The Study Of Iontophoresis Of Cyathula Officinalis Ethanol Extract In Treating Different TCM Classified Group Of Knee Osteoarthritis

ObjectiveThis clinical trial aims to evaluate the efficiency of iontophoresis of ethanol extract of Cyathula officinalis (NX Extract) when compared to iontophoresis of Huo Xue Zhi Tong Ding (HXZTD) in treating different Traditional Chinese Medicine (TCM) classified groups of Knee Osteoarthritis (KOA) patients.MethodsPatients (N=120) were screened and recruited from Jan to Nov 2014 by the department of traumatology, Shenzhen TCM hospital, a teaching hospital of Guangzhou University of Chinese Medicine. Patients were screened based on Western and Chinese Medicine clinical diagnostic criteria and divided into 3 TCM classification groups:1. Liver-kidney depletion and Sinews obstruction group,2. Spleen-kidney depletion, dampness pouring joint group and 3. Liver-kidney depletion, phlegm-blood stasis obstruction group. For each TCM classification group,40 patients were recruited and randomly allocated 1:1 into:A. NX Extract group and B. HXZTD group. All patients were treated daily for 2 weeks. WOMAC and related scales will be used as outcome measures.ResultsBefore treatments, patients between 2 groups of patients are of no statistically significant difference (P<0.05) in symptoms scales, showing the outcome results of the 2 groups are comparable.For the 3 TCM classified groups that used NX extract, after the treatment, symptoms, including night pain, morning stiffness, walking discomfort, skin temperature, standing discomfort, daily activities, bending of the knee, going up and down the stairs and walking on difference surface, are improved when compared to baseline (p<0.05).Outcome symptoms of the 3 TCM classified groups that used NX extract were also compared. For night pain, morning stiffness, walking distance, daily activities, bending of the knee, walking discomfort and standing discomfort, there are statistically significant differences among the 3 groups (p<0.05). However, there are no statistically significant differences in skin temperature, going up and down the stairs and walking on different surfaces among the 3 groups (p>0.05).Among the 3 TCM classified groups that used NX extract,1. Liver-kidney depletion and Sinews obstruction group is suggested to be the most effective with an overall effective rate (OER) of 95%; followed by 3. Liver-kidney depletion and phlegm-blood stasis obstruction group with an OER of 84.22% and 2. Spleen-kidney depletion and dampness pouring joint group with an OER of 75%.For all the 59 patients using NX extract, the remarkably effective rate is 49.15%, effective rate is 35.59%, not effective rate is 15.25% and the overall effective rate is 84.75%.For all the 58 patients using HXZTD, the remarkably effective rate is 44.82%, effective rate is 36.20%, not effective rate is 22.41% and the overall effective rate is 77.59%.ConclusionsIn conclusion, both iontophoresis of ethanol extract of Cyathula officinalis (NX Extract) amd Huo Xue Zhi Tong Ding (HXZTD) are shown to be useful in reducing symptoms of KOA, but NX Extract appears to be more effective than HXZTD. Among the 3 TCM classified groups, the effective rate of NX Extract is the highest in 1. Liver-kidney depletion and Sinews obstruction group followed by 3. Liver-kidney depletion and phlegm-blood stasis obstruction group and 2. Spleen-kidney depletion and dampness pouring joint group at last.