| Objective1.Through evaluation of the efficacy of Zhuang gu tong bi pill in the treatment of liver and kidney deficiency type of knee osteoarthritis,provide the basis for its clinical application.2.To explore the mechanism of action of Zhuang gu tong bi pill in protecting the knee by observing its effect on the expression of leptin and adiponectin.MethodsA total of 60 patients with knee osteoarthritis who met the criteria of study were selected from September 2016 to September 2017 in the department of Quanzhou Orthopedic Hospital of Fujian University of traditional Chinese medicine.60 patients who met the inclusion criteria were divided into control group(conventional medical treatment group)and experimental group(Zhuang gu tong bi pill group)by single and double numbers in the order of adimission,with 30 patients in each group.The control group was treated with direct oral Glucosamine Hydrochloride and Celecoxib capsules.The experimental group was given Zhuang gu tong bi pill in addition to the control group.The total duration of treatment in both groups were 8 weeks and all the patients were guided for the quadriceps muscle power training.The VAS and WOMAC scale of two groups were compared before starting the treatment,at 1 week,4 weeks and 8 weeks after the treatment.The clinical effect of traditional Chinese medicine was evaluated before the treatment and at 8 weeks after the treatment.The concentrations of leptin and adiponectin in the two groups were compared before and at 8 weeks after the treatment.Gastrointestinal adverse events in two groups were recorded and treated timely.The efficacy of Zhuang gu tong bi pill for liver and kidney deficiency type of knee osteoarthritis was evaluated retrospectively through statistical analysis of the clinical data,whereas the effect of Zhuang gu tong bi pill on the expression of serum leptin and adiponectin was evaluated through retrospective statistical analysis of the experimental data.Results1.About the VAS Scale:There were significant differences in VAS Scale in both groups before and 1 week after treatment,1 week and 4 weeks after treatment,4 weeks and 8 weeks after treatment within the group(P<0.05).There was a significant difference in the interaction of group and time(p<0.05).In addition,there was no significant difference in VAS Scale between both groups before the treatment(P>0.05).While there were significant differences in VAS Scale before and after the treatment from the same point in time in both groups(P<0.05).2.About the WOMAC Scale:There were significant differences in WOMAC Scale between before and after 1 week treatment,1 week and 4 weeks after treatment,4 weeks and 8 weeks after treatment in both groups(P<0.05).There was a significant difference in the interaction of group and time(P<0.05).There was no significant difference in WOMAC Scale between both groups before the treatment or before and after treatment from the same point in time between both groups(P>0.05),but the WOMAC Scale of both groups were lower than before treatment,and the changes in the experimental group were more obvious.3.About the effect of TCM treatment:The total effective rate in experimental group was 92.59%,the control group had a total effective rate of 77.78%,and there was a significant difference between both studied groups(P<0.05).4.The concentration of serum leptin and adiponectin:There were no significant difference in serum leptin expression before and 8weeks after treatment in both studied groups,and there were no significant difference in adiponectin expression before treatment in both studied groups(P>0.05).While there was a significant difference in adponectin expression at 8 weeks after treatment in both studied groups(P<0.05).There were no significant difference in serum leptin and adiponectin expression before and 8weeks after treatment in control group and the expression of serum leptin before and 8 weeks after treatment in experimental group(P>0.05),while there was a significant difference in the expression of serum adponectin before and 8 weeks after treatment(P<0.05).5.Adverse events:In the process of the treatment,there was one case of gastrointestinal adverse events in the control group and one case of dizziness in experimental group,and the incidence of adverse events in both groups was 3.70%.Conclusion1.The treatment of both goups can reduce the pain and relieve the joint function of KOA patients,and the effect of Zhuang gu tong bi pill in addition to the Conventional medical treatment is more obvious.But there was no significant difference in WOMAC Scale between both groups,it may take longer time to observe.2.Zhuang gu tong bi pill has no obvious effect on leptin concentration,but it effectively reduced the expression of adiponectin,this might be one of the mechanism of action of Zhuang gu tong bi pill in the treatment of knee osteoarthritis. |
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