| Osteoarthritis (OA) of knee is a chronic disease which badly harms health of the old. The patients mainly suffer from pain, stiffness and limitation of activity. OA is the same meaning as "bi of bones" in traditional Chinese medicine. Its characteristic is that articular cartilage appears primary or secondary degeneration, with hypcrplasia of the bone under cartilage, but the cause and pathogenesis of OA are not completely clear yet, there is no satisfying way to treat OA besides replacement of knee joint in the present medicine. However some traditional Chinese medicine (TCM) maybe have a good effect. Long-We Capsule is an agent of TCM, which has been used for a long time in the department of orthopaedics of Guang Dong provincial hospital of TCM. Its effect has been proved to be satisfying by many years'clinical application, and its side-effect is tiny. This thesis is based on the studies about OA which have been finished by traditional Chinese medicine and Western medicine. In order to explore the pathogenesis of OA and the effect of Long-Bie capsule, we carry out this clinical study-"the curative effect of Long-Bie capsule to OA of knee" The first part is preface which has been divided into two sections. The former summarizes the causes, pathogenesis, diagnosis and treatment of OA; the later discusses regulation of prostaglandin (PG) and the relation between PG and OA. PG plays an important role and its density changes accordingly during the course of OA. So we take PG as an index to reflect the progress of OA. The second part is study of correlative literature. In this part we summarize the domestic and foreign studies during the latest several years. The defining and meaning of OA is explained in details, as is adopted by all that OA is caused by primary and secondary pathogeny. The primary pathogeny is related to age, sex, occupation, race, genetic factor, constitution, chronic strain, over-activity of joint and climate, etc. The second pathogeny is related to direct wound in the joint, inclined strength line, bad correspondence between two articular surface, confused structure within joint, joint instability. etc. These etiological factors make articular cartilage degenerate. Pathogenesis of OA is degeneration of cartilage cell and stroma caused by the following factors: stasis of blood circulation, free radical, microelement, autoimmune reaction, cytokine, enzyme, hormone, prostaglandin, etc. After articular cartilage degenerates and destroys, the bone below it starts to grow in excess, then synovium and capsule of joint becomes plump gradually, synovitls happens later, step by step articular capsule presents fibrosis even contracture, at last the joint presents fibrous ankylosis. In early period the clinical situation of OA is pain under patella, the suffering joint swells time after time, in late period deformity maybe appears. During clinical examination tenderness of knee is found on the inner surface of patella or round the joint, its motion is lightly or moderately limited, but in those serious cases varum or exstrophy exists usually. In the initial stage no evident change is found by X-ray, then joint space gets narrow gradually and bone wears out, with hyperplasia of bone. It is considered by TCM that OA of knee is the special type of "bi" namely "bi of bones" According to its cause and mechanism OA can be divided into the following types: coldness and dampness blocking collaterals, phlegm and dampness blocking together, deficiency of liver and kidney, deficien... |
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