Objective:To study the effect and safety of graded therapy featuring integrative traditional Chinese and Western medicine for the treatment of hemophilic arthritis.Methods:Forty patients with hemophilic arthritis were hospitalized randomly,with their blood coagulation factor activity determined by one-stage method and their arthritis classified into 4 stages.The treatment was applied according to the stage of arthritis and finding of intra-articular cavity puncture.For stageⅠ,based on the principle of RICE(rest,ice,compression and elevation),1.8g of Xuefuda(血府达)was medicated orally once per day,intravenous dripping of 250mL of hemostasis mixture twice a day and 1.2g of clindamycin per day were also given for hemostasis and anti-inflammation.For stageⅡ-Ⅲ,Kangyanling(抗炎灵)was additionally administered via intra-articular cavity injection twice a week,2mL every time,for 5-6 times in total.For stageⅣ,the drug for intra-articular cavity injection was replaced with 25mg of sodium hyaluronate and the frequency of injection reduced to every two weeks,for 5-6 times in total.Coagulation factorsⅢandⅣas well as blood plasma were not given in the whole treatment course.Short-term therapeutic effects and adverse reaction in patients were evaluated,and the long-term effects were followed-up after patients left the hospital with 6-month consolidation therapy by Xuefuda.Results:After a 3-week treatment,33 patients (82.5%)were completely remitted;5(12.5%)were partially remitted and 2(5.0%)un-remitted,setting the short-term effective rate at 95.0%(38 cases).The 6-month follow-up showed that except for a relapse in 2 and 4 patients of stageⅢandⅣrespectively,long-term remission displayed in all the other 34 patients,with the remission sustaining rate being 85.0%.No complication such as an infection,bleeding or aggravating pain occurred in the 215 times intra-articular puncturing conducted in the 40 patients.Normal figures were shown in liver and kidney function,electrolytes,ECG,blood glucose and routine test of blood and urine throughout the course.Conclusion:The graded treatment of integrative medicine for hemophilia with non-blood preparation has a favorable effect and is safe or without any adverse reaction,which opens a high efficacy and new safe path and thinking for the treatment of and deformity prevention in the hemophilic patients.
