Duhuo Jisheng Tang for treating osteoarthritis of the knee: a prospective clinical observation

BACKGROUND Little scientific evidence supports the efficacy of herbal medicines in the treatment of degenerative arthritis of the knee. The purpose of this study is to evaluate both the efficacy and safety of a finished Chinese herbal preparation duhuo jisheng tang (DJT) in reducing symptoms of degenerative osteoarthritis of the knee. METHODS A prospective follow-up study was carried out in two hospitals in Taipei between April and October 2005. Sixty-eight osteoarthritis patients, with symptoms diagnosed by radiologists, received DJT at a rate of 2.5 g, twice daily for four weeks. Baseline scores were measured on the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, followed by further measures at the end of weeks 1, 2 and 4. The World Health Organization Quality of Life (WHOQOL) assessment was undertaken as a secondary outcome, with pattern identification questionnaires being adopted. Regression models were constructed to explore the score differences between the baseline and at weeks 2 and 4 by various determinants including age, gender, body mass index (BMI), severity at baseline, use of rescue medication, aversion to cold and flaccidity of the lower back and knees. RESULTS Among the 68 participants, there were statistically significant reductions in the WOMAC index scores for pain, stiffness and physical functioning in the second and fourth weeks, with effects first appearing during week 2. By week 4, the mean WOMAC index scores had fallen from 22.2 (+/- 19.2) to 16.1 (+/- 16.2) for pain, from 28.1 (+/- 24.9) to 18.5 (+/- 20.3) for stiffness, and from 22.6 (+/- 18.0) to 18.2 (+/- 17.8) for physical functioning, while the global score for pain under the visual analogue scale (VAS) was reduced from 38.7 (+/- 21.5) to 27.8 (+/- 19.8). CONCLUSION In the treatment of degenerative osteoarthritis of the knee, a 4-week therapy with the Chinese herbal preparation DJT reduced pain and stiffness and improved physical functioning, but it was less effective in treating flaccidity and aversion to cold.