The Clinical Study Of Knee Osteoarthritis With Effusion Treated By Gushibao Capsule Combined With High Viscoelastic Injection Therapy

Objective: This topic is under the guidance of professor Wang Jinb ang, through clinical observation,comparison with Gushibao capsule com bined high viscoelastic injection therapy and the simple application of s odium hyaluronate injection treatment the curative effect of kidney defici ency and blood stasis type of knee osteoarthritis,and to compare the pai n of patients after treatment,function score and joint mobility and stabilit y improvement,validation Gushibao capsule combined high viscoelastic in jection therapy treatment of advantage,to explore the diagnosis and treat ment with traditional Chinese medicine prescription's Gushibao capsule t he mechanism of action of kidney deficiency and blood stasis type of k nee osteoarthritis,summed up in this paper,the kidney deficiency and blo od stasis type of knee osteoarthritis pathogenesis,to combine traditional Chinese and western medicine to prevent knee osteoarthritis provide reli able theoretical basis and effective drug treatment.Methods: Strict selection between September 2014 and December 2014 in hospital of Hebei province during the period of hospitalization a nd conform to the kidney deficiency and blood stasis type of knee ost eoarthritis patients,120 cases of(men and women not limited),randomly divided into two groups:experimental group of 60 cases,control group 60 of cases.The experimental group contains 14 patients with men,46 patie nts with women,aged 40 to 70, the average age of 55.95 years,course o f 1 month to 20 years,to give patient's Gushibao capsule oral 6 pills,thr ee times a day.Gushibao capsule contains:cistanche, epimedium herb,radi x dipsaci,astragalus root,angelica,rehmannia glutinosa,calcined natural cop per,rhizoma drynariae,frankincense,myrrh,ground beetle insect,the centipede,earthworm,notoginseng,rhizoma citobii,dog tibia,the cucumber seed, win e,into 0 capsule after grinding,the medicine has the kidney strong bone,t he effect of invigorate the circulation,and cooperate with the knee high viscoelastic injection therapy once a week,five weeks,for a period of tre atment.Injection method: using outside genu eye the puncture point,name ly the knee half bends,on the outer rim,tibia lateral knee ligament,use fi nger to press the skin has a cavity, the puncture point,puncture strict ro utine disinfection shop towel program,wear sterile gloves, according to t he aseptic technique of standard operation,using sodium hyaluronate inje ction dedicated direct puncture needle,have frustrated feeling into the joi nt cavity,probe into no more than 1. 5 mm(advance 2 ~ 3 m L of 2% lidocaine injection pain),needle with Bausch Lomb Freda pharmaceutical producing sodium hyaluronate injection 2 m L(20 mg),because of injecti on of sodium hyaluronate is sticky stiff,must be slowly into the joint ca vity,after injection of sterile dressing,cover the eye of a needle,24 h can remove, together with the push method,press, kneading massage massag e technique make full dispersion of sodium hyaluronate.The control grou p contains 13 patients with men,47 patients with women,aged 40 ~ 70, the average age of 56.05 years,course of 1 month to 20 years,just to gi ve sodium hyaluronate injection articular cavity injection once a week, f ive weeks,for a period of treatment.Curative effect evaluation standard re ference to the "standard of diagnosis of disease and curative effect of tr aditional Chinese medicine",to observe pain in patients with visual analo gue scale VAS values,function and measure of the knee joint mobility,st ability, strength and deformity of the HSS score.Application spss19 statis tical analysis,draw the conclusion.Results:1 Before and after treatment in patients with VAS pain score comp arison:comparison within two way,VAS pain score was reduced, the pati ents before and after treatment have significant difference,P <0.01;Comp arison between the two way,experimental pain score improvement is better than that of control group, with significant difference, P < 0.01).2 Before and after treatment in patients with knee joint HSS score comparison: comparison within two way, HSS score was improved, the patients have significant difference before and after treatment,P<0.01; c omparison between the two way, experimental pain score improvement i s better than that of control group, wih significant difference, P <0.01).3 TCM symptoms curative effect comparison:after five weeks of tre atment,treatment group 60 cases patients, 14 cases cured, 27 cases were markedly effective,effective 25 cases,4 no effect,the total effective rate was 93.3%.Control group patients with 60 cases, 7 cases cured,20 cases were markedly effective,effective 20 cases, 13 cases of invalid, the tota l effective rate was 78.3%,the experimental group compared with control group curative effect have statistically significant,P <0.05,the treatment group curative effect is better than that of control group.4 Two groups of patients during treatment and after treatment the blood,urine,stool routine,liver and kidney function,and there were no obv ious abnormal ecg examination,examination in patients with only 2 cases of mild abdominal distension and constipation symptoms,no other adver se reactions.Conclusion:1 The Gushibao capsule combined high viscoelastic therapy and si mple injection of sodium hyaluronate treatment can be effective treatmen t of knee osteoarthritis.Gushibao capsule remains high viscoelastic injecti on therapy in the treatment of kidney and blood stasis type of knee ost eoarthritis efficacy,treatment effect of intra-articular injection of sodium h yaluronate of higher than pure.2 Kidney deficiency deficiency and blood stasis is the root cause o f the onset of knee osteoarthritis,Guluo is obstructed,cannot support to j oint lead to kidney deficiency and blood stasis type of knee osteoarthriti s,as the basis of the treatment of kidney deficiency and blood stasis typ e of knee osteoarthritis starting from the concept of "kidney disease",invigorating the kidney and strengthening bone,invigorate the circulation,provi ding for the modern Chinese medicine treatment of kidney deficiency an d blood stasis type of knee osteoarthritis has provided a new theoretical basis.3 The professor Wang Jinbang think that high viscoelastic injection therapy is not only the simple will sodium hyaluronate injected into ar ticular cavity,but to cooperate with traditional Chinese medicine massage technique: press,kneading, pushing method,make high viscoelasticity of sodium hyaluronate sufficient dispersion,relatively evenly cover the articu lar cartilage that can maximize the use of sodium hyaluronate lubricatin g joints,the function of the repair of articular cartilage.