This study aims to assess the efficacy and safety of Hulisan Capsules in the treatment of knee osteoarthritis, which is expected to serve as a reference for clinical practice. To be specific, randomized controlled trial(RCT) on the treatment of knee osteoarthritis with Hulisan Capsules was retrieved from EMbase, PubMed, Cochrane Library, Web of Science, CNKI, Wanfang, SinoMed, and VIP(from inception to November 15, 2021). Two researchers independently screened the articles, extracted the data, and evaluated the risk of bias with ROB. RevMan 5.4 was used for Meta-analysis. Finally, 12 RCTs were screened out, involving 1 703 cases(1 075 in the experimental group and 628 in the control group). Meta-analysis showed that conventional treatment + Hulisan Capsules was superior to conventional treatment alone in terms of symptom relief rate(RR=1.19, 95%CI[1.09, 1.30], P<0.000 1), Lysholm score(MD=11.17, 95%CI[7.35, 15.00], P<0.000 01), visual analogue scale(VAS) score(MD=-0.99, 95%CI[-1.30,-0.68], P<0.000 01), and knee function score(RR=8.94, 95%CI[6.51, 11.37], P<0.000 01). Hulisan Capsules alone was superior to the conventional treatment alone in terms of the symptom relief rate(RR=1.38, 95%CI[1.13, 1.69], P=0.002) and knee function score(MD=2.88, 95%CI[0.81, 4.94], P=0.006), but VAS score was insignificantly different between the patients treated with Hulisan Capsules alone and those with conventional treatment alone(MD=-0.57, 95%CI[-1.42, 0.29], P=0.19). Hulisan Capsules + conventional treatment showed insignificant difference in symptom relief rate from the Zhuifeng Tougu Capsules + conventional treatment(RR=1.07, 95%CI[0.91, 1.25], P=0.44). The Lequesne score was insignificantly different between Hulisan Capsules + conventional treatment and conventional treatment/Zhuifeng Tougu Capsules + conventional treatment(MD=-2.17, 95%CI[-6.29, 1.96], P=0.30). The incidence of adverse reactions in the experimental group was significantly lower than control group(RR=0.57, 95%CI[0.34, 0.96], P=0.03). According to the available data and methods, Hulisan Capsules/Hulisan Capsules + conventional treatment could improve the symptom relief rate, Lysholm score, knee function score, and VAS score of patients with knee osteoarthritis, and alleviate the symptoms of pain, stiffness, and swelling of them. No serious adverse reactions were found yet. In the future, more large-sample and standard clinical trials are needed to verify the effect and safety of Hulisan Capsules in the treatment of knee osteoarthritis.
Humans ; Osteoarthritis, Knee/drug therapy* ; Capsules ; Pain

OBJECTIVETo evaluate the efficacy and safety of glucosamine hydrochloride for the treatment of osteoarthritis.

METHODSA multi-central, randomized, controlled clinical trial of glucosamine hydrochloride comparing glucosamine sulfate for the treatment of osteoarthritis was performed. One hundred and forty-three patients suffering from knee or hip osteoarthritis were randomized into study (glucosamine hydrochloride) or control (glucosamine sulfate) group. Patients in study group orally took glucosamine hydrochloride 2 times daily for 6 weeks, each time 1 capsule, and those in control group took glucosamine sulfate 3 times daily for 6 weeks also, each time 2 capsules.

RESULTSThe symptomatic improvement of joint pain at walking, at rest and stiffness after 6 week treatment with glucosamine hydrochloride was better than those with glucosamine sulfate. The results had significant difference (P < 0.05). Total effective rates of patients with glucosamine hydrochloride was 75.4% and 60.6% with glucosamine sulfate, but no statistical difference. The results suggested both glucosamine had the considerable efficacy in the treatment of osteoarthritis. Three cases in study group and 2 in control group reported mild adverse events. No severe adverse events (SAE) was observed.

CONCLUSIONGlucosamine hydrochloride is as effective and safe as glucosamine sulfate for the treatment of osteoarthritis.

