The clinical study of Tongbi capsule combined with acupuncture in the treatment of knee osteoarthritis / 国际中医中药杂志

ABSTRACT

Objective To explore the clinical effect of Tongbi capsule combined with acupuncture for the patients with knee osteoarthritis and explore the mechanism of inflammatory response and hemorrheology. Methods According to the random table method, 88 KOA patients in our hospital from February 2016 to January 2017 were divided into the control group and the research group with 44 in each group. Patients in the control group were treated bycelecoxib capsule, while the patients in the research group were treated by Tongbi capsule combined with acupuncture. The treatment courses of two groups were two months. The clinical total effective rate of two groups of patients were compared after treatment. At the same time, the osteoarthritis index visual scale (WOMAC) and morning stiffness, joint tenderness index score were detected and compared after the treatment.The levels of serum tumor necrosis factor-α(TNF-α), interleukin (IL)-1β and IL-6 were detected by enzyme linked immunosorbent assay before and after the treatment. The hemorheology indexes were tested by automatic biochemical analyzer. In addition, the incidence of adverse reactions of two groups of patients was observed during treatment. Results The clinical total effective rate of the research group was 93.18％ (41/44), which was significantly higher than the control group72.73％ (32/44), and the difference was statistically significant (χ2=6.510, P=0.011). After treatment, the WOMAC (31.26 ± 6.12 vs. 36.17 ± 7.09, t=-3.477), joint tenderness index (1.75 ± 0.46 vs. 2.11 ± 0.54, t=-3.366) and morning stiffness score (1.62 ± 0.53 vs. 2.14 ± 0.51, t=-4.690) of the research group were significantly lower than those of the control group (P<0.05). The levels of TNF-α (7.36 ± 1.45 pg/ml vs. 8.02 ± 1.54 pg/ml, t=-2.070), IL-1β (27.82 ± 5.22 μg/ml vs. 33.05 ± 5.17 μg/ml, t=-4.722), IL-6 (2.81 ± 0.58 ng/ml vs. 3.34 ± 0.53 ng/ml, t=-4.475) of the research group were significantly lower than those of the control group (P<0.05). The whole blood high shear viscosity (12.09 ± 3.46 mPa?s vs. 14.22 ± 3.51 mPa?s, t=-2.867), whole blood low shear viscosity (2.53 ± 0.68 mPa?s vs. 3.32 ± 0.71 mPa?s, t=-5.330), whole blood viscosity (1.35 ± 0.29 mPa?s vs. 1.60 ± 0.41 mPa?s, t=-3.302), erythrocyte sedimentation rate (7.10 ± 2.06 mm/h vs. 8.02 ± 2.13 mm/h, t=-2.059), fibrinogen (2.71 ± 0.53 g/L vs. 3.42 ± 0.65 g/L, t=-5.615) and erythrocyte deformation index (0.57 ± 0.16 vs. 0.71 ± 0.19, t=-3.739) of the research group were significantly lower than those of the control group (P<0.05). The incidence of adverse reactions of control group was 11.37％ (5/44), while the incidence of adverse reactions of resarch group was 6.82％ (3/44), which the difference of the incidence of adverse reactions between two groups showed no statistical significance (χ2=0.550, P=0.458). Conclusions The Tongbi capsule combined with acupuncture can reduce the degree of inflammation, and also improve hemorheology indexes of KOA patients.