Effect Of Chinese Medicine Treatment According To Syndrome Differentiation On The Proteoglycan In Synovial Fluid Of Knee Osteoarthritis: Randomized Control Study

AIM: Level changes of proteoglycan (PG) in the synovial fluid is an indicator of cartilaginous affection by stages. This study was designed to evaluate the effect of Chinese medicine treatment according to syndrome differentiation on the PG in the synovial fluid of knee osteoarthritis.METHODS:â‘ From December 2006 to March 2007, sixty patients with knee osteoarthritis admitted in the Outpatient Department of Orthopaedics, Wangjing Hospital, China Academy of Chinese Medical Sciences, were divided into treatment group (n=32, mean age 47.1 years) and control group (n=28, mean age 48.7 years) by random. The treatment group was consisted by three Chinese disease models, 11 cases with deficiency of liver and kidney and stasis of tendons and vessels (model A), 13 cases with insufficiency of spleen and kidney and dampness infusion into bone and joints (model B), and 8 cases with insufficiency of liver and kidney and obstruction of channels by phlegm (model C).â‘¡The treatment group took Chinese medicine particles orally, one administration per day, totally 3 months; A model was treated with Liuwei Dihuang Tang (consisting of Shudi, Huaishanyao and Fuling, etc); B model was treated with Chushi Tongbi Tang (consisting of Weilingxian, Jixueteng and Yiren, etc); C model was treated with Zuogui Tang (consisting of Shudi, Huaishanyao and Shanyurou, etc). The control group got normal treatment as taking celecoxib and Glucosamine Hydrochloride Capsules.â‘¢Both groups were followed up 3 months. The synovial fluid was taken by the first and the last time to detect the level of PG. The patients also took the index of severity for osteoarthritis of the knee (ISOA) grades system to evaluate the treatment effect.RESULTS: All of 60 patients were involved in the result analysis.â‘ No significant differences were found in the PG level before treatment (P > 0.05), after the treatment, the level in the treatment group went down obviously compared with the control group (P < 0.05).â‘¡By contrasting the PG levels before and after the treatment, there was a significant difference in the treatment group (P < 0.05), while no difference among the three Chinese disease models (P > 0.05).â‘¢The ISOA grades system showed both of the two treatment methods could significantly release patients' clinical syndrome (P < 0.05), and the effect of treatment group was much better than the control group (P < 0.05).CONCLUSION: Chinese medicine treatment according to syndrome differentiation is an efficient therapy to the knee osteoarthritis, and its effect is superior to that of non-steroidal anti-inflammatory drug and amino monosaccharides drug treatment. The PG level in the synovial fluid can be a sensitive and objective clinical guidepost.