Assessment of effect of jadwar capsule (Delphinium Denudatum) on clinical manifestation of knee Osteoartheritis versus pelacebo : A double blind randomized controlled clinical trial

Abstract

Abstract Introduction: Osteoarthritis is the most common arthritis which is characterized by degeneration of articular cartilage. The most important symptoms are joint pain, stiffness, movement, deformity, different effect from the subject. Osteoarthritis is rated as the fifth cause of the year of life last index in high income countries and ninth in low to middle income countries. Due to complications of medical and surgical interventions and the growing demand to herbal medicine, the research on the medicinal plants can be decide as a beneficial strategy. One of the most useful plants in the Traditional Persian Medicine is Jadwar (Delphinium denudatum wall.).Jadwar is used as medicinal plant in many diseases in Traditional Persian Medicine. One of the most important usages of Jadwar in Traditional Persian Medicine is for joint problems like, arthralgia, joint stiffness, and arthritis. Aim: Determining the effect of Jadwar (Delphinium denudatum wall.) on clinical manifestation of knee Osteoarthritis versus placebo Methods: 104 patients with mild to moderate knee osteoarthritis met the inclusion criteria and after obtaining informed consent, detailed history and clinical examination were performed. Patients allocated to the two equivalent groups of 52 people (intervention and control groups) randomly using the block design method. Jedwar and placebo capsules were identical in appearance and were placed in the same shaped containers, and in order to the allocation concealment, by someone other than the researchers, the drug containers were placed in identically numbered seeled envelopes. In the next step the intended drug (jadwar and placebo capsules) prescribed to patients. Patient consumed the drugs two times a day for four week. The outcomes, including pain, stiffness, and physical activity were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and the Visual Analogue Scale (VAS) at baseline two and four weeks after the intervention. Results: The statistical comparison between intervention and control groups showed that the jadwar significantly reduces the pain compared with control group according to the vas questionnaire (P=0.0000). Also according to the womac questionnaire the statistical analysis showed that the jadwar reduces the pain and stiffness of knee and improves the physical activity of patients better than placebo. This effect was statistically significant at the end of the second week for VAS index and improvement of physical activity by WOMAC index and for all indices in the fourth week (end of study) (P = 0.000). Conclusion: This study showed that taking oral capsules twice a day orally on the symptoms of patients with mild to moderate osteoarthritis for one month has a better effect on reducing pain, dryness and improving patients' daily activities than placebo capsules.