Clinical Observation Of Duhuo Jisheng Decoction On Patients With Rheumatoid Arthritis Of Liver And Didney Deficiency Syndrome After Total Knee Arthroplasty

Objective: To observe the clinical efficacy of Duhuo Jisheng Decoction in rheumatoid arthritis(RA)patients of liver and kidney deficiency syndrome after total knee arthroplasty(TKA),this research aims to provide objective basis for the treatment of RA by integrated Traditional Chinese and Western medicine.Methods: A total of 68 RA patients with liver and kidney deficiency from January 2021 to January 2022 meeting the inclusion criteria were selected,and randomly divided into 33 cases in control group and 35 cases in experimental group.Control group: total knee replacement was performed by the same surgeon with normal postoperative anticoagulation,gastric protection and other conventional treatment.Experimental group: on the basis of the control group,Duhuo Jisheng decoction granules were taken from the 1st day to the 1st month after operation,2 doses per day,divided in the morning and evening.Erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),rheumatoid factor(RF)and interleukin-6(IL-6)were recorded in both groups before surgery and at 3,7 and 30 days after surgery.Hospital for Special Surgery Kenee Score(HSS),Visual Analogue Scale(VAS),and the score of clinical symptoms of traditional Chinese medicine(TCM)were recorded at 3,7 and 30 days after surgery.The clinical efficacys of the two groups were compared before and after treatment.The statistical methods used are general statistical description and repetitive measurement deviation analysis.All data were analyzed by SPSS 25.0 statistical software.Results: The number of patients who completed the final follow-up was 31 in the two groups,respectively.There was no statistical significance in gender,age,body mass index and surgical side of the two groups(P >0.05).1.Laboratory index: There was no interaction effect in ESR and RF between two groups(P >0.05),indicating that there was no statistically significant difference regarding the clinical efficacy on ESR and RF among the two groups.CRP and IL-6 had an interaction effect between the two groups.To give more details,there was no statistical significance in CRP before surgery and post-3 days(P>0.05),and the CRP in the experimental group was lower than that in the control group at post-7 and post-30 days,with statistical significance(P<0.05).There was no significant difference in IL-6 between two groups before and 1 month after surgery(P>0.05),and the IL-6 in the experimental group was lower than that in the control group 3 days and 1 week after surgery,the difference was statistically significant(P <0.05).2.HSS score: According to repetitive measurement deviation analysis,HSS score had an interaction effect among two groups(P <0.05).There were no statistically significant differences between the two groups before surgery,post-3 and post-30 days(P >0.05),and the knee HSS score of the experimental group was higher than that of the control group 7 days after surgery,with statistically significant differences(P <0.05).3.VAS score: According to rank sum test,there was no statistically significant difference in VAS score between the two groups before and 1 month after surgery(P>0.05),while there was statistically significant difference at 3 days and 1 week after surgery(P<0.05).4.TCM syndrome score and efficacy: After treatment,the TCM syndrome score of iver and kidney deficiency syndrome in the experimental group was higher than that in the control group,with statistically significant differences(P <0.05).The effective rate of treatment in the experimental group(96.68%)was higher than that in the control group(74.19%),and the difference was statistically significant(P <0.05).Conclusion: 1.Combined treatment with Duhuo Jisheng decoction after TKA can improve the levels of pro-inflammatory factors and improve joint pain and activity,and contribute to the rehabilitation of knee joint function.2.Combined treatment with Duhuo Jisheng decoction after TKA can reduce the TCM syndrome score of liver and kidney deficiency syndrome and improve the symptoms of liver and kidney deficiency after TKA,with effective safety.