Preventive Treatment With The Integrated Traditional Chinese And Western Medicine On The Latent Knee Osteoarthritis With Syndrome Of Deficiency Of Kidney

OBJECTIVE:1.Investigate the traditional Chinese medicine syndrome Types of knee osteoarthropathy and the relationship with TCM constitution2. Preliminary a new diagnosis index and testing approaches with COMP and CTX-Ⅱ of the latent disease of OA. To establish a meaningful biological marker and reference data of latent disease of OA.3. Investigate the characteristics constitution of OA of kidney qi deficiency syndrome,to provide reference for the dialectical of constitution.4. Observation clinical effects of Preventive Treatment of OA of kidney qi deficiency syndrome.METHODS:1.According to the ways of clinical epidemiology, the female586patients who were diagnosed to be osteoarthriitis were studied prospectively between50to74years old from three hospital in Beijing. Collect the four diagnostic information,analysis for the Clustering analysis by SPSS11.5software.Investigate the the nine constitution in traditional Chinese medicine information of586patients with the nine constitution in traditional Chinese medicine information scale writed by WangQi.2.Select five groups,the group of kidney qi deficiency of the latent OA of aged45-60years old;the group of kidney qi deficiency of OA of aged45-60years old; the group of rheumatoid arthritis aged45-60years old;the group of healthy people of aged35-50years old;the group of sub-healthy adults of aged35-50years old. Take fasting plasma10ml and urine samples. Measure the contents of COMP and CTXI-II by ELISA.3.the four group, kidney qi deficiency of the latent OA of aged45-60years old;the group of kidney qi deficiency of OA of aged45-60years old;the group of healthy people of aged35-50years old;the group of sub-healthy adults of aged35-50years old,were to fill in the information of nine TCM constitution, analysis the characteristics. preliminary understanding of characteristics of kidney qi deficiency of the latent OA.4.Select the group of kidney qi deficiency of the latent OA of aged45-60years old as research subjects, block randomized into two groups, one group taking Jin-Gui Shen Qi Wan plus glucosamine hydrochloride capsules, another group taking glucosamine hydrochloride capsules and Jin-Gui Shen Qi Wan placebo, two course of treatment. Compared between two groups of clinical efficacy. Two groups at the same time fill in the information of nine TCM constitution to observe the changes of the constitution of the two groups before and after medication.Results:1.(1) diagnostic information by clustering analysis that can be divided into3patterns, that was the type of wind cold damp impediment (141cases),the type of kidney deficiency (386cases) and the type of phlegm-blood stasis blocking (59cases)(2) in the nine types of traditional Chinese Medicine constitution information,59peoples had normal constitution (10.1%),527peoples had abnormal constitution (89.9%).The common abnormal constitutions were Qi-deficiency constitution (26.8%), Yang-deficiency constitution (27.3%). Yin-deficiency constitution (13.7%).(3) the type of wind cold damp impediment were significant correlation with Qi-deficiency constitution, Yang-deficiency constitution and the normal constitution, the type of kidney deficiency were significant correlation with Qi-deficiency constitution, yin-deficiency constitution and the normal constitution, the type of phlegm-blood stasis blocking were significant correlation with Qi-deficiency constitution, Yang-deficiency constitution, phlegm-dampness constitution and blood stasis constitution.2.(1)Sort by the contents of CTX-Ⅱ, The order is the group of kidney qi deficiency of OA of aged45-60years old, the group of rheumatoid arthritis aged45-60years old, the group of kidney qi deficiency of the latent OA of aged45-60years old, the group of sub-healthy adults and the group of healthy peoples. Comparison the contents of CTX-Ⅱ between the group of kidney qi deficiency of the latent OA of aged45-60years old and the group of healthy peoples, P<0.05. Comparison the contents of CTX-Ⅱ between the group of kidney qi deficiency of the latent OA of aged45-60years old and the group of sub-healthy adults, P<0.05. Comparison the contents of CTX-Ⅱ between the group of kidney qi deficiency of O A of aged45-60years old and the group of healthy peoples, P<0.05. Comparison the contents of CTX-Ⅱ between the group of kidney qi deficiency of OA of aged45-60years old and the group of kidney qi deficiency of the latent OA of aged45-60years old, P>0.05. Comparison the contents of CTX-Ⅱ between the group of kidney qi deficiency of the latent OA of aged45-60years old and the group of rheumatoid arthritis aged45-60years old, P<0.05.