The Clinical And Experimental Research Of Abdominal Acupuncture On Knee Osteoarthritis Defined By Deficiency Of Kidney And Blood Stasis

ObjectivesBased on the systematic review in both the literature of modern integrated Chinese & Western medicine and ancient literature about osteoarthritis, the randomly controlled clinical trials research was conducted to investigate the clinical effect of abdominal acupuncture on knee osteoarthritis defined by Deficiency of Kidney and Blood stasis. The randomized controlled animal experiment was also carried out to examine the effect of abdominal acupuncture on the production of serum tumor necrosis factorα(TNF-α) and Interleukin-1 (IL-1) contents in rabbits with knee osteoarthritis, and to investigate the mechanism and target of abdominal acupuncture at the molecular levels. The study enhanced the reliable clinical evidence and experimental basis and further promote abdominal acupuncture into the practice。Methods150 individuals with knee osteoarthritis who met the inclusive criteria from the Guangdong Hospital of Traditional Chinese Medicine, were randomly divided into treated group and control group. The control group were treated with the primary treatment for 3 months (Glucosamine hydrochloride, P0.0.48, tid), The treated group received both the primary treatment and abdominal acupuncture for 3 months. Respectively, we scored the pain and knee function prior and post to treatment according to Visual Analogue Scale (VAS) and the HSS scale, and analyzed their therapeutic effect and differences according to Guiding Principles of new drug clinical research of Chinese medicine.20 rabbits with knee osteoarthritis were generated according to Hulth procedure,15 into experimental group with treatment of abdominal acupuncture (once every 3 days, a total of 10 times),5 was into control group with regular feeding without treatment. Venous blood was collected via ear vein pricr and post to treatment, TNF-αand IL-1 contents detected with EILSA and compared.ResultsAmong 150 individuals,23 failed to be followed-up,7 were unable to adhere to treatment, the rest of 120 individuals completed the final test,68 of them were in experimental group,52 in control group. Between the two groups, the gender, age, location, course, VAS score, HSS score and X-ray Kellgren-Lawrence grade showed no significant difference, indicating the identification in general condition. The average HSS scores in the two groups were negatively correlated with X-ray Kellgren-Lawrence grade, that is, the higher the X-ray classification, the lower the HSS scores; however, the average VAS scores were positively correlated with X-ray Kellgren-Lawrence grade, the higher the X-ray classification, the higher the VAS scores.Prior and post to treatment, it showed significant differences between groups, P<0.01, indicating that the treatment was valid in the two groups; after the treatment, the experimental group and control group showed significant differences, P<0.01, indicating that the treatment was more effective in experimental group than in control group; one month later after treatment, it showed differences between groups, P<0.05, indicating that the treatment efficacy in experimental group become weaker, though it still better than control group; two months after treatment, it showed no statistically significant differences, P>0.05, indicating there was no difference in the two groups.Evaluation of the therapeutic efficacy between groups showed the significant differences in effective rate, P<0.05, indicating the efficacy in experimental group was better than control group. While the evaluation of syndromes showed stronger significant differences in the rate, P<0.01, indicating the treatment efficacy in experimental group was still better than control group.By Hulth method, animal model of knee osteoarthritis was generated after 4 weeks. Prior and post to treatment, there was no differences in the body weight, serum TNF-α, IL-1 contents between experimental group and control group, P>0.05, indicating identification in general condition. Prior and post to model establishment, the contents of serum TNF-α, IL-1 in both experimental group and control group showed statistics differences, P<0.05, indicating it was higher in animal models than control ones. Before and after treatment, the contents of serum TNF-α, IL-1 in experimental group showed statistics differences, P<0.05, indicating that treatment made it decline. Before and after treatment, the contents of serum TNF-α, IL-1 in control group showed statistics differences, P<0.05, indicating that treatment had the effect.ConclusionsIt was concluded in this study that 1. Abdominal acupuncture needle as a new therapy, proven by clinical studies, is effective in the treatment of knee osteoarthritis, so it is worth promoting, although certain timeliness.2. The clinical dialectical, the syndrome types changes foundation of the knee osteoarthritis is deficiency of Kidney and Blood stasis, between them deficiency of kidney is the root while blood stasis is the branch.3. The study confirms that abdominal acupuncture can reduce the TNF-α, IL-1 contents in animal model of knee osteoarthritis, thus protect the articular cartilage and improve symptoms of osteoarthritis.4. Cytokines is closely related to the incidence of knee osteoarthritis, among them the serum tumor necrosis factor a and interleukin-1 contents is positively correlated with the destruction of cartilage.5. By Hulth method, animal model of knee osteoarthritis was produced after 4 weeks, but to middle and late osteoarthritis, modeling time can be extended.6. Abdominal acupuncture has a positive impact on the regulation of cartilage by cytokine, which may be one of the mechanism or target about abdominal acupuncture for knee osteoarthritis.7. The symptoms and signs in patients with knee osteoarthritis have a positive correlation with the radiological Kellgren-Lawrence grade.