| Objective:According to clinical experience of years from my tutor and the Chinese medical theory, We adopted the experienced TCM prescription Jianxi Formula (boiling-free granules) of professor CaiHua, who is my tutor, to treat chondromalacia patellae under the TCM therapeutic principle of nourishing the Liver and invigorating the Spleen in order to strengthening tendons and muscles In this dissertation, we attempted to evaluate the therapeutic effects of the TCM methods, and the guiding significance of the TCM theories, the liver governing tendons, the Spleen mastering muscles and Preventive Treatment Of Disease, in treating chondromalacia patellae.Methods1Grouping the study objectivesFrom April2010to April2012,62patients with chondromalacia patellae available in the Outpatients Department of Third affiliated Hospital of Guangzhou University of TCM, were randomly divided two groups:the Study group and the Control group. The Study group, which had32cases (11male and21female) with mean age of32.25±10.69years and mean course of disease of15.25±6.32months, was treated with Jianxi Formula (boiling-free granules) and functional exercise. The Control group, which had30sufferers (8male and22female) with mean age of33.45±11.32years and mean course of disease of16.35±7.25months, was treated with western medicine and functional exercise. There were no significant difference between the Study group and the Control group in the ages, the courses of disease and the patients’ condition.2therapeutic methods The Study group:the patients were asked drink solution of Jianxi Formula (boiling-free granules), a dose daily. The Control group:the patients orally took Glucosamine Hydrochloride Capsules,0.75g/capsule, one capsule each time, twice daily. The patients of both groups underwent the same patterns of functional exercise and were treated6weeks. During the treatment, other treatments, such as analgesic and physiotherapy, were forbidden.3Observing indexWe referred to and applied "the Evaluation standard of therapeutic effect" defined by "The guidance principle of clinical study on new drug of traditional Chinese medicine" promulgated by the National Ministry of Health:(1) clinical recovery:knee pain and swelling disappeared completely, activities of the Joint became normal, N≥95%(2)markedly effective:knee pain and swelling was disappeared, pain occasionally when moving around,70%≤N≤94%;(3)effective:pain occasionally, uncomfortable when walking, the activities of the Joint is roughly normal,30%≤N≤69%(4) invalid:knee pain, swelling and the pain during walking remained unchanged.(Note:refered to Nimodipine method:N=[(the score before treatment-the score after treatment)÷the score before treatment]×100%). Score calculation tooke the Western Ontario and McMaster Universities Index of Osteoarthritis Overview (WOMAC).Simultaneously, the thigh circumference of the affected limbe(TCOAL), the time of the straight leg raise (TSLR), patellar axial radiographs as well as congruence angle (CA) and lateral patellofemoral angle(LPA) were observed before and after the treatments4Statistic MethodWe applied chi-square test to evaluate the enumeration data distribution, t-test to the clinic measurement data distribution, and rank-test to the curative effects.Result:1. After6weeks’ treatment, the total effective rate of the treatment group was90.6%, while the control group was90.0%. The difference between two groups was not statistically significant.(P>0.05)2. In both groups, the scores of pain, activity and the total score were improved as comparing with those before the treatments with statistical significance (P<0.01), while the score of stiff remained unchanged (P>0.05) and the situations was the same between two groups.3. Comparison of the TCOALs:the TCOAL in the Study group seemed increased after the treatment, but with no statistical significance (P>0.05); and so did the Control group. There was not statistically significance in the analysis of variance about the TCOALs between the two groups (P>0.05).4. Comparison of the TSLRs:Before the treatment, there was not statistically significant difference in TSLR between the two groups,(P>0.05). After the treatment, the TSLRs of the two groups were prolonged with statistically significant difference as comparing with those at the beginning (P<0.05). There was statistical significance(P<0.01) in TSLR between the two groups after the treatment, TSLR of the Study group being longer than that of the Control group.5. CA and LPA:Because the compliance of the patients, only40patients took patellar axial radiographs at the beginning of the treatment, and30of them did again after the6-week treatments, of those12was belonged to the Study group and18belong to the Control group. We could only analyze the cases who took patellar axial radiographs twice (before and after the treatments). No significant difference in angle (CA) and angle (LPA) was found between before and after the treatment in both groups, neither between the two groups (P>0.05).Conclusion:1. Both the therapy of Jianxi Formula (boiling-free granules) and the therapy of Glucosamine Hydrochloride Capsules combined with functional exercise can obviously relieve Symptoms of chondromalacia patellae, while the Study group had more advantages in strengthening thigh quadriceps2. The TCM theories, the liver governing tendons, the Spleen mastering muscles and Preventive Treatment Of Disease, have positive significance in the treatment of chondromalacia patellae. |
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