(2) Sort by the contents of COMP, The order is the group of kidney qi deficiency of OA of aged45-60years old, the group of rheumatoid arthritis aged45-60years old, the group of kidney qi deficiency of the latent OA of aged45-60years old, the group of sub-healthy adults and the group of healthy peoples. Comparison the contents of COMP between the group of kidney qi deficiency of the latent OA of aged45-60years old and the group of healthy peoples, P<0.01. Comparison the contents of COMP between the group of kidney qi deficiency of the latent OA of aged45-60years old and the group of sub-healthy adults, P<0.01. Comparison the contents of COMP between the group of kidney qi deficiency of OA of aged45-60years old and the group of healthy peoples, P<0.01. Comparison the contents of COMP between the group of kidney qi deficiency of OA of aged45-60years old and the group of kidney qi deficiency of the latent OA of aged45-60years old, P<0.05. Comparison the contents of COMP between the group of kidney qi deficiency of the latent OA of aged45-60years old and the group of rheumatoid arthritis aged45-60years old, P>0.05.3. the group of healthy peoples have three types of abnormal constitution, the group of sub-healthy adults have seven types of abnormal constitution, the group of kidney qi deficiency of the latent OA of aged45-60years old and the group of kidney qi deficiency of OA of aged45-60years old have eight types of abnormal constitution.Yang-deficiency constitution was common in the group of kidney qi deficiency of the latent OA;Qi-deficiency constitution was common in the group of kidney qi deficiency of OA.4.(1)The Integral of joint tenderness, morning stiffness, joints swelling,and the WOMAC was decreased after treatment than before. In the experimental group,The decreasing degree of Integral of joint tenderness, morning stiffness times, morning stiffness, joints swelling and range of motion was higher than those in the control group.(2) The decreasing degree of Integral of TCM syndrome of the experimental group was higher than those in the control group. In the experimental group, four symptoms has a very significant improvement (P<0.01),they are knee pain, lower back pain, soreness-tired of waist and knee, shortness of breath;one symptom significantly improved (P<0.05), it was the symptoms of a cold joints, in the control group, two symptoms has a very significant improvement (P<0.01),they are knee pain, lower back pain;three symptom significantly improved (P<0.05), they was the symptoms of a cold joints soreness-tired of waist and knee, shortness of breath.(3)The effective rate of experimental group was74%, control group was59%. The the experimental group higher than the control group.(4) The of the experimental group the symptoms of joint tenderness, knee pain, the WOMAC for the constitution changed improved more than the constitution unchanged.Conclusion:1.The traditional Chinese medicine syndrome Types of knee osteoarthropathy female patients between50years old-74years old was divided into3types in conformity with clinical practice. The common abnormal constitutions were Qi-deficiency constitution and Yang-deficiency constitution. Most constitution were abnormal constitution.The relationship between constitution and the traditional Chinese medicine syndrome Types was that the type of wind cold damp impediment were significant correlation with Qi-deficiency constitution,Yang-deficiency constitution and the normal constitution, the type of kidney deficiency were significant correlation with Qi-deficiency constitution, yin-deficiency constitution and the normal constitution. the type of phlegm-blood stasis blocking were significant correlation with Qi-deficiency constitution,Yang-deficiency constitution, phlegm-dampness constitution and blood stasis constitution.2.The serum COMP content and the content of the urine of CTX-Ⅱ in early OA began to rise,they can be used as an indicator of the prevalence of detection of OA. With the continuous development of OA, the content continues to rise. Serum content of COMP can be used as a secondary indicator to distinguish between early OA and rheumatoid arthritis.3. As the occurrence of OA, type of constitution were more and more complex. Yang-deficiency constitution was common in the group of kidney qi deficiency of the latent OA. treatment maystart with Yang-deficiency constitution.4.The combination of Chinese and Western medicine can significantly relieve joint tenderness, reduce duration of morning stiffness, reduce joint swelling, improve joint range of motion, improve kidney qi deficiency of TCM, better than the simple use of Western medicine. After drug treatment, physical change, to further improve the symptoms of OA. Prove physical adjustment to changed the inclination of the disease.