The Clinical Research Of Treatment Of Duhuojisheng Decoction In Knee Osteoarthritis With Liver And Kidney Deficiency Syndrome

Objective:To observe the clinical curative effects of Duhuojisheng decoction combined with Western medicine in the treatment of knee osteoarthritis with liver and kidney deficiency syndrome. Using Duhuojisheng decoction as a basic recipe which comes from "Emergency Preparedness Prescriptions",Pain, joint function and quality of life improvement are considered to be compared between integrative treatment and Western medicine treatment. To find serum markers for early diagnosis of osteoarthritis and explore methods to determine the condition of development,through the observation of inflammatory markers,cartilage and bone metabolism markers.Methods:40patients of knee osteoarthritis with liver and kidney deficiency syndrome from inpatient and outpatient departments of Wuxi Traditional Chinese Medicine Hospital during March2013to January2014were randomly divided into2groups,20cases in each group.Patients in the integrative treatment group were administrated with Duhuojisheng decoction combined and western medicine,while the other western medicine group with western medicineonly.Ten healthy people were collected as a control group.General laboratory tests like WBC、HB、PLT、BUN、Cr、AST、ALT and inflammatory markers CRP were observed during the pre-and post-treatment changes.Joint pain,swelling,stiffness degree were evaluated by the Western Ontario and McMaster. Universities Osteoarthritis Index(WOMAC). Patients’ signs,symptoms and functional activities were scored before and after treatment by Traditional Chinese Medicine Pattern Effect Scale.Tumor Necrosis Factor-α (TNF-α)、Cartilage oligomeric matrix protein (COMP)、C-terminal crosslinking telopeptide of type Ⅰ collagen (CTX-Ⅰ) and C-terminal crosslinking telopeptide of type Ⅱ collagen(CTX-Ⅱ) were measured to discover the differences in osteoarthritis patients and healthy controls serum and their effect on the scores before and after treatment.Using SPSS19.0to do statistical processing.Results:There were no significant statistical differences among the groups in age, sex and other risk factors.The integrative treatment group and the western medicine group were statistically comparable.Remarkable differences showed in the WOMAC and Traditional Chinese Medicine Pattern Effect Scale before and after the12week treatment,specifically in the integrative treatment group(P<0.05).Meanwhile,TNF-α、COMP、CTX-Ⅰ、CTX-Ⅱ had higher expression in patients of knee osteoarthritis with liver and kidney deficiency syndrome than the healthy control group(P<0.05).They were negatively related with therapy.Conclusion:Duhuojisheng decoction effectively improved the clinical symptoms, joint function and syndromes, combined treatment performed significantly better than western medicine treatment alone,while lack of the evidence of Chinese medicine treatment alone. TNF-α、COMP、 CTX-Ⅰ、CTX-Ⅱ in serum of patients with high expression of osteoarthritis can be used as indicators of early diagnosis and determine disease progressionmarkers.