Comparison of a Polyherbal Mixture “Chappong-Haeng-Khao” and “Topical Capsaicin” add-on Treatment for Patients with Knee Osteoarthritis in Khaopanom hospital, Krabi Province

Abstract

Osteoarthritis, a chronic disease, is a major cause of disability among elderly population. The treatment procedures regarding Thai traditional clinical practice guideline (CPG) are including therapeutic massage, herbal compress and herbal medicines. Polyherbal mixture Chappong-Haeng-Khao and topical capsaicin have been prescribed as add-on therapies to treat osteoarthritis in Thai traditional medicine clinic at Khaopanom hospital, Krabi province, Thailand. This study aimed to compare the effects of Chappong-Haeng-Khao and topical capsaicin as add-on treatments for patients with knee osteoarthritis using retrospective cross sectional analytic study design. The medical records of 33 patients (50-80 years old) with osteoarthritis from Khaopanom hospital during October 2017 and March 2018 were analyzed. The patients were divided into 3 groups (11 patients/group); group 1 received CPG treatment, group 2 received CPG treatment and Chappong-Haeng-Khao and group 3 received CPG treatment and topical capsaicin. The clinical assessments included visual analog scale (VAS) assessing and WOMAC index scale (Thai version) that involved with pain, stiffness, and physical function levels of knee (functional subscale). The adverse effects of each group were recorded. All data was expressed as percentages or mean values with standard error. Differences in clinical outcomes in each group and between groups were analyzed by Paired t-test and One way ANOVA with post-hoc analysis (Tukey), respectively. A p-value less than 0.05 was regarded as statistically significant. In a within-group evaluation at week 1, 2, and 3, the results demonstrated that the mean values of VAS pain score and WOMAC pain, stiffness, functional subscales, and total scores in all groups were significantly different when compared to week 0. In a between-group comparison at the end of the study, the mean change from week 0 of VAS pain score and WOMAC pain, functional subscales, and total scores of Chappong-Haeng-Khao group was significantly higher than that of CPG group. However, there were no statistically significant differences in all parameters between add-on groups. In addition, the adverse effects in all group did not occur. The results from the study indicated that an add-on treatment group with Chappong-Haeng-Khao could reduce pain score and pain level and increase physical function level of knee more than CPG group. A controlled clinical trial for comparison between Chappong-Haeng-Khao and topical capsaicin has to be explored.