Retrospective Study Of Knee Osteoarthritis Syndrome And The Relationship Between Clinical Indicators

Research BackgroundKnee Osteoarthritis (KOA) is a common multiple chronic bone and joint disease, mainly with the elderly, is caused by surface degenerative articular cartilage of the knee joint variable lesions. The main pathological features of articular cartilage damage, cystic degeneration, ligament contracture or relaxation, marginal bone hyperplasia (i.e. osteophyte formation), subchondral sclerosis and synovial hyperplasia. Chinese medicine believes that knee osteoarthritis in TCM belongs to "rheumatism", "Gubi" category, whose name "Xibi". its pathogenesis is deficiency of liver and kidney, pathogens invade the body, and this disease is asthenia in origin and asthenia in superficiality. At present, more and more people pay attention to the quality of life is increasing, the treatment of knee osteoarthritis has become the focus of people. For severe KOA, both western medicine and traditional Chinese medicine conservative treatment effect is not ideal, often need surgical treatment. For early knee osteoarthritis patients, because of its mild clinical symptoms, people general use traditional Chinese medicine and Western medicine conservative treatment. Western medicine treatment of this disease include topical and systemic medication, intra-articular injection of drugs and osteoarthritis slow acting drugs and cartilage protective agent. Have a certain effect of Western medicine treatment, but the side effects of Western medicine, especially the damage of oral drugs on the gastrointestinal tract and liver is larger, so it should not be long-term use. Method of Chinese medicine treatment of this disease are mainly Chinese medicine, dressing, iontophoresis, acupuncture, massage and acupuncture, the side effect is small, curative effect is good, has attracted the attention of people.ObjectiveCombination of TCM and modern medicine clinical classification, through statistical methods to observe knee osteoarthritis TCM syndromes and common clinical indexes such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), the relationship between X-ray classification, and provide reference for clinical work.MethodsFrom January 1,2014 to December 2015 on the 30 day of TCM Department of rheumatism in our hospital in patients with knee osteoarthritis which met the inclusion criteria were a total of 115 cases as the research object, using the method of retrospective investigation, in order to record the patients’gender and age, course of disease, knee side, predisposing factor, knee pain, like cold, Na eat sleep, two, tongue and pulse, ESR, C-reactive protein, bone density and X-ray. The record is completed, according to record the results according to the 2009 State Administration of traditional Chinese medicine "knee osteoarthritis (osteoarthritis) treatment program" syndrome differentiation standard dialectical, then by variance analysis, multiple comparison analysis of KOA patients with TCM syndrome type and clinical to observe the relationships between the indexes, and use statistical methods analysis of type of KOA distribution.Results(1) In 115 patients, men accounted for 24.3% (28/115), women accounted for 75.7%, the proportion of male and female 13.11 (87/115). Arthralgia accounted for 47%(54/115), rheumatic fever arthralgia accounted for 13% (15/115), blood stasis syndrome accounted for 25.2% (29/115), liver and kidney deficiency syndrome accounted for 14.8% (17/115). Patients aged 50 years and above accounted for 87.4% (89/115), patients aged 60 years and above accounted for 42.6% (49/115). From the beginning of the onset of left knee accounted for 13.04%(15/115), from the onset right knee accounted for 19.13%(22/115), both knees onset accounted for 67.83% (78/115). A total of 60 patients were recorded as predisposing factors, cold diseases accounted for 53.33% (32/60), because of tired incidence accounted for 23.33% (14/60), cold and fatigue can induce disease accounted for 23.33% (14/60).(2) Various types of CRP and ESR had no significant difference, mean CRP and ESR of rheumatic fever arthralgia syndrome than other syndromes, blood stasis obstruction syndrome mean CRP ranked second. No significant differences between the various syndromes of age and disease duration. Wind dampness syndrome mean age and disease duration were the lowest, blood stasis obstruction syndrome mean age highest, average age is the highest liver and kidney deficiency syndrome. Each type of imaging had no significant difference between grade, liver and kidney deficiency syndrome mean highest, lowest average arthralgia, and between the imaging classification and duration are positively correlated, but the correlation is poor. The bone mineral density in rheumatic fever arthralgia syndrome, osteoporosis and low bone mass were accounted for 55.6% in this syndrome (5/9) and 44.4% (4/9), the number of low bone mass in blood stasis obstruction syndrome accounted for 54.5% in the C (12/22).Conclusions(1) In the type of KOA, with the wind dampness syndrome is most common, the most uncommon is rheumatic fever arthralgia, the clinical type with KOA comply with the pathogenesis of deficiency of liver and kidney deficiency, and wind-cold-dampness invasion of human.(2) Rheumatic fever arthralgia with higher CRP and ESR, blood stasis obstruction syndrome with higher CRP, higher grade of liver kidney asthenia imaging, a higher proportion of rheumatic fever arthralgia syndrome and blood stasis syndrome of osteoporosis and low bone mass number for this card, illustrate the clinical indicators such as CRP, ESR, X-ray and bone density can provide the basis for the clinical classification.