Clinical Observation On The Treatment Of Enile Knee Osteoarthritis With Duhuojisheng Decoction Combined With Moxibustion Or Fumigation

ObjectiveTo observe the clinical effect of Duhuojisheng Decoction combined with moxibustion or fumigation in the treatment of senile knee osteoarthritis,and to explore the therapeutic advantages of Duhuojisheng Decoction combined with moxibustion or fumigation in the treatment of different types(kidney deficiency and marrow deficiency type,Yang deficiency and cold coagulation type,and stagnation of blood stasis type)of senile knee osteoarthritis,guide the clinical prescription application.MethodsThe patients diagnosed as senile knee osteoarthritis in the orthopedic outpatient department of Hubei Hospital of traditional Chinese medicine from October 1,2018 to September 30,2019 were selected as the research objects.Among them,those who used Duhuojisheng Decoction for oral administration and moxibustion treatment belonged to moxibustion group,those who used Duhuojisheng Decoction for oral administration and then decocted it again for external use belonged to fumigation group,and those who only used Duhuojisheng Decoction for treatment as the control group of this study.There were 112 patients who met the inclusion criteria of this study,including 40 cases of moxibustion group(14 cases of kidney deficiency and marrow deficiency type,14 cases of Yang deficiency and cold coagulation type,12 cases of stagnation of blood stasis type),38 cases in the fumigation group(14 cases of kidney deficiency and marrow deficiency type,13 cases of Yang deficiency and cold coagulation type,11 cases of stagnation of blood stasis type),34 cases in the control group(12 cases of kidney deficiency and marrow deficiency type,11 cases of Yang deficiency and cold coagulation type,11 cases of stagnation of blood stasis type),all patients were treated for 3 weeks.The VAS score and WOMAC score of each group before and after the treatment were compared and analyzed respectively.Through the comparative analysis of moxibustion group and control group,fumigation group and control group,to explore the therapeutic advantages of Duhuojisheng decoction combined with moxibustion or fumigation in the treatment of different syndrome types of senile knee osteoarthritis,and the comprehensive effect of each group was evaluated.Two months after the treatment,the patients were followed up by telephone to evaluate the recurrence of each group.ResultsIntra group comparison:Moxibustion group:VAS score and WOMAC score are compared separately before and after treatment,P<0.05,there is statistical difference.Fumigation group: VAS score and WOMAC score are compared separately before and after treatment,P<0.05,there is statistical difference.Control group: VAS score and WOMAC score are compared separately before and after treatment,P<0.05,there is statistical difference.Comparison between groups:Comparison of general conditions(age,gender,disease location and course): age,gender,disease location and course of patients in moxibustion group and control group,fumigation group and control group are statistically compared,P>0.05,with no statistical difference and can be compared.Kidney deficiency and marrow deficiency type:There is no statistical difference in VAS score and WOMAC score between moxibustion group and control group,fumigation group and control group before treatment(P>0.05);there is no statistical difference in VAS score and WOMAC score between moxibustion group and control group after treatment(P>0.05).There is statistical difference in VAS score and WOMAC score between fumigation group and control group after treatment(P<0.05).Yang deficiency and cold coagulation type : There is no statistical difference in VAS score and WOMAC score between moxibustion group and control group,fumigation group and control group before treatment(P>0.05);there is statistical difference in VAS score and WOMAC score between moxibustion group and control group after treatment(P<0.05),there is no statistical difference in VAS score and WOMAC score between fumigation group and control group after treatment(P>0.05).Stagnation of blood stasis type:There is no statistical difference in VAS score and WOMAC score between moxibustion group and control group,fumigation group and control group before treatment(P>0.05);there is statistical difference in VAS score and WOMAC score between moxibustion group and control group after treatment(P<0.05),and there is statistical difference in VAS score and WOMAC score between fumigation group and control group after treatment(P<0.05).The effective rate is 97.50% in moxibustion group,97.37% in fumigation group and 85.29% in control group.Comparison of clinical effect between moxibustion group and control group,fumigation group and control group,(P<0.05),there is statistical difference.After 2 months follow-up,the recurrence rate is 20.51% in moxibustion group,21.62% in fumigation group,44.93% in control group,Comparison of recurrence between moxibustion group and control group,fumigation group and control group,(P<0.05),There is statistical difference.Conclusion1.The clinical effect of Duhuojisheng Decoction combined with moxibustion or fumigation in the treatment of senile knee osteoarthritis is better than that of Duhuojisheng Decoction alone,and the recurrence rate is lower;2.Compared with the treatment of Duhuojisheng Decoction alone,Duhuojisheng Decoction combined with moxibustion has a better clinical effect in the treatment of senile knee osteoarthritis of Yang deficiency and cold coagulation type,Duhuojisheng Decoction combined with fumigation and washing has a better clinical effect in the treatment of senile knee osteoarthritis of kidney deficiency and marrow deficiency type,and Duhuojisheng Decoction combined with moxibustion or fumigation has a better clinical effect in the treatment of senile knee osteoarthritis of stagnation of blood stasis type;3.Duhuojisheng Decoction combined with moxibustion or fumigation can give full play to the advantages of traditional Chinese medicine in the treatment of arthralgia,especially one side for two purposes,internal and external treatment,which is more conducive to saving medical resources,reducing medical costs,and relieving patients' symptoms more quickly and economically.