Double-Blind Method ; Female ; Glucosamine ; therapeutic use ; Humans ; Male ; Osteoarthritis, Hip ; drug therapy ; Osteoarthritis, Knee ; drug therapy ; Treatment Outcome

OBJECTIVETo assess the efficacy of tendons of minimally invasive therapy (TMIT) combined drug therapy by comparing it with treatment by drug therapy alone on patients with knee osteoarthritis (KOA).

METHODSTotally 60 KOA patients were assigned to the treatment group and the control group according to random digit table, 30 in each group. Patients in the control group took Hydrochloric Acid Glucosamine Capsule and Celecoxib Capsule. Patients in the treatment group additionally received TMIT. The treatment course for all was 4 weeks. Scores for visual analogue scale (VAS) and the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index were observed and recorded at week 1 and 4 after treatment by acupotomology mirror.

RESULTSCompared with before treatment, improvement was shown in VAS score, pain and stiffness degrees, activities and functions, and WOMAC scores at week 1 and 4 after treatment in all patients with statistical difference (P < 0.05). Besides, better effect was shown in the treatment group (P < 0.05).

CONCLUSIONSTMIT combined drug therapy could relieve KOA patients' pain, stiffness and joint activities, elevate the overall efficacy. TMIT was easily operated with less injury.

Celecoxib ; Drug Therapy, Combination ; methods ; Humans ; Knee Joint ; Osteoarthritis, Knee ; drug therapy ; Pain ; Pain Measurement ; Tendons ; Treatment Outcome

Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; drug therapy ; Phytotherapy ; Tablets

Osteoarthritis (OA) is a common chronic progressing disease in the elderly. In current there are many methods of drug treatment for knee osteoarthritis, the intra-articular injection belongs to local application, can direct effect on arthritis, is the most used and most effective methods in osteoarthritis treatment. A single medication may exist that anti-inflammatory effects produce a marked effect but articular cartilage injury is induced, or articular cartilage repairing are promoted but anti-inflammatory effects is not ideal. Therefore,the best method of treatment should be a comprehensive analysis of articular structure, function and possible pathogenic factor to understand the expectations of level of recovery and use in patients to design an individualized treatment plan.
Glucocorticoids ; administration & dosage ; Humans ; Injections, Intra-Articular ; Morphinans ; therapeutic use ; Osteoarthritis, Knee ; drug therapy

To evaluate the efficacy and safety of Chinese patent medicine in the treatment of knee osteoarthritis(KOA) with network Meta-analysis, and provide evidence-based medicine evidences for clinical practice. PubMed, Cochrane Library, EMbase, CNKI, Wanfang, VIP and CBM were used to search for clinical randomized controlled trials(RCTs) on Chinese patent medicines for treatment of knee osteoarthritis, with a time limit from the establishment of each database to March 2020. The bias risk assessment tool recommended by Cochrane was used to evaluate the quality of the included RCTs. The network Meta-analysis was performed by Stata 14.0 software. A total of 5 788 patients in 58 RCTs were included, involving 9 kinds of Chinese patent medicines. The results of the network Meta-analysis indicated that in terms of total effective rate, the top three optimal medication regimens were Jinwu Gutong Capsules + Amino Acid Glucose(AAG), Xianling Gubao + AAG and Biqi Capsules; the top three interventions to reduce the VAS score were Panlongqi Tablets > Xianling Gubao + AAG > Xianling Gubao + non steroidal anti-inflammatory drugs(NSAIDs); the top three interventions to reduce the total score of WOMAC were Jintiange Capsules+NSAIDs> Jinwu Gutong Capsules + AAG > Biqi Capsules + NSAIDs; the top three medication schemes with better curative effect to reduce Lequesnse index were Xianling Gubao + NSAIDs > Biqi Capsules + NSAIDs > Jintiange Capsules + NSAIDs; the top three interventions to reduce TNF-α level Xianling Gubao + AAG > Jintiange Capsules > Jintiange Capsules + AAG=Jinwu Gutong Capsules + AAG. In terms of safety, the top five interventions with the least adverse reactions were Biqi Capsules > Jinwu Gutong Capsules > Biqi Capsules + NSAIDs > Xianling Gubao + NSAIDs > Jintiange Capsules. The combined application of Chinese patent medicine and NSADIs or AAG can improve the clinical treatment effect and reduce adverse reactions in KOA patients.
Biological Products ; China ; Drugs, Chinese Herbal ; Humans ; Network Meta-Analysis ; Nonprescription Drugs ; Osteoarthritis, Knee/drug therapy*

