effect.