Clinical Study Of Cold Convulsion Decoction With Intrauterine Adhesion Therapy To Treat Coagulated Cold Syndrome Type Of Knee Osteoarthritis

Objective: Trough this paper we will observe and evaluate the clinical efficacy and security that cold convulsion decoction with intrauterine adhesion therapy to treat coagulated cold syndrome type of knee osteoarthritis.preliminarily evaluation the advantage of cold convulsion decoction with sodium hyaluronate anticular injection to treat coagulated cold syndrome type of knee osteoarthritis,improve knee osteoarthritis treatment effect.Then,exploe the academic innovation and clinical efficacy of master Li Shimao's diaphoresis method.Provide clinical research support to enrich and develop therapeutic principle of the master of traditional Chinese medicine group characteristics.Inherit and develop his clinical experience on sweating method of curing cold coagulation.Methods: To select the 90 patients in strict accordance with the diagnostic criteria for knee osteoarthritis,the selection criteria selected Hebei Province hospital of traditional Chinese medicine department in 2015,January to 2016 June through the inpatient treatment of knee osteoarthritis patients,between patients aged 40 to 70 years old,underwent knee radiograph,shows the joint space stenosis,condyle of tibia,patella,femur condyle there are different degrees of hyperplasia,blood check rheumatoid factor negative,joint pain,the symptom is heavier,downstairs,after exercise exacerbation of symptoms,diagnosed as osteoarthritis of the knee.Combined with the symptoms and signs,operation index did not reach the requirements of patients,conservative treatment,divide them into three groups: test group and I control group and II control group,according to treatment sequence making randomly n = 30,for I control group male 9,female 21,age 40 to 70 years,an average of 58.50 years,duration of 1month to 20 years;II control group,9 men,women 21,age40 to 70 years old,with an average of 58.77 years old,duration of 1month to20 years;test group,male 8,female 22,age 40 to 70 years,with an average of58.23 years of age,duration of 1month to 20 years.I control group: give sodium hyaluronate,massage the knee flexion and extension joints 30 times or 1 minute(Sodium Hyaluronate Injection adopts Shandong Bausch & Lomb Freda Pharmaceutical Co.Ltd production,commodity name: Sofast)joint cavity injection.II control group: given cold convulsion decoction modification.Composition: Contains cinnamon cassia twig,gypsum,ginger,date,ephedra,asarum,acomite,centipede.This decotion can sweat and dispelling the cold evil.Scolopendra subsinipes and scorpions are antispasm powder,which can dredge collaterals,relieve urgency,pain,and muscle spasm.Usage:1.take 200 ml at 9 point after breakfast;if do not sweat,after3 hours take 200 ml again;if still do not sweat,,take second dose,every 3 hours take one time,until healthy sweat appears.Otherwise,the next day as before take,not up to standard third day continue to take two doses.If three days take six doses,healthy sweat does not appear and convulsion pulse does not stop that do not take again and observe the index.2.According to the third method aided sweating taking drugs: after taking the decotion drink hot gruel,cover clothes,continuous take.3.The best sweating standards: is healthy sweating method: " healthy sweat appear,convulsion pulse stop".That is slight sweating,all over the body,last 2-5 hours and self convergence.Vein convulsion check: namely pulse string restraint also appellation "convulsion vein".We put the heavy string constrained pulse named convulsion pulse.Convulsion pulse stop is pulse tends to be moderate after treatment by sweating method.4.In accordance with the principles of "view its pulse and syndrome,know where will invade,and treat it as is syndrome " to treat the residual symptoms that after sweating.Test group: give cold convulsion decoction with intrauterine adhesion therapy.Sodium hyaluronate injected into the articular cavity method for once a week,for 30 days.Concomitant treatment: Health Education:1.Weight loss and reduce unreasonable movement: avoiding long standing,climb stairs and other aggravating knee weight-bearing exercise,keep the reasonable weight index.2.Using the tools we will strengthen the protection of the knee joint: wearing knee pads,use a cane,cane,walker and so on.3.Strengthen functional exercise of knee jiont: instruct patients aerobic exercise like swimming,pedaling a empty bicycle and exercise extension apparatus of knee jiont.I control group,articular cavity injection once a week.II control group,take one or two doses every day according to the condition,test group take one or two doses every day according to the condition with intrauterine adhesion therapy,the course is 30 days for each group.Record the clinical curative effect,visual analog pain score VAS values and grade of the knee joint activity function of before and after treatment and follow-up of 3 months after treatment,and compare the results of observation,analysis,conclusion.Results:1 After the treatment,three groups of patients did not show significant changes in blood count,ESR,liver and kidney function.2 patients have symptoms of mild nausea,flustered in test group,no other adverse reactions.2 The three groups before treatment,the random factors(gender,age,knee pain degree)had no significant difference(P>0.05).3 Efficacy comparison: at the end of treatment,for the test group of 30 patients,15 cases were cured,8 cases markedly effective,6 case effective,and 1 case not effective,the total effective rate was 96.7%;for I control group of 30 patients 8 cases were cured,9 cases were markedly effective,9 case effective,and 4 cases not effective,the total effective rate was 86.7%;for II control group of 30 patients,10 cases were cured,7 cases markedly effective,10 case effective and 3 cases not effective,the total effective rate was 90.0%.The total efficiency rate of the three groups are statistically significant difference(P<0.01).Test group is superior to I control group and II control group.4 Three groups of patients after treatment and 3 months after treatment,the symptoms of pain and joint activity was improved,and have obviousdifference(P<0.01 or P<0.05),so three methods of treatment are to treat knee osteoarthritis,but cold convulsion decoction with sodium hyaluronate anticular injection compared with the other two groups,clinical curative effect significantly better than the other two groups;Test group after treatment and after 3 months follow-up,joint pain symptoms and activity significantly are better than I and II control group(P<0.01 or P<0.05).5 Three groups of patients after treatment and 3 months after treatment,Chinese medicine symptom score was improved,and have obvious difference(P<0.01 or P<0.05),Compared with the control group,the difference between the treatment group and the control group was statistically significant.Compared with the control group,P> 0.05 showed that there was no significant difference between the treatment group and the control group Learning meaning.Conclusion:1 Cold convulsion decoction with sodium hyaluronate anticular injectioncan effectively treat coagulated cold syndrome type of knee osteoarthritis and improve the clinical symptoms and signs and it is safe,less adverse reactions,effective,reliable and worthy of clinical promotion.2 Li Shimao professor break the bondage of diaphoresis used for exterior syndrome and innovatively apply diaphoresis to treat Yang deficiency and coagulated cold syndrome,deficiency-excess mixing syndrome,interior syndrome,enrichs theoretical research of diaphoresis,expands the scope of application of diaphoresis,obtains satisfactory curative effect in clinic.