Wangbi Tablets are widely used in the treatment of rheumatoid arthritis, knee osteoarthritis and other diseases at pre-sent. Long-term clinical application and research have shown that this drug has a good effect in reducing the pain of related diseases and improving symptoms. Due to the lack of guidance in the instructions and currently no relevant norms to guide the clinical application of Wangbi Tablets, in order to further improve clinicians' understanding of the drug and fully tap the clinical advantages of the drug, the Professional Committee of Orthopedics and Traumatology Drug Research of China Association of Chinese Medicine organized experts in the fields of rheumatism, orthopedics, pharmacy and methodology in Chinese and western medicine to develop expert consensus on Chinese patent medicines in accordance with the relevant requirements of the consensus methodology. Based on full consideration of clinical research evidence and expert experience, the clinical issues were summarized in the consensus, and for those clinical problems supported by evidences, the internationally recognized recommendation evaluation and formulation method GRADE was used to evaluate the evidence and form recommendations; for those clinical issues not supported by evidences, a consensus was reached through the nominal group method to form consensus recommendations. The consensus adopted a concise and clear format to form re-commendations or reach consensus suggestions on the medication regimen, medication characteristics, intervention timing, usage and dosage, course of use and safety issues for the treatment of rheumatoid arthritis and knee osteoarthritis with Wangbi Tablets. It is suggested that its application will better improve the efficacy of Wangbi Tablets in the treatment of rheumatoid arthritis and knee osteoarthritis, at the same time provide a reference for clinicians to use Wangbi Tablets in a standardized, reasonable and safe manner.
Arthritis, Rheumatoid/drug therapy* ; Consensus ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Osteoarthritis, Knee/drug therapy* ; Tablets

OBJECTIVETo observe the difference in the therapeutic effects on knee osteoarthritis (KOA) among auricular electroacupuncture therapy plus isolated moxibustion with Lingxian herbal paste (combined therapy), electroacupuncture (EA) and TDP irradiation.

METHODSEighty-nine cases were randomized into three groups. In the combined therapy group (30 cases), the auricular electroacupuncture therapy was adopted together with the isolated moxibustion with Lingxian herbal paste. The auricular points were xi (AH4), pizhixia (AT4), shenmen (TF4), etc. The Lingxian herbal paste was applied at Yanglingquan (GB 34), Dubi (ST 35), Zusanli (ST 36), Neixiyan (EX-LE 4), Heding (EX-LE 2) and Ashi points. In EA group (29 cases), EA was applied at the acupoints that were same as those in the isolated moxibustion with Lingxian herbal paste. In TDP group (30 cases), TDP irradiation was given at the affected knee. The treatment was given once every day, 10 treatments made one session and there was 1 week at the interval among sessions. Totally, 3 sessions of treatment were required. KOA clinical symptom and physical sign score and the single item pain symptom score of Lequesne index were observed before treatment and 1 week after treatment in the patients of each group separately. The efficacies were compared among the three groups.

RESULTSOne week after treatment, the total score of symptoms and physical signs of the patients in each group was reduced significantly as compared with that before treatment (all P < 0.05). The improvements in the symptoms and physical signs in the combined therapy group were better than those in the other two groups (1.50 +/- 1.57 vs 2.52 +/- 1.82, 2.63 +/- 1.97, both P < 0.05). The improvement in pain in the combined therapy group was also better than that in the other two groups (2.37 +/- 0.81 vs 2.83 +/- 0.92, P < 0.05; 2.37 +/- 0.81 vs 3.03 +/- 0.77, P < 0.01). The curative rate in the combined therapy group was 40.0% (12/30), which was higher than 17.2% (5/29) in EA group and 20.0% (6/30) in TDP group separately (both P < 0.01). The overall efficacy in the combined therapy group was superior to the other two groups (P < 0.05).

