| Objective:This topic proposed by HFUS quantitative evaluation of Chinese and western medicine treatment of knee osteoarthritis correlation research,explore HFUS diagnosis and to evaluate the treatment effects of knee osteoarthritis in advantage,for the effect of diagnosis and treatment of knee osteoarthritis provide a new method of quantitative evaluation.Methods:In this study,70 patients with mild and moderate knee osteoarthritis who were admitted to the joint orthopaedic department of the Gansu Provincial Hospital of TCM from October 2015 to September 2017 were selected.It was randomly divided into TCM treatment group and western medicine treatment group,each group had 35 cases.According to TCM syndrome differentiation,the TCM group gives the treatment of external application of internal medicine,the rheumatism and rheumatism type: the internal medicine to remove the cold and the wind particles,and the external use of the ointment;Rheumatic fever: internal heat removal and dehumidification,external use of clear heat;Blood stasis resistance closed type:internal and acetanilide detumescence particles,external use blood know luo Juan tincture certification;Liver and kidney deficiency type: internal medicine and kidney tonic pills,external use of strengthening the kidney and invigorating the kidney.The western medicine group was treated with sodium hyaluronate injection(HA)and acetaminophen tablets were taken orally.Group respectively in the two groups of patients during the diagnosis of knee joint X-ray three examination(knee weight-bearing is slice slice + + load side 45 °tangent slice),distal femur HFUS examination,improved floating patellar test,as wellas the method of visual analogue scale(VAS)score,western Ontario and McMaster universities osteoarthritis index score(WOMAC)score,and after treatment in patients with the same VAS score of march,June,WOMAC evaluation results,improvement of patellar test results,the results of the distal femur HFUS check line statistical analysis to observe the two groups of patients with symptoms,signs,the changes of different parts and distal femoral cartilage thickness changes.Finally,SPSS 22.0statistical software was applied to analyze the difference between HFUS rating and X-ray diagnosis classification by statistical analysis.Analysis of the correlation between HFUS rating and VAS score and WOMAC in different treatment stages;The correlation between HFUS rating and improved patellar test scores was analyzed.Results:1.Pre-treatment evaluation of knee osteoarthritis: moderate consistency between the pre-treatment HFUS rating and the X-ray diagnosis results(Kappa=0.581,P<0.001);There was a moderate positive correlation between the pre-treatment HFUS rating and the visual simulation(VAS)score and the knee osteoarthritis index(WOMAC)score.There was a moderate positive correlation between the pre-treatment HFUS rating and the improved patellar test scores.There was no correlation between the pre-treatment HFUS rating and femoral condyle,femoral condyle and femoral cartilage thickness(P>0.05).2.Efficacy evaluation after knee osteoarthritis treatment: there is a highly positive correlation between HFUS rating and VAS score after 3 months of treatment,and there is a moderate positive correlation with the WOMAC score.There was moderate positive correlation between HFUS rating and VAS score and WOMAC score after June.There was a moderate positive correlation between the HFUS grade and the improved patellar test scores after 3 months of treatment.There was a moderate positive correlation between the HFUS grade and the improved patellar test scores after June.There was no statistically significant difference in the thickness of the left femoral condyle and the femoral block in different time points(P>0.05).There was no statistically significant difference in the thickness of the left femoral condyle and the femoral block in different time points(P>0.05).HFUS rating after 3 months of treatment and on the left side of the femoral condyle,lateral femoral condyle femoral articular cartilage thickness and the right femoral condyle inside a block and tackle,femoral block there is relationship between the thickness of articular cartilage are not(P>0.05),HFUS rating after 3 months of treatment with lateral femoral condyle is an injury to the right side of the low positive correlation between the thickness of articular cartilage;HFUS rating after 6 months of treatment with lateral femoral condyle is an injury to the left,on the right side of the femoral condyle,the femoral trochlear articular cartilage thickness is moderate negative correlation relationship between HFUS rating and on the left side of the femoral condyle has low negative correlation relationship between the thickness of articular cartilage,HFUS rating of articular cartilage with the left side of the lateral femoral condyle is moderate positive correlation between the thickness.3.Two groups of patients with KOA treatment effects: two groups of KOA patients before treatment VAS,WOMAC,floating patellar test result comparison difference had no statistical significance(P > 0.05),3 months and 6 months after treatment VAS,WOMAC,floating patellar test effect of comparative differences are statistically significant(P < 0.05),the effect of Chinese medicine group is superior to western medicine group.There was no statistically significant difference in the thickness of the femoral condyle and the femoral head of the femur in different time points 7 and different groups of HFUS(P BBB 0.05).The total effective rate(91.4%)was better than that in western medicine group(80.0%).Conclusion:HFUS can be found by this research as a means of the diagnosis of knee osteoarthritis,also can be used as a kind of knee osteoarthritis treatment effect evaluation method,improved floating patellar tests may be semi-quantitative diagnosis and evaluate the curative effect of knee osteoarthritis,Chinese medicine treatment of KOA patients curative effect is superior to western medicine group,worthy of clinical popularization and application. |
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