| Objective: 1.To evaluate the clinical efficacy of Gubi Mixture combined with basic anti-osteoporosis drugs in the treatment of knee osteoarthritis;2.To explore the significance of changes of subchondral bone marrow edema in the treatment of knee osteoarthritis.Methods: 1.Patients with knee osteoarthritis who met the inclusion criteria were screened out by fracture risk prediction tool(FRAX).According to the principle of randomized grouping and concurrent controlled trial,30 patients were divided into treatment group and control group in a ratio of 1:1.The total number of cases was60.The treatment group was treated with Gubi mixture twice a day,100ml/time,Calcium 600D(600mg*30 tablets),once a day,one tablet/time,calcitriol capsules(0.25mg*10 tablets*10),twice a day,one tablet/time intervention;the control group was treated with Gubi mixture twice a day,100ml/time.The treatment lasted for 4weeks.After 4 weeks,the symptoms of knee osteoarthritis patients in the treatment group and the control group were evaluated by the scale of symptoms classification quantification and the score of the knee joint WOMAC scale,in order to determine the effect of Gubi mixture combined with basic anti-osteoporosis drugs on the treatment,prevention and delay of knee osteoarthritis patients' degeneration.2.Thirty patients in the treatment group were divided into group A with 12 cases of bone marrow edema-like change and group B without 18 cases of bone marrow edema-like change according to the observation of knee joint magnetic resonance imaging.Thirty patients in the control group were equally divided into group C with11 cases of bone marrow edema-like change and group D without bone marrow edema-like change.The treatment method remained unchanged.After 4 weeks of treatment,the patients were evaluated for observation.Significance of subchondral bone marrow edema in the treatment of knee osteoarthritis.RESULTS: Total effective rate: After 4 weeks of intervention,there were 30 cases in the treatment group,the total effective rate was 97.0%.Among them,1 case was ineffective,24 cases were effective,5 cases were markedly effective and 0 cases were clinically controlled.In the control group,the total effective rate was 93.0%.Among them,2 cases were ineffective,25 cases were effective,3 cases were markedly effective and 0 cases were clinically controlled.There was no significant difference in the curative effect between the treatment group and the control group(P > 0.05).Chemo-tabular comparison: Compared with before treatment,the total score of symptoms in the two groups improved after treatment(P < 0.01),the treatment group was better than the control group(P < 0.01);the single score of the two groups decreased compared with before treatment(P < 0.01),indicating that both the treatment group and the control group can effectively improve the pain,symptoms,signs and functions of knee joint.Compared with the control group(P < 0.05),the treatment group had significant differences in pain during night bed rest,walking,standing from seat and walking on uneven road(P < 0.05).The treatment group was better than the control group.There were no significant differences in morning stiffness or waking pain,maximum walking distance,daily activities,stairs,squatting or knee bending(P > 0.05).(3)WOMAC score of knee joint:The total score of WOMAC of knee joint after treatment in both groups was improved compared with that before treatment(P < 0.01);the score of single part in both groups was lower than that before treatment(P < 0.01),indicating that the treatment group and the control group could effectively improve the degree of pain,stiffness and daily life difficulty of knee joint.Among them,compared with the control group,the pain degree and daily life difficulty score of the treatment group had statistical significance(P < 0.05).According to the comparison of the two groups,the treatment group was superior to the treatment group in improving knee pain and daily life difficulty,and could better improving knee pain and daily life difficulty,and could better improve the quality of life of patients.There was no statistical significance in stiffness score of the two groups(P > 0.05).?(4)After treatment,the scores of symptom scale and WOMAC scale in group A and group B decreased.There was statistical difference between group A and group B.The curative effect of group B was better than that of group A.The scores of symptoms scale and WOMAC scale in group C and group D decreased,but there was no statistical difference between group C and group D.Adverse reactions: A total of 2 patients had adverse reactions,1 case in the treatment group had mild upper abdominal discomfort,and 1 case in the control group had mild gastric discomfort without serious adverse events.CONCLUSION: Gubi Mixture combined with calcium and vitamin D can better improve the pain and joint function of knee osteoarthritis patients,especially those with knee osteoarthritis without subchondral bone marrow edema in the early stage. |
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