| Objective: The purpose of this study was to observe the clinical efficiency of the knee osteoarthritis with Extracorporeal shock wave therapy combined Zhanjin Huoxue Decoction and to explore the mechanism about it.Methods: 80 cases of outpatients and inpatients with the knee osteoarthritis were chosen as the object of the study.They were conformed to? Chinese medicine industry standards of The people's Republic of China ·The standard of the diagnosis and efficacy of Traditional Chinese Medicine·the knee osteoarthritis?.All patients were divided into the control group and the treatment group by the table of random digit.The patients of the treatment group were treated with Extracorporeal shock wave therapy combined with Zhanjin Huoxue Decoction and the control group were treated with Hyaluronate Sodium combined with Zhanjin Huoxue Decoction,with40 people in each group.There were 17 males and 23 females in the treatment group with 58 invalid knees.The mean age(?x±s the same below)of them was 67.0 ± 5.1 years old;There were 19 males and 21 females in the control group with 49 invalid knees.The mean age of them was 66.0 ±4.8 years old.The general situation of all patients of the two groups had no statistical difference.The patients of the two groups were all applied with Zhanjin Huoxue Decoction for 30 minutes for once a day.The course of the treatment was 20 days.We irradiated Chinese herbal drugs with TDP therapeutic instrument in the course of treatment.Zhanjin Huoxue Decoction contained twenty kinds of Chinese herbal medicine such as: Japanese Clubmoss Herb30 g,Speranskia Tuberculata 30 g,Ground Beetle 15 g,Safflower 10 g,Suberect Spatholobus Stem 60 g,Chinese Ephedra Herb 15 g,Graden Balsam Seed 9g,Chinese Clematis Root and Rhizome 60 g,Stephania tetrandra 15 g,HimalayanTeasel Root 20 g,Common Floweringquine Fruit 20 g,Doubleteeth Angelica Root 9g,Cassiabarktree Twig 10 g,Argy Wormwood Leaf 15 g,Beautiful Sweetgum Fruit 15 g,Taiwan Angelica Root 15 g,Ovientvine Stem 25 g,Variegated Coralbean Bark or Root-bark 30 g,Chinese Starasmine Stem 15 g,Szechwan Lovage Rhizome 30 g.These Chinese herbal drugs were triturated to powder firstly,and then attempered with yellow rice wine and old vinegar(rate 1:3).After the applyment,the paitients could arrest for half an hour.And then we located the pain points around the knees and treated the sick area with shock wave once every three days of the patients in the treatment group.There was 5 times in one course of the treatment.The patients of the control group were injected with Hyaluronate Sodium for 2ml a join.The injection frequency was once a week,5 times as a course of the treatment.I followed the aseptic principles in each operation.The observation indexes included the VAS score which reacted the pain degree of the patients,the duration which reacted the therapeutic effect(unit: week)and the signs that reacted the symptoms of osteoarthrosis of knee.We classfied all the patients before the treatment based on the symptom-sign integral schedule.The scores of the mild patients were less than 10,mid-range patients' scores were more than or equal to 10 but less than 20 and fantasy patients' scores were more than or equal to20.The scores of the VAS,symptom-sign integral and duration of efficacy were counted and sorted before and after the treatment of the two groups.We analyzed the data of the two groups statistically.VAS score and symptom-sign integral were compared between groups and within groups according to severity grade.Duration of efficacy was compared between groups according to severity grade too.Results:1 There were no significant differences in VAS score before the treatment(P>0.05).There was a marked drop in VAS scores of mild and mid-range patients of within groups.The results showed they had significant differences(P<0.05).VAS scores of fantasy patients had reduced but we found that the data had no significant differences(P>0.05).For the control group,there hasbeen a decline of the VAS score comparing the mild and mid-range patients before and after the therapy.This statistics had statistical significance(P<0.05).The fantasy patients of the control group on this index had no significant change(P>0.05).Comparing all mild and mid-range patients' VAS score in the treatment group and the control group,they had statistical significance(P<0.05);There were no significant differences and no statistical significance of the fantasy patients between the two groups(P>0.05).2 Symptom-sign integral of the two groups had no significant differences and statistical significance before the treatment(P>0.05).For the treatment group: there was an obvious decline for this index of the mild and mid-range patients within the groups before and after the treatment(P<0.05).By comparison the fantasy patients within the treatment group,it had statistical significance(P<0.05),however,the integral had descended.For the control group: there has been a decline of the symptom-sign integral comparing the mild and mid-range patients before and after the therapy within the groups.This statistics had statistical significance(P<0.05).The fantasy patients of the control group on this index had significant change and no statistical significance(P<0.05).Comparing all mild and mid-range patients' symptom-sign integral in the treatment group and the control group,they had statistical significance(P<0.05);There were no significant differences and no statistical significance of the fantasy patients between the two groups(P>0.05).3 We followed up the patients of the two groups for 52 weeks.The duration of efficacy of the treatment group had significant differences with the control group for each mild,mid-range and fantasy patients,it had statistical significance(P<0.05).Conclusions:1 Extracorporeal shock wave therapy combined with Zhanjin Huoxue Decoction bring more obvious relief from the pain than sodium hyaluronate injection combined with Zhanjin Huoxue Decoction of the mild and mid-range patients.In terms of the rate of pain relief,the former is faster than the latter.2 The treatment group is superior to the control group in improving symptoms and relieving pains for the mild and mid-range patients.The efficiency of Extracorporeal shock wave therapy combined with Zhanjin Huoxue Decoction is more thoroughly.3 Following up the patients of the two groups,we find that the duration of efficacy of the treatment group is superior to the sodium hyaluronate injection combined with Zhanjin Huoxue Decoction group.4 The clinical effect of two methods in treating knee osteoarthritis is poor. |
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