Clinical Observation Of Gushang No. 1 Prescription Combined With Celecoxib In The Treatment Of Knee Osteoarthritis Of Cold-damp Arthralgia Syndrome

Objective:To study the clinical efficacy of orthopedics No.1 prescription combined with celecoxib in the treatment of secondary cold-dampness syndrome knee osteoarthritis(KOA)and its effect on serum cytokines levels.Methods:A total of 60 patients with intermediate cold-dampness syndrome KOA who were admitted to the outpatient department of bone disease C,dongzhimen hospital,Beijing university of traditional Chinese medicine from June 2019 to October 2019 were included.The 60 patients were randomly divided into control group and observation group,each with 30 cases.In the observation group,there were 10 males and 20 females,with an average age of(63.10±11.00)years and an average course of disease of(2.7±1.1)years.In the control group,there were 9 males and 21 females,with an average age of 64.87±9.72 years and an average course of disease of 2.6±1.2 years.Control group was given celecoxib capsules orally only,0.2g/time,1 time/day.On the basis of the control group,the observation group was treated with fumigation and washing treatment of orthopedics No.1 prescription mianjian granule of traditional Chinese medicine(provided by the hospital traditional Chinese medicine pharmacy),1 bag for each time,1 time/day,5 times a week,and the patients in both groups were treated for 4 weeks.Changes in levels of visual analogue pain score(VAS),American knee association score(KSS),serum interleukin-1?(IL-1?),tumor necrosis factor-?(TNF-?),transforming growth factor-?1(TGF-?1)were observed before and after administration and the clinical efficacy was evaluated.Results:1.Comparison and analysis in the control group:the mean VAS score before and after treatment were 5.40 and 3.77,respectively.The mean KSS score were 57.17 and 69.37,respectively.Compared with that before treatment,the VAS and KSS score after treatment were significant difference(P<0.01).The mean serumIL-1? levels were 88.50 and 67.34,and the difference between the levels of IL-1? after treatment and those before treatment were statistically significant difference(P<0.01).The mean levels of TNF-? in the serum were 158.87 and 117.67,respectively.The mean values of TGF-?1 in serum were 20.63 and 48.29,respectively.Compared with that before treatment,the content of TNF-? after treatment was showing statistically significant differences(P<0.01).It is known that oral administration of celecoxib alone can relieve pain in patients with knee osteoarthritis,improve knee joint mobility,reduce the serum levels of inflammatory factors IL-1?,TNF-? in patients,and increase the level of TGF-?1.2.Comparison and analysis in the observation group:the mean VAS score before and after treatment was 5.60 and 2.97,respectively.The mean KSS score was 56.90 and 79.00,respectively.Compared with that before treatment,the VAS and KSS score after treatment were significant difference(P<0.01).The mean serumIL-1? level was 97.55 and 53.32,respectively,and the difference between the levels of IL-1? after treatment and those before treatment was statistically significant(P<0.01).The mean levels of TNF-? in the serum were 149.57 and 101.17,respectively.The mean contents of TGF-?1 in serum were 25.23 and 61.76,respectively.Compared with that before treatment,the contents of TNF-? after treatment were showing statistically significant differences(P<0.01).It can be found that the combination of orthopedics No.1 prescription and celecoxib can reduce pain in patients with knee osteoarthritis,improve knee joint mobility,reduce serum levels of inflammatory cytokines IL-1? and TNF-?,and increase levels of TGF-?1.3.Comparison and analysis between the control group and the observation group:after treatment,clinical efficacy of the two groups was determined:8 patients in the control group showed obvious efficacy,15 patients were effective,and 7 patients were ineffective,with a total effective rate of 76.67%.The total effective rate in the observation group was 93.33%,with a statistically significant difference(P<0.05).After treatment,the contents of IL-1? and TNF-? in the serum of the two groups were statistically significant differences(P<0.05).The other observation indicators were P>0.05,and the difference was not statistically significant.It can be seen that the observation group was superior to the control group in terms of the overall observation indicators after treatment.Conclusion:The efficacy of orthopedics No.1 prescription combined with celecoxib in the treatment of middle stage cold-dampness syndrome KOA is better than that of celecoxib alone,which can effectively relieve the clinical symptoms of patients with KOA,improve joint function,improve quality of life,reduce the contents of inflammatory factors IL-1? and TNF-? in serum,and increase the expression of TGF-?1protein.