Traditional Chinese medicine ointment combined with tuina therapy in treatment of pain and swelling after total knee arthroplasty

BACKGROUND The most effective treatment for knee joint pain is total knee arthroplasty(TKA),but the risk of pain and swelling in patients after surgery is high.Ice application,ankle pump exercise and non-steroidal anti-inflammatory painkillers are the primary clinical treatments after surgery.However,long-term use of nonsteroidal anti-inflammatory pain relievers can easily cause gastrointestinal damage.Traditional Chinese medicine(TCM)ointments and tuina therapy integrate TCM and manipulation,which effectively promotes the penetration of TCM into the skin lesions,improves local blood circulation and inflammatory reaction and has good long-term effects on patients.AIM To evaluate the efficacy of TCM ointment combined with tuina therapy in the treatment of pain and swelling after TKA.METHODS The randomized controlled clinical trial enrolled 80 patients who underwent TKA via the same procedure.The patients were randomly divided among the treatment group(n=40)and the control group(n=40).The control group was given an analgesia pump in addition to oral painkillers as the postoperative intervention.The treatment group received TCM ointment with tuina therapy in addition to the analgesia pump and oral painkillers in the postoperative period.The following variables were recorded 3 d before surgery and 3 d,7 d and 14 d after surgery:Visual analogue scale(VAS)score;skin temperature;circumferences at 15 cm above and below the patella;maximum active knee flexion angle;and the knee injury and Osteoarthritis Outcome score(KOOS).RESULTS After treatment,VAS was significantly lower in the treatment group than the control group at 7 d(t=7.536,P<0.001)and 14 d(t=8.563,P<0.001).The skin temperature of participants in the treatment group was significantly lower than that in the control group at 7 d(t=2.968,P=0.004)and 14 d(t=4.423,P<0.001).The circumference values of the two positions in the treatment group were lower than those in the control group at 7 d[t=2.315,P=0.023(above);t=2.121,P=0.037(below)]and 14 d[t=2.374,P=0.020(above);t=2.095,P=0.039(below)].After 14 d of treatment,the maximum active knee flexion angle and KOOS of the two groups were significantly improved but were significantly higher in the treatment group(P<0.05 for both).CONCLUSION TCM ointment and tuina therapy have significant advantages over standard care in the treatment of pain and swelling after TKA.This additional treatment may improve knee function but additional studies are needed to confirm our observations.

Medication rules of traditional Chinese medicine ointment for diabetic foot ulcer

Objective:Based on data mining,to explore the clinical characteristics of traditional Chinese medicine ointment in the treatment of diabetic foot ulcer.Methods:to search the literatures about the treatment of diabetic foot ulcer by traditional Chinese medicine ointment in CNKI,Wangfang and VIP.In this paper,the prescription of traditional Chinese medicine ointment in the literature of treating diabetic foot ulcer was extracted,and the database of prescription was established by using v2.5 to analyze and mine the rule of medication.Results:95 prescriptions for diabetic foot ulcer were sorted out,involving 158 prescriptions.Among them,dragon's blood and Lithospermum are the most frequently used drug combinations.The core combination of 10 groups and 5 new prescriptions are obtained by evolution.Conclusion:the treatment of diabetic foot ulcer with traditional Chinese medicine ointment mainly includes clearing away heat,promoting blood circulation and removing blood stasis,and tonifying deficiency.

Heijiangdan Ointment(黑绛丹膏)Relieves Oxidative Stress from Radiation Dermatitis Induced by ^(60)Co γ-Ray in Mice

Objective：To investigate the effects of Heijiangdan Ointment（黑绛丹膏,HJD） on oxidative stress in （60）Co γ-ray radiation-induced dermatitis in mice.Methods：Female Wistar mice with grade 4 radiation dermatitis induced by ^（60）Co γ-rays were randomly divided into four groups（n=12 per group）;the HJD-treated,recombinant human epidermal growth factor（rhEGF）-treated,Trolox-treated,and untreated groups,along with a negative control group.On the 11 th and 21 st days after treatment,6 mice in each group were chosen for evaluation.The levels of superoxide dismutase（SOD）,malondialdehyde（MDA）,and lactate dehydrogenase（LDH） were detected using spectrophotometric methods.The fibroblast mitochondria were observed by transmission electron microscopy（TEM）.The expressions of fibroblast growth factor 2（FGF-2） and transforming growth factor β1（TGF-β1） were analyzed by western blot.Results：Compared with the untreated group,the levels of SOD,MDA and LDH,on the 11 th and 21 st days after treatment showed significant difference（P〈0.05）.TEM analysis indicated that fibroblast mitochondria in the untreated group exhibited swelling and the cristae appeared fractured,while in the HJD group,the swelling of mitochondria was limited and the rough endoplasmic reticulum appeared more relaxed.The expressions of FGF-2 and TGF-β1 increased in the untreated group compared with the negative control group（P〈0.05）.After treatment,the expression of FGF-2,rhEGF and Trolox in the HJD group were significantly increased compared with the untreated group（P〈0.05）,or compared with the negative control group（P〈0.05）.The expression of TGF-β1 showed significant difference between untreated and negative control groups（P〈0.05）.HJD and Trolox increased the level of TGF-β1 and the difference was marked as compared with the untreated and negative control groups（P〈0.05）.Conclusion：HJD relieves oxidative stress-induced injury,increases the antioxidant activity,mitigates the fibroblast mitochondrial damage,up-regulates the expression of growth factor,and promotes mitochondrial repair in mice.