ABSTRACT
Objective:To observe the controlling effect of addition and subtraction therapy of Xuanbi tang on knee osteoarthritis of rheumatic fever arthralgia type (KOA) at attack stage and to investigate the influence to acute inflammation factors. Method:One hundred and twenty-eight patients were randomly divided into control group and observation group (1∶1) by random number table with SAS software. The patients in both groups got celecoxib capsules, 0.2 g/time, 1 time/day, glucosamine hydrochloride capsule, 1 grain/time, 2 times/day. Patients in control group addiiontally got Simiaowan, 6 g/time, 2 times/day. Patients in observation group got addition and subtraction therapy of Xuanbitang, 1 dose/day, with a treatment course of 2 weeks in both groups. Visual analogue scale of pain (VAS) was used to discuss pain degree of knee joint, and the VAS scores during activity and resting state were recorded every day, and the time to pain relief and time to pain disappearance were also recorded. Before and after treatment, the scores of osteoarthritis index visual scale of Western Ontario and McMaster University (WOMAC), scores of swelling degree and scores of rheumatism heat arthralgia syndrome were graded. The levels of high sensitive C-reactive protein (hs CRP), interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and serum matrix metalloproteinase-3 (MMP-3) were detected before and after treatment. In addition, safety was evaluated and discussed. Result:The comprehensive total effective rate in observation group was 95.00% (57/60), higher than 83.05% (49/59) in control group (P<0.05). At the third, seventh, tenth, fourteenth day after treatment, scores of knee joint pain degree in observation group were lower than those in control group (P<0.01). Time to pain relief and time to pain disappearance were shorter than those in control group (P<0.01). Scores of WOMAC, swelling degree and rheumatism heat arthralgia syndrome were all lower than those in control group (P<0.01). Levels of hs-CRP, IL-1β, IL-6, TNF-α and MMP-3 were lower than those in control group (P<0.01). In addition, there was no adverse reaction related to Xuanbitang. Conclusion:Addition and subtraction therapy of Xuanbitang can relieve pain, swelling and other symptoms, improve knee joint function, shorten the course of disease, and control the acute inflammatory reaction, with significant clinical efficacy and safety.