Clinical Observation Of Early And Intermediate Knee Osteoarthritis Treated With Weishi Manipulation Combined With Sodium Hyaluronate Injection In Knee Joint

Objective: To evaluate the clinical efficacy of early intervention and mid-term knee osteoarthritis by using Weishi manipulation combined with sodium hyaluronate knee joint injection and glucosamine sulfate capsules combined with oral sodium hyaluronate injection to treat knee osteoarthritis.The current study estimates the effectiveness and safety of these two combining therapies of early and intermediate knee osteoarthritis,and explores their efficacy mechanism.Methods: These patients who we studied were diagnosed from December 2016 to December 2017 in the Department of Osteoarthritis and Exercise Subjects and Wards of Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine.These patients met the diagnosis,inclusive criterions of knee osteoarthritis.After inclusion,we divide these patients into treatment group and control group followed the principle of randomization,with 30 cases in each group.With using the Weishi manipulation combined with sodium hyaluronate knee joint cavity as the therapy for the treatment group,the control group was given glucosamine sulfate capsules orally combined with sodium hyaluronate knee joint cavity injection.We followed up these two groups for 3 weeks,5 weeks and 3 months after the end of treatment respectively,and collected the data of WOMAC,knee pain index score(VAS),and knee osteoarthritis severity.Analysing the date through SPSS 22.0 software,and obtained the results.Results: According to the results,there were no statistically significant differences between in VAS pain scores,WOMAC disease scores,and Lequesne severity index scores between the two groups before treatment(P>0.05).VAS pain scores: Results indicated that the VAS pain scores from the follow-up of 3 weeks,5 weeks,and 3 months after the end of treatment were both lower than before treatment(P<0.01),with significant differences.Statistically significant difference existed between the therapeutic efficacies of two groups at different time points(P=0.006<0.05),with a time effect(P=0.000<0.01)and no time-group interaction(P=0.175>0.05).On the basis of results of VAS pain scores from the follow-up of 3 weeks(P=0.026<0.05),5 weeks(P=0.000<0.05),and 3 months after the end of treatment(P= 0.003<0.05),statistically significance was found too.WOMAC scores: Results showed that the WOMAC scores from the follow-up of 3 weeks,5 weeks,and 3 months after the end of treatment were both lower than before treatment(P<0.01),with significant differences.Statistically significant difference existed between the therapeutic efficacies of two groups at different time points(P=0.019<0.05),with a time effect(P=0.000<0.01)and no time-group interaction(P=0.056>0.05).On the basis of results of WOMAC scores from the follow-up of 3 weeks(P= 0.040<0.05),5 weeks(P=0.021<0.05),and 3 months after the end of treatment(P=0.006<0.05),statistically significance was also discovered.Lequesne Severity Index scores: The analysis shows that the Lequesne severity index scores from the follow-up of 3 weeks,5 weeks,and 3 months after the end of treatment were both lower than before treatment(P<0.01),with significant differences.Statistically significant difference existed between the therapeutic efficacies of two groups at different time points(P=0.041<0.05),with a time effect(P=0.000<0.05)and no time-group interaction(P=0.076>0.05).After three weeks' treatment,there was no statistical significance(P=0.024<0.05).But according to the results of Lequesne severity index scores from the follow-up of 5 weeks(P=0.018 <0.05),and 3 months after the end of treatment(P=0.017<0.05),statistically significance was discovered.Assessment of pain Clinical Efficacy: After 5 weeks' of treatment,the effective rate of the treatment group was 96.67%,and of the control group was 90.00%(P=0.000<0.05),with statistical significance.After the period of treatment ends,the 3 month follow up of treatment group showed the effective rate of 93.33%,with significant difference(P=0.003<0.05)as compared to the control group,which showed the effective rate of 80.00%.Evaluation of safety indicators: during the entire therapeutic process,there was one case appearing clinical response in each group,without other discomfort,and no abnormalities in liver and kidney function,blood routine,and two stool routines were found.Conclusions: 1.Weishi manipulation combining with sodium hyaluronate knee joint injection and glucosamine sulfate capsules oral sodium hyaluronate knee joint injection have good early efficacy and reliable safety in the treatment of early and mid-term knee osteoarthritis.2.The efficacy of Weishi manipulation treatment combing with sodium hyaluronate injection into the knee joint cavity was better than that of the control group.Three months after the end of treatment,the therapeutic efficacies of the two groups' were both declined.But,the therapeutic efficacy of Weishi manipulation treatment combining with sodium hyaluronate and knee joint injection decreased slightly.