| Osteoarthritis (OA) of knee is a chronic disease which badly harms health of the old. OA is the same meaning as "bi of bones "in traditional Chinese medicine, 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-Bie 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 task which has been divided into seven sections. It includes Chinese and English summary, foreword, theory study.clinic study project,discuss and conclusion etc.thereinto.the first section of theory study goes into prticulars the general situation of modern times abourt OA.it includes pathogenesis,diagnose and treatment etc.the second discusses the relation and modulation between three kinds of cytokines interleukin-l( IL-1),IL-6,TNF- a and OA. three kinds of ytokines plays an important role and its density changes accordingly durin the course of OA. So we take three kinds of ytokines as an index to reflect the progress of OA.the last part simpale discusses the cognition of OA for TCM. It is considered by TCM that OA of knee is the special type of ubf\ 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, deficiency of kidney->-a籫. So treatment of OA is based on the following rules: nourishing the liver and kidney, dispelling wind-evil and wetness-evil, relieve pain by dredging collaterals, activating blood circulation to dissipate blood stasis.In the project of clinical study. We divide the selected patients randomly into two groups: cure group and contrast group, record their score of pain ,territoty,suffer degree of initiative stretch,walkability.ordinary act, abnormality of way inside and outside ,walk ability, before they are treated. And after treatment record them again.the change of chroma about three kinds cytokines also were recorded.after three weeks.we should record them again after treatment with long-bie capsule and diclofenac sodium separately,it make sure that the two drugs should be applied to OA in early and middle stage, not to OA in late stage.In the part of discuss and conclusion we infer that the curative mechanism of long-bie capsule is to promote regeneration of cartilage and restrain inflammation. Secondly we illustrate the gist of long-bie capsule and analyze effect of every herb composing the capsule. According to theory of TCM, OA belongs to primary sthenia-symptoms and secondary asthenia-symptoms: deficiency of kidney is primary, and cold-wetness blocking collaterals is secondary, we infer that the curative mechanism of long-bie capsule is to promote regeneration of cartilage and restrain inflammation. Lastly some problems of this study are pointed out: estimate of symptoms and physical signs is hard to be objective really; the index PGEj cannot precisely reflect curative effect; compliance of patients is hard to control in clinical study; the concrete mechanism of is Long-bie capsule not very clear yet. |
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