Clinical Observation On Treatment Of Early And Middle Knee Osteoarthritis With Yishen Xiaotong Pills Combined With Platelet-rich Plasma (PRP)

Objective: To observe the clinical efficacy of Yishen Xiaotong Pills combined with intra-articular injection of PRP in the treatment of early and mid-stage liver and kidney deficiency knee osteoarthritis,and to explore the short-term clinical effect of this method.Methods: A total of 64 patients with early to mid-stage liver and kidney deficiency knee osteoarthritis who were hospitalized in the Joint Disease Department of Henan province hospital of TCM from December 2019 to December 2020,who met the inclusion criteria were selected,and adopted according to the time of admission after signing the informed consent.SPSS software was used to randomly divide patients 1:1into PRP group and Chinese medicine combined PRP group,with 32 patients in each group.PRP group: Based on the regular treatment,PRP was injected into the joint cavity;Chinese medicine combined with PRP group: On the basis of PRP group,patients were given Yishen Xiaitong pills orally.Both groups were treated for 5 weeks.WOMAC index,VAS score were recorded before,after and 3 months and 6 months after treatment,respectively.Anteroposterio-lateral radiographs of weight-bearing knee were taken before and 6 months after treatment,the imaging evaluation at 6months follow-up after treatment were compared with the ones before treatment.The WOMAC index,VAS score before and after treatment,3 and 6 months after treatment were compared between the two groups.The clinical effect of Yishen Xiaotong pills combined with intra-articular injection of PRP in the treatment of knee osteoarthritis with liver and kidney deficiency type in the early and middle stages was analyzed and discussed.Results: A total of 64 patients were collected in this study,with 32 cases in each group.The total completion rate was 100%,and no drop-out cases were found.1.Before treatment,there were no significant differences in gender,age,affected knee,BMI and course of disease between the two groups(P > 0.05).There was no significant difference in the observation indexes between the two groups(P > 0.05),and the baseline was consistent and comparable.2.The VAS in the two groups decreased over time after treatment,which was related to time factor.The VAS in the same group was significantly lower after treatment than the scores before treatment(P < 0.05).PRP combined with Chinese medicine group was superior to PRP group.3.There was no significant change in the K-L grade of knee joint X-ray between the two groups before treatment and 6 months after treatment(P>0.05).4.In both groups before treatment,after treatment,follow-up of 3 months and 6 months after treatment,WOMAC index decreased over time(P < 0.05),which was related to time factor.Any two comparative differences at any timepoint in the PRP group after treatment are statistically significant(P < 0.05),PRP combined traditional Chinese medicine group after treatment for 3 months and 6 months after treatment,P = 0.212 >0.05,which has no statistically significant difference,the rest of the time point of two comparative differences are statistically significant.The therapeutic effect of PRP combined with Chinese medicine group was better than that of PRP group(P < 0.05).Conclusions: Through the comparative study of the two groups of patients with different treatment methods,Yishen Xiaotong pills combined with intra-articular injection of PRP has a definite effect on the treatment of knee osteoarthritis of liver and kidney deficiency type in the early and middle stage,this method can significantly improve the clinical symptoms of patients,improve the function of knee joint,improve the quality of life of patients,which is worthy of clinical promotion.