The Application Of Zhuang Gu Tong Bi Pills To The Minimal Invasive Osteotomy With External Fixation Treating Varus Of Liver And Kidney Deficiency Knee Osteoarthritis

Purpose:On the basis of our previous research, the aim of this study was to observe the clinical effect of Zhuang Gu Tong Bi (ZGTB) pills used after the minimally invasive osteotomy orthopedics in the treatment of liver and kidney deficiency knee osteoarthritis (LKD-KOA). to explore the partial mechanism as well as offering a further clinical evidence for the application and popularization.Methods:70 patients with LKD-KOA were divided into two groups:3Speople in control group and 35 in treatment group; The control group patients took Xian ling Gubao(XLGB) 4 pills Bid two weeks after operation; Patients in treatment group took 10 g Bid two weeks after operation, each treatment course is 3 months, for 2 period of treatment. Patients’liver and kidney function was checked every month, and reexamined in 3 month and 6 month after therapy. Patients were respectively checked as follows:the VAS score evaluating degree of knee pain, KSS score evaluating of knee joint function, SF-36 scale evaluating of quality of life; The serum COMP and TNF alpha test evaluating osteoarthritis progression; Knee joint with the full weight bearing for assessing the healing of bone.Result:There were no severe complication in all cases such as infection, thrombosis:there were no obvious adverse reactions;there were no significant difference in the patients age and gender (P> 0.05). All varus deformity were corrected; There were no angle loss and no nonunion of osteotomy sites, and so on. The treatment group and control group including VAS score. KSS knee function score. SF-36 scale were obviously improved compared with preoperative, the difference was statistically significant (P< 0.05). Comparison between two groups. VAS scores for 3 months and 6 months after treatment, the two groups were of statistical significance (P value were 0.001 and 0.024). showed it can reduce the knee pain of bone cutting better. Two groups of KSS score in different time of preoperative and postoperative had significant difference (P< 0.01). KSS score also has significant differences between groups (P< 0.01):It remains beneficial to the improvement of knee function after surgery for KOA cut bone. Treatment group and control group in SF-36 life quality scale score, according to the results of limited physical function, body pain, emotional rolelin limited and overall health treatment group compared with control group, the four dimensions after treatment for 3 months there was statistical difference (P value were 0.001、0.005、 0.031.,0.010), and 6 months after treatment had no statistical difference which suggested that can quickly improve the quality of life of patients with KOA osteotomy. In the aspect of determination of serum biological markers, the treatment group in different time of preoperative and postoperative, serum COMP and TNF alpha levels are lower than before treatment (P< 0.05). compared with the control group after treatment were statistically difference of each index (P< 0.05):The control group before and after treatment. TNF alpha concentration was significant difference (P< 0.05). It suggested that it better reduce the COMP and TNF alpha level.Conclusion:In ues ZGTB after the Minimally invasive high tibia osteotomy with external fixation in the treatment of LKD-KOA with genu varus.which can effectively improve the symptoms of joint pain, promote the joint function rehabilitation.ZGTB pills can inhibit the joint synovial inflammation, improving joint pain and swelling, its mechanism may be related to the above reason, which can effectively reduce the COMP and TNF alpha level in serum.