| Objective: To investigate the cooperative effect and find a more effective trearment for the disease by observing the clinical effect of Duhuo Jisheng Decoction combined with Platelet Rich Plasma(PRP)on knee osteoarthritis(KOA)of liver and kindney deficiency.Methods: The 81 KOA patients from September 2018 to August 2019 in the hospital of integrated traditional Chinese and Western Medicine Affiliated to Jiangxi University of traditional Chinese Medicine were secelected for a prospective study.They were divided randomly into 3 groups and there were 27 patients in each group.All the patients in 3 groups were treated by general method such as health education and functional exercise.The patients in the A group were treated by drinking Duhuo Jisheng Decoction.PRP was injected into knee of patients in the B group.The patients in the C group were treated by drinking duhuo jisheng decoction and injecting PRP into knee.They were all abided by treatment in the research strictly and were followed up regularly.The VAS score,the WOMAC score,the volume of the TNF-αand the IL-1,are measured and compared between the 3groups Before treatment,at the end of treatment,3 months and 6 months follow-up.The clinical effect and excellence rate are measured and compared between the 3groups at the end of treatment.And evaluate the safety of the treatment.Results:(1)Ultimately only 75 patients were included in the research,because 2patients were weeded.There were no significant difference between the three groups in general condition(gender,knee side of disease,K-L grade,BMI index,course of disease,age),the VAS score,the WOMAC score,the volume of serum TNF-α and IL-1 before the treatment(P>0.05).(2)The VAS score,the WOMAC score,the volume of the TNF-α and IL-1with factors of time and group all had significant interaction effect(P < 0.05),and there was significant time effect at different times(P < 0.05).The results showed that the changes of VAS score,WOMAC score,the volume of the TNF-α and IL-1 were different in the three groups before and after treatment.With the time going on,these values would gradually decrease.(3)The comparison between the three groups,the VAS score,the WOMAC score,the volume of the serum TNF-α and the IL-1 levels at the end of the treatment course,3 months and 6 months follow-up were statistically significant than the values before the treatment(P<0.05).(4)At the end of the treatment course,3 months and 6 months follow-up,the comparison between the C group and the A group: the VAS score,the WOMAC score,the volume of the serum TNF-α and IL-1 in the C group have significantly lower than the values in the A group(P<0.05).(5)The comparison between the C group and the B group: the WOMAC score and the volume of the serum TNF-α in the C group is significantly lower than the values in the B group at the end of the treatment,but there were no significant differences in VAS score and the volume of the serum TNF-α(P>0.05).The VAS score,the WOMAC score,the serum TNF-α and IL-1 were significantly lower than the values in the B group at the 3 and the 6 months of follow-up(P<0.05).(6)The comparison between the B group and the A group: at the end of the treatment,the VAS score and the WOMAC score in the B group are significantly lower than the values in the A group(P<0.05),But there were no significant differences in the volume of TNF-α and IL-1(P>0.05).the WOMAC score,thevolume of TNF-αand IL-1 except VAS score were significantly better than the values in the A group at 3 and 6 months of follow-up(P<0.05).(7)The comparison of the distribution of clinical effect: the distribution of clinical effect in the C group was significantly better than that in the A group and B group(P<0.05).There were no significant differences between the A group and B group(P>0.05).(8)The comparison of excellence rate: the excellence rate in the A group,B group and C group was 20%,28% and 56% respectively.The excellence rate in the C group was significantly higher than that in the the A group and B group(P<0.05).There were no significant differences between the A group and B group(P>0.05).(9)None of the three groups had serious adverse reactions.Conclusions: The three therapies can relieve pain,improve function,and reduce the levels of serum IL-1 and TNF-α.Duhuo Jisheng Decoction combined with PRP is better than Duhuo Jisheng Decoction or PRP for KOA of Liver and Kindney Deficiency.They have cooperative effect,relieves knee pain,improves knee function,enhances clinical effect and decreases the level of the serum IL-1 and TNF-αbetter.The safety is high,which is worthy of reference for clinicians. |
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