Abstract
Knee osteoarthritis (KOA) has become one of the leading causes of workforce loss in the middle-aged and elderly population and a global public health problem second only to cardiovascular disease, so we need to find more effective treatments for this disease. In this study, we selected 120 patients with KOA admitted to our hospital from June 2018 to December 2020 and divided them into treatment group 1, treatment group 2, and joint group according to the random number table method, with 40 patients in each group. Treatment group 1 was treated with Tongluozhitong prescription dip-soaking therapy, treatment 2 group was treated with intra-articular injection of sodium hyaluronate, and the joint group was treated with a combination of both modalities for 4 weeks in all three groups. Clinical efficacy, visual analogue scale (VAS), Lysholm knee score (LKS), activity of daily living score (ADL), the levels of bone metabolic markers such as cartilage oligomeric matrix protein (COMP), type II collagen degradation maker (CTX-II), and matrix metalloproteinase-3 (MMP-3), and the levels of inflammatory mediators such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and hypersensitive C-reactive protein (hs-CRP) were used as observations to compare and analyze the therapeutic effects of the three treatment regimens in KOA patients. The results showed that the clinical excellence rates of the joint group, treatment group 1, and treatment group 2 were 72.50%, 50.00%, and 90.00%, respectively, with statistically significant differences between any two comparisons. After treatment, VAS scores, serum COMP, CTX-II, MMP-3, IL-1β, TNF-α, and hs-CRP levels decreased in all three groups, and the levels of each index were as follows: joint group < treatment group 1 < treatment group 2, and the difference between any two comparisons was statistically significant. The LKS score and ADL score increased in all three groups, and the levels of each index were as follows: joint group > treatment group 1 > treatment group 2, with statistically significant differences in any two groups compared. None of the patients in the three groups experienced any significant adverse effects during treatment. This suggests that the dip-soaking therapy of Tongluozhitong prescription is more advantageous than intra-articular sodium hyaluronate injection treatment in suppressing the level of serum bone metabolic markers and inflammatory mediators, reducing pathological joint damage, relieving symptoms of pain, alleviating degenerative joint symptoms, and improving knee function in KOA patients. The combination of the two in KOA patients can significantly improve the efficacy and has a good safety profile.
Highlights
(1) Treatment group 1 was treated by dip-soaking with Tongluozhitong prescription, and the specific operations were as follows: 30 g of frankincense, 30 g of myrrh, 30 g of garden balsam stem, 30 g of Zanthoxylum bungeanum Maxim., 30 g of radix puerariae, and so forth were put into a cloth bag of about 15 × 20 cm sewn with a towel and soaked in a thermostat for 1 hour and heat to about 40°C and taken out and wet-applied to the knee joint, and the treatment was administered for 30 minutes
We conducted a statistical analysis of the excellent rates of treatment in the three groups. e results showed that the excellent efficacy rate of the three groups was as follows: joint group > treatment group 1 > treatment group 2, and the difference between any two groups was statistically significant (P < 0.05) (Figure 1)
Comparison of visual analogue scale (VAS), Lysholm knee score (LKS), and activity of daily living score (ADL) Scores before and after Treatment. ere was no significant difference in the scores of VAS, LKS, and ADL in the three groups before treatment (P > 0.05). e VAS scores decreased and Lysholm scores and ADL scores increased in all three groups after treatment (P < 0.05)
Summary
Knee osteoarthritis (KOA) is a chronic joint disease characterized by deformation and destruction of articular cartilage and osteophytes, which can cause joint pain and dysfunction and seriously affect the quality of life of patients, and is one of the chronic diseases commonly seen in middleaged and elderly people [1]. e incidence of KOA is increasing year by year with the aging trend of our population, which brings about a great economic burden to the patients. Chinese medicine dip-soaking therapy is a kind of wet compression method, which is a method to grind the drug and put it in a bag and soak it in the liquid, warm it, and take it out and apply it wet on the affected area and maintain the temperature by heating it with electromagnetic wave therapeutic apparatus. It has the advantages of exact efficacy, simplicity, and ease of use, as well as few side effects, and is widely used in clinical practice [8]. We selected the dip-soaking therapy of Tongluozhitong prescription, intra-articular injection of sodium hyaluronate, and the combined application of the two treatments and conducted a comparative analysis of the efficacy of different treatment methods to clarify the effect of combined treatment on the clinical efficacy of KOA patients and provide some reference for the selection of more appropriate treatment methods for KOA patients
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