CONCLUSIONThe auricular electroacupuncture therapy plus isolated moxibustion with Lingxian herbal paste is advantageous at the total score of the symptoms and physical signs and the overall efficacy in the patients of KOA as compared with EA at the local acupoints and local TDP irradiation.

Aged ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Electroacupuncture ; Female ; Humans ; Knee Joint ; drug effects ; Male ; Middle Aged ; Moxibustion ; Osteoarthritis, Knee ; drug therapy ; therapy ; Treatment Outcome

OBJECTIVETo investigate the effect of HBP-A on meniscal injuries and the expressions of genes associated with pathological hypertrophy and calcification of the meniscusinduced by abnormal loading.

METHODSBovine meniscus explants were subjected to 25% strain at 0.3 Hz for 3 h and treated with 0.6 mg/mL of HBP-A. The cell viability in the meniscus explants after 72 hin culture was determined using live/dead staining and the expression levels of genes associated with pathological hypertrophy and calcification of the meniscus (ANKH, ENPP1, ALP, MMP13, and IL-1) were measured using real-time PCR and Western blotting. The conditioned medium was collected for testing sulfated glycosaminoglycan (GAG) release.

RESULTSThe number of dead cells, loss of proteoglycan content, and the expressions of ANKH, ENPP1, ALP and MMP13, and IL-1 at both the mRNA and protein levels were all significantly lower in the meniscus explants treated with 0.6 mg/mL HBP-A than in the explants with only 25% abnormal pressure stimulation (n=3, P<0.05).

CONCLUSIONHBP-A can effectively alleviate meniscal injuries induced by abnormal loading and suppress the expressions of genes related with pathological hypertrophy and calcification of the meniscus, and can serve as a potential drug for treatment of knee osteoarthritis.

Animals ; Calcinosis ; drug therapy ; Cattle ; Glucans ; pharmacology ; Hypertrophy ; Menisci, Tibial ; drug effects ; Osteoarthritis, Knee ; drug therapy ; Real-Time Polymerase Chain Reaction ; Tibial Meniscus Injuries ; drug therapy

OBJECTIVETo retrospectively analyze the long-term efficacy of intra-articular injection with sodium hyaluronate for the treatment of knee osteoarthritis.

METHODSFrom January 2006 to August 2007,120 patients (181 knees) with knee osteoarthritis, (mild 61 knees, moderate 72 knees, severe 48 knees), were treated by intra-articular injection with sodium hyaluronate, 2 ml every week for 5 weeks. The clinical effects were analyzed according to VAS, JOA scoring before treatment, at the 1 month, 1, 2 years after treatment.

RESULTS(1) VAS scores were respectively (7.26 +/- 1.83), (1.85 +/- 1.21), (2.54 +/- 1.40), (3.07 +/- 1.51) scores before treatment, at the 1 month, 1 and 2 years after treatment. There was significant difference between every post-treatment and pre-treatment. (2) JOA scoring of knee function was respectively (18.7 +/- 6.6), (84.3 +/- 15.5), (75.4 +/- 22.4), (64.8 +/- 25.6) scores before treatment, at the 1 month, 1 and 2 years after treatment. There was significant difference between every post-treatment and pre-treatment. (3) Assessment of long-term efficacy among 181 knees who were followed up 1 year, 70 cases got excellent results, 54 good, 34 fair and 23 poor. Those who were followed up 2 years,40 cases got excellent results, 54 good, 53 fair and 34 poor. Knee function became poor along with time-lapse. The efficiency was respectively 86.89% (53/61), 79.17% (57/72), 54.17% (26/48) in mild knees, moderate knees, severe knees at the 2 years after treatment.

CONCLUSIONThe long-term efficacy of intra-articular injection with sodium hyaluronate is satisfactory in treating knee osteoarthritis. The efficacy is better for mild and moderate osteoarthritis than for the severe osteoarthritis. The short-term efficacy is acceptable and the long-term one is worse for the severe knees.

Adult ; Aged ; Female ; Humans ; Hyaluronic Acid ; administration & dosage ; Injections, Intra-Arterial ; Knee Joint ; drug effects ; physiopathology ; Male ; Middle Aged ; Osteoarthritis, Knee ; drug therapy ; physiopathology ; Retrospective Studies ; Treatment Outcome