The Applied Research Of The Knee Osteoarthritis Traditional Chinese Medicine Clinic Path

Background:knee osteoarthritis (KOA) is a common chronic progressivity joint disease. Articular cartilage degenerative change is an important pathological characteristic of this disease. Its representative clinical feature is chronic pain repeated out breaking, when this process happens for a long time, knee-joint will be stiff and not able to exercise. We call it knee paralysis disease in Chinese medicine. In recent years as China’s ageing population structure changing, the amount of ageing people is increasing gradually. The quantity of KOA is more and more at the same time. The investigation shows that, exceed80%of45-70ages people have OA in China, and KOA is the most common disease in OA, which is also the most principal factor hindering the work and life of the patient who have KOA. Meanwhile this disease cause heavy economic burden for patients’family and the whole society. Clinical pathway is a new medical management model that reduce medical expenses、 save medical resources、improve the quality of medical treatment. Traditional Chinese medicine (TCM) is an important part of national health care system, and it has a long history and rich clinical experience in the treatment of knee paralysis disease, it has obvious advantages in treating KOA. As the reform of the medical health in recent years, traditional Chinese medicine hospital in Wuhan formulate and implement TCM clinical pathway of knee paralysis disease in order to standardized treatment、improving hospital medical quality、 improve the medical efficiency and reduce the patient’s medical expenses as well as the time of LOS.purpose:we formulate traditional Chinese medicine clinical pathway and clinical implementation plan on the patients in hospital, then we discuss the scientificalness、feasibility and security of the Chinese medicine clinical pathway, in order to analyze the implementation and effectiveness evaluation of it. Finally faretheewell the traditional Chinese medicine clinical pathway of knee paralysis disease,and provides evidence for the utilizing of the clinical pathway of traditional Chinese medicine.Method:according to the clinical pathway of traditional Chinese medicine that made by State Administration of Traditional Chinese Medicine, we design the clinical pathway correspond our own patients’characters in Traditional Chinese medicine hospital in Wuhan. Then we do the research in before and after the comparison way. We contrast the patients who have gotten knee paralysis disease and been in orthopedics of Traditional Chinese medicine hospital in Wuhan before(2010、12～2010、11) and after(2010、12～2011、11) utilizing the clinical pathway. Main evaluation index including:1、clinical effects2、time of LOS3、the patient’s medical expenses4、 syndrome integral5、the change of the life quality6、the complication during their hospitalization7、the satisfaction of patients8、hospital admission rates in3months9、the education condition of the patientsResult:there are195patients join in this research, traditional group95, man25, woman70.The clinical pathway of traditional Chinese medicine group100, man26, woman74. There are not significant differences between these two groups in common information. The average hospital days reduce from18.34to12.54days. P<0.05, the distinction has statistical significance. The total medical expenses reduce from6528.59Yuan to5708.08Yuan P<0.05; Drug expenses are increased. The syndrome integral of clinical pathway of traditional Chinese medicine group are less than traditional group after treatment. The clinical treatment effective rate of clinical pathway of traditional Chinese medicine group is higher than traditional group after treatment. We compare the two groups with SF-36,there is obvious difference between these two groups in SF-36. The life quantity of clinical pathway of traditional Chinese medicine group is obviously better than traditional group after treatment. The hospital admission rates in3months obviously reduced than traditional group. Meanwhile the satisfaction of patients is higher than traditional group. The life quantity of clinical pathway of traditional Chinese medicine group is obviously better than traditional group after treatment. We use more treatments that have traditional Chinese medicine characters than traditional group. We pay attention to the publicity and communication of clinical pathway of traditional Chinese medicine group, so the publicity condition is better than traditional group. There is no obvious difference of the complication during their hospitalization between these two groups. Conclusion:the formulation and implement of TCM clinical pathway could stander diagnosis and treatment behaviors, improve the clinical effects and medical care, reduce the patient’s medical expenses as well as the time of LOS, it can save the medical and health resources; the formulation and implement of TCM clinical pathway provide a foresight model for the treatment of patient and medical care, this impel the doctor and patients to promote the health of patients together. Finally we hope that this model could improve the clinical effects and medical care, reduce the patient’s medical expenses improve the satisfaction of patients. Meanwhile we rule the method how to utilize Chinese medicine and the treatments with traditional Chinese medicine character, so it standers the use of traditional Chinese medicine in knee paralysis disease treatment. TCM clinical pathway of knee paralysis disease is a scientific、security medical model, it worth to be widely used in clinical field.