Theoretical And Clinical Research Knee Osteoarthritis Treatment Of Postmenopausal Yin Heat Method

In the course of the disease osteoarthritis gradually to be realized in the medical profession,the correlation between menopause and the occurrence of OA has long been noticed and considered. The occurrence of OA in postmenopausal women is very common. A name "Postmenopausal osteoarthritis" was proposed by foreign scholars and they described the common symptoms,signs,the average age of onset and so on.This thesis consists of three parts. The literature review combed the research progress on postmenopausal osteoarthritis made by Chinese and western scholars in recent years. The TCM review summarized many perspectives about the etiology and pathogenesis of postmenopausal osteoarthritis, TCM scholars generally believe that osteoarthritis are of "Bi Syndrome", a category of TCM disease,liver and kidney deficiency is the internal foundation of the disease,wind cold and damp evil are the external causes,the core pathogenesis is the closed resistance of meridians. Many TCM scholars do syndrome differentiation and treating without realizing the connection between women’ s OA and menopause,some scholars linked the two,and realized Chong and Ren deficiency did influence the onset of OA,but they still kept the viewpoint of Bi syndrome. The article also cited some TCM scholars’s clinical experience of treating postmenopausal OA. Western medicine overview described the recent research results of the molecular mechanisms of how estrogen affect the onset of OA.and researches on many other factors such as androgens,vitamin D,bone mineral density,etc.The part of theoretical study refuted the traditional point of view that,post menopausal OA of knee is a disease of Bi syndrome, and put foreword a new perspective that post menopausal OA of knee is not a Bi syndrome, but a disease of internal injuries--yin deficiency.which happens in humans aging process, and also heat evil; The TCM truth of post menopausal OA of knee was expounded in this part,yin deficiency and heat evil is the core pathogenesis,clinical symptoms of OA such as pain, joint stiffness,rest pain,joint deformities was analyzed in TCM theory,extended to menopausal arthritis and OA in general.Clinical research. The objective is to study the effect of the method of nourishing yin and clearing away heat to treat post menopausal knee osteoarthritis.51post menopausal women with knee OA were divided into treatment group and control group, they were given a medicine decoction which has the effect of nourishing yin and clearing away heat or aceclofenac enteric-coated tablets,then visual analogue scale was used to evaluate the severity of knee pain at baseline and after1,2weeks of treatment,and also the stiffness time and Lequenes index would also be recorded, compare and analysis the changes before and after treatment,in two groups of patients’s score. The results show that, after1week of treatment, compared with baseline,pain at night,pain during walk and pain during up and down stairs were significantly different (P<0.01).compared with each other group,significant difference in pain at night, pain during walk and pain during up and down stairs was also seen (P=0.010,0.000,0.006);After2weeks of treatment,the significant difference in pain at night and pain during up and down stairs between two groups disappeared (P=0.375and0.051),but pain during walk in two groups was still significantly different (P=0.018);After2weeks of treatment,the improvement of pain during walk and pain during up and down stairs between treatment group and control group showed significant difference (P=0.012and0.003), The improvement of pain at night between two groups has no significant difference (P=0.449). Conclusions: The method of nourishing yin and clearing away heat to treat post menopausal knee osteoarthritis has a relatively slow but sustained effect to relieve pain,stiffness and dysfunction,the effect is close to but still lower than aceclofenac enteric-coated tablets after2weeks,the effect of relieving pain during night is similar to aceclofenac enteric-coated tablets,and the effect of relieving stiffness is superior.