Clinical Study Of Quhan Zhufeng Mixture Combined With Sodium Hyaluronate For The Treatment Of Knee Osteoarthritis Of Wind-cold-dampretention Type In Early And Mid-stage

Objective:The research aims to observe and assess the clinical efficacy and safety of oral Quhan Zhufeng mixture combined with intra-articular injection of sodium hyaluronate and singly intra-articular injection of sodium hyaluronate for the treatment of knee osteoarthritis of wind-cold-damp retention type in early and mid-stage. Meanwhile, the treatment advantage of Quhan Zhufeng mixture combined with sodium hyaluronate is evaluated.Methods:From May 2015 and December 2015, 60 cases of out-patients with knee osteoarthritis in accordance with the inclusion criteria in Gansu provincial hospital of TCM in the department of orthopedics were included and divided into the observation group and the control group using parallel contrast random number table method.Thirty patients in the observation group were given oral Quhan Zhufeng mixture combined with intra-articular injection of sodium hyaluronate to treat KOA and the control group received singly intra-articular injection of sodium hyaluronate.The treatment in both groups lasted five weeks which is one course of treatment. Before the treatment, at the end of treatment, 6 weeks and 12 weeks after the end of treatment pain walking on the ground, knee pain, stiffness, functional status and symptom classification quantization table were respectively assessed by vsual analogue scale(VAS), WOMAC scores and the improvement of TCM syndromes.Before the treatment and 12 weeks after the end of treatment, the Nimodipine method was used to assess the clinical efficacy. Before treatment and 12 weeks after the end of treatment,the volume of the knee joint effusion, the thickness of the synovialmembrane and the the thickness of articular surface cartilage of medial femoral were examined by high frequency ultrasound,blood routine, urine routine, liver function,renal function, blood glucose, electrocardiogram were detected to compare the safety of treatment methods of the two groups.Results:In the observation group, 5 cases were excellent, 16 cases were better, 6 cases were fair, 2 cases were bad, the total effective rate was 93.3%;In the control group, 3 cases were excellent, 8 cases were better, 15 cases were fair, 4 cases were bad, the total effective rate was 86.7%. The observation group was better than the control group(P< 0.05).Compared with that before treatment,VAS,WOMAC Osteoarthritis Index score and symptom score were significantly improved at the end of treatment as well as 6 weeks and 12 weeks after the end of treatment(P < 0.05), and the observation group was better than the control group(P < 0.05). Compared with before treatment,using high frequency ultrasound examination of the knee cavity effusion quantity,synovial thickness at 12 weeks after the end of treatment, have a significant improvement(P < 0.05). Compared between the two groups, the thickness of articular surface cartilage of medial femoral at 12 weeks after the end of the treatment, there was no significant difference(P>0.05). Between the two group of patients, blood routine, urine routine, liver function, renal function, blood glucose, ECG showed no obvious difference before treatment and 12 weeks after the end of treatment.No adverse reactions were observed in the patients of two groups.Conclusion:1.Both oral Quhan Zhufeng mixture combined with intra-articular injection of sodium hyaluronate and singly intra-articular injection of sodium hyaluronate for the treatment of knee osteoarthritis of wind-cold-damp retention type in early and mid-stage have good clinical efficacy and are safe.2.The clinical efficacy of Oral Quhan Zhufeng mixture combined with intra-articular injection of sodium hyaluronate for the treatment of knee osteoarthritis of wind-cold-damp retention type in early and mid-stage is superior to that of single intra-articular injection of sodium hyaluronate.3. Quhan Zhufeng mixture combined with sodium hyaluronate for the treatment of knee osteoarthritis of wind-cold-damp retention type in early and mid-stage may possess advantages of supporting healthy energy to eliminate evils, reinforcement andelimination in combination, as well as treating both principal and secondary aspect of disease.The recent clinical efficacy is good.