To study the effects of homemade Duhuo-jisheng decoction combined with extracorporeal shock wave (ESW) on the recovery of joint function and serum glucose phosphate isomerase (GPI), transforming growth factor(TGF)-β in patients with rheumatoid and dampness arthritis of knee.

Inclusion criteria: meeting the diagnostic criteria for wind-cold-dampness Bi type arthralgia; no other treatment within three months; no drug contraindications; tolerance to shock waves; unilateral knee disease; good compliance, able to be followed up; be informed and voluntarily agree the participation. Exclusion criteria: meniscus and neurovascular damage caused by trauma; the patients with major systemic diseases; pregnant or breastfeeding pateints; knee joint tumors; bony ankylosis. A total of 159 patients with wind-cold-dampness Bi type knee osteoarthritis who were treated in Beijing Rehabilitation Hospital Affiliated to Capital Medical University from June 2019 to June 2020 were randomly divided into three groups by lots drawing: the control group (accepting celecoxib), the ESW treatment group (accepting celecoxib+ ESW) and the traditional Chinese medicine (TCM) combination group (accepting self prepared Duhuojisheng decoction+ ESW), 53 patients in each group. All three groups were treated continuously for four weeks. The symptom score of TCM, Lysholm function score, visual analogue scale(VAS) score, serum GPI and TGF-β before and after treatment were recorded. The data of the three groups were recorded and analyzed by t test, chi square test and single factor analysis of variance to compare the clinical efficacy.

The scores of the TCM combination group were the lowest in fatigue, joint stiffness, lumbago and back pain (F=108.1, 22.73, 32.30, 45.02, 45.92, all P<0.05) , the differences were statistically significant comparing with the control group and ESW group (both P<0.05); the difference between the control group and ESW group was not statistically significant (both P >0.05). After the treatment the Lysholm functional score increased in the three groups comparing to the data before treatment(t=2.48, 2.41, 3.43, all P<0.05), and the difference among the groups was statistically significant (F=27.15, P<0.001); compared with the ESW group and the control group, the Lysholm score of TCM combined group was better (both P<0.05). The VAS scores of the three groups were significantly lower than those before the treatment(t=4.98, 5.11, 7.91, all P<0.05), and the difference among the three groups was statistically significant (F=19.92, P<0.001). Compared with the ESW group and the control group, the VAS score of TCM combined group was less(both P<0.05). The excellent rates of the control group and ESW group were 64.2% and 62.3% respectively, with no statistically significant difference (χ²=0.04, P>0.05). The excellent rate of the patients in the TCM combination group was 84.9%, which was higher than that of the control group and the ESW group (χ²=6.01, 6.99, both P<0.05). After the treatment, GPI level of the TCM combined group was lower than that before the treatment(t=3.14, P=0.003); GPI level of the TCM combined group was lower than the ESW group and the control group (both P<0.05). After the treatment, TGF- β level increased in the TCM combined group compared with that before the treatment (t=2.03, P=0.047) ; TGF- β of the TCM combined group was higher than the ESW group and the control group (both P<0.05).

The combination of self-designed single active parasitic decoction and ESW may promote the recovery of remission function, reduce serum GPI level and improve TGF-β level. The efficacy of combination with celecoxib or celecoxib with ESW is better.