Clinical Research Of Wenshen Juanbi Decotion In KOA Of Kidney Deficiency And Dampness Blocking Syndrome

Osteoarthritis of knee (KOA) is a chronic disease which badly harms health of the middle and old age people. Traditional Chinese medicine (TCM) knows it as "Bi syndrome", "Gu Bi". Its characteristic is that articular cartilage appears primary or secondary degeneration, with hyperplasia of the bone under cartilage. The main clinical expressions of KOA are knee joint pain, tumidness and limitation of activity. The cause and pathogenesis of KOA is not completely clear yet, which is in modem times medicine known related with intrasseous pressure, cytokine, metabolizing turbulence of radical, enzyme of articular cartilage, self-immunoreaction abnormality and so on. Typical treatments to KOA are oraltaken drugs and surgical operations. Nonsteroid anti-inflammatory drugs (NSAIDs) are the first-line pharmacological therapy. NSAIDs can palliate pains and decrease osteoarthritic inflammation. However, these drugs can not modify the natural history of the disease; they are actually toxic to cartilage, and they may lead to more progressive KOA. Patients have to accept their side-effects such as in gastroenterostomy, cardiovascular system. Surgical interventions can only be used on the patients with severe pain day and night that can not be relieved by drugs, so they are the last-line method in treating KOA. And patients may expend more, and have surgical trauma. In TCM, KOA is caused by that kidney, liver and spleen are insufficient and wind, cold, dampness and heat affect. The key of pathologic machnism is that collaterals are blocked by phlegm and stagnation. KOA can be treated by TCM in a more effective, safer and cheaper way, so it is necessary to develop the work in clinic and research of TCM.Objective: Observe the therapeutic effect in KOA of kidney deficiency and dampness blocking syndrome by WenShen JuanBi Decoction, in order to provide proof in clinical treatment of KOA in further.Methods: Forty cases of KOA were divided into two groups randomly, one group (curing group) which has twenty patients of the prescription of WenShen JuanBi Decoction, and the other group (controlling group) which has twenty patients of JinGuTongXiao Pill. The course of treatment was one month. The symptoms and physical signs were observed before and after treatment. Result: The symptoms of patients in two groups were improved after treatment. In treatment group, the controlled and remarkable effective rate is 85% and totally effective rate is 90%. While in the controlled group, the controlled and remarkable effective rate is 45% and the totally effective rate is 85%. The controlled and remarkable effective rate of the treatment group is equivalent to that of the controlled group, while the totally effective of the treatment is superior to that of the controlled group. There is a very significant difference between the symptomatic integrals of the treatment group and the controlled group before and after treatment(p＜0.01). Besides, the treatment group is superior to the controlled group in improving the main symptoms of KOA. Except "crutch" and "lock", there is a significant difference between the symptomatic score of the treatment group and controlled group before and after treatment. The treatment group is superior to the control group in improving symptoms of"swell", "climbing", "squating", besides two groups match in improving the other symptoms.Conclusion: The basic pathogenesis of KOA of kidney deficiency and dampness blocking syndrome is that kidney, liver and spleen are insufficient, with the tendons and collaterals blocked by dampness. It is proved that warming and replenishing the liver and kidney, and invigorating spleen to eliminate dampness assisted with removing obstructions is an effective therapeutic method in treating KOA. It’s not only the symptoms were improved, but that is a kind of effective traditional Chinese method.