Clinical Study On Treatment Of Hip Arthralgia Based On Differentiation Of Symptoms And Signs Combined With Chinese Medicine External Washing

Objective:To observe the clinical effects and safety of treatment of hip arthralgia based on differentiation of symptoms and signs combined with Chinese medicine external washing.Methods:One hundred and twenty-seven patients with hip arthralgia were randomly divided into experimental group and control group,65 cases in experimental group(according to the results of syndrome differentiation:15cases in qi stagnation and blood stasis type,24 cases in deficiency of liver and kidney type and 26 cases in phlegm dampness and blood-accumulation stasis type),62 cases in control group.The experimental group were treated by oral administration of Chinese medicine(qushang decoction,bushenzhuangjin decoction,shuanghe decoction)combined with Chinese medicine external washing.The control group was treated with oral celecoxib capsule and Chinese medicine external washing.They were both treated for 4 weeks.After 2 courses of treatment,the clinical curative effect and the recurrence of the disease in the 3 months,6 months after treatment were recorded in all groups.The Harris hip scores and pain were evaluated by using Harris hip scoring standard and FPS-R scoring standard at before treatment,3 and 6 months after treatment.The adverse reactions and liver and kidney functions of each group were observed at the treatment and follow-up period.Results:There was statistical difference in Harris hip scores between different post-treatment timepoints,in other words,there was time effect(F=63.160,P=0.000).There was no statistical difference in Harris hip scores between the 4 groups at 1 and 3 months after treatment(85.22+/-4.14 vs 82.92+/-4.20 vs 83.29+/-3.61 vs 83.50+/-3.07points,F=1.415,P=0.242;82.09+/-2.72 vs 83.11+/-2.33 vs 82.77+/-2.86 vs 82.04+/-2.72 points,F=1.178,P=0.321).The Harris hip scores were lower in control group compared to other three groups at 6 months after treatment(86.18+/-3.56 vs 85.58+/-4.10 vs 84.99+/-2.80,F=64.364,P=0.000.Using the least squares method(LSD method)comparison:qi stagnation and blood stasis type and deficiency of liver and kidney type P=0.587,qi stagnation and blood stasis type and phlegm dampness and blood-accumulation stasis type P=0.275,deficiency of liver and kidney type and phlegm dampness and blood-accumulation stasis type P=0.534,there was no statistical difference.The control group compared to other three groups P=0.000,there was statistical difference).The Harris hip scores were lower in control group compared to other three groups in general,in other words,there was group effect(F=23.174,P=0.000).There was interaction between time factor and group factor(F=14.651,P=0.000).There was statistical difference in FPS-R scores between different post-treatment timepoints,in other words,there was time effect(F=153.490,P=0.000).There was no statistical difference in FPS-R scores between the 4 groups at 1 and 3 months after treatment(1.39+/-0.35 vs 1.35+/-0.12 vs 1.37+/-0.10 vs 1.35+/-0.11,F=0.265,P=0.851;1.38+/-0.11 vs 1.37+/-0.12 vs 1.38+/-0.28 vs 1.36+/-0.11,F=0.104,P=0.958).The FPS-R scores were higher in control group compared to other three groups at 6 months after treatment(1.28+/-0.09 vs 1.26+/-0.11 vs 1.28+/-0.16 vs1.53+/-0.15,F=38.412,P=0.000.Using the least squares method(LSD method)comparison:qi stagnation and blood stasis type and deficiency of liver and kidney type P=0.655,qi stagnation and blood stasis type and phlegm dampness and blood-accumulation stasis type P=0.986,deficiency of liver and kidney type and phlegm dampness and blood-accumulation stasis type P=0.617,there was no statistical difference.The control group compared to other three groups P=0.000,there was statistical difference).The FPS-R scores were higher in control group compared to other three groups in general,in other words,there was group effect(F=4.809,P=0.003).There was interaction between time factor and group factor(F=3.022,P=0.016).At the end of the 2 course of treatment,there was no significant difference between the groups(Z=0.268,P=0.966).After 3 months of treatment,there was no significant difference in recurrence rate(?~2=0.428,P=0.934).After 6 months,the recurrence rate of the control group was higher than the other three groups,the difference between the 4 groups was statistically significant(?~2=8.859,P=0.031).Conclusion:Treatment of hip arthralgia based on differentiation of symptoms and signs combined with Chinese medicine external washing can effectively relieve hip symptoms,improve the hip function and reduce the pain.In the long term,it can reduce the recurrence rate of the disease,meanwhile it has high safety.