| Objective:By randomized controlled clinical study, observed the score changes in knee pain, stiffness and joint function, walking distance, and quality of life before and after treatments, to study the clinical efficacy of acupuncture and cupping in combination with TDP ("Magic Lamp") therapy, on knee osteoarthritis (KOA)(the Cold-Damp syndrome) in Singapore, hence to provide a scientific approach and theoretical basis for further exploring clinical prevention and treatment of KOA as well as its applications.Method:70cases of Traditional Chinese and Western medicine clinically qualified patients of knee osteoarthritis (the Cold Damp syndrome) in Singapore were selected and randomly assigned into the Treatment Group, treated with acupuncture and cupping in combination with TDP therapy, and Control Group, treated with acupuncture and cupping. The main acupoints of the treatment for both groups are:Xuehai (SP10), Liangqiu (ST34), and both Xiyan (EX-LE4and EX-LE5). The auxiliary acupoints are selected based on Chinese medical syndrome differentiation. For the Treatment Group, the main acupoints are located under the situation of knee's naturally bending position. After routine sterilization on the acupoints, needle both Xiyan (EX-LE4and EX-LE5) with1.5cun needles medial toward the patella to a depth of1-1.2cun. It is prohibited to needle into the articular cavity. Xuehai (SP10) and Liangqiu (ST34) are needled with1.5cun needles to a depth of about1.2cun, dictated by the need to get Qi. Retain the needles in the acupoints for about30min, while manipulating the needles every5minutes to conduct uniform reinforcing-reducing. The auxiliary acupoints are needled in a routine method. Meanwhile, light up TDP on the acupoints for30minutes through the full acupuncture operation. After the acupuncture operation, alternatively select3acupoints among Weizhong (BL40), Xuehai (SP10), and Liangqiu (ST34), as well as Ashi points to apply cupping. Keep cupping for5-10min. The same treatment with the same acupoints as in the Treatment Group are applied to the Control Group. Retain the needles in the acupoints for about30min, while manipulating the needles every5minutes to conduct uniform reinforcing-reducing. Both the Treatment and Control Groups were treated once per3days and one course per15days. The clinical efficacy was assessed after two courses of the treatment. Evaluation:The clinical efficacy of the treatment was assessed by four different observation criteria: Short-Form McGill Pain Questionnaire (MPQ), Indexes of Severity for Osteoarthritis of the Hip and Knee (Lequesne MG), the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Judging Standard of Clinical Effect on KOA (JOA). All the results were evaluated by using the Nimodipine calculating method, that is,(the score before treatment-the score after treatment)/the score before treatment×100%.Results:The group comparison shows that there are no statistically significant differences between the Treatment and Control groups on gender, age, course of disease (p>0.05). Therefore, the Treatment and Control groups are comparable. The results also show that, after the treatment, there are significant improvements in knee pain, stiffness and joint function, increases in walking distance, and fundamentally, improving in quality of life. After two courses of treatment for36patients in the Treatment group,5cases clinically had the basically recovered effect;13cases clinically had the obviously recovered effect;16cases clinically had the fairly recovered effect; and2cases clinically had no effect. The total clinically effective rate is94.4%. For34patients in the Control group after two courses of treatment,1case clinically had the basically recovered effect;9cases clinically had the obviously recovered effect;16clinically had the fairly recovered effect; and8cases clinically had no effect. The total clinically effective rate is76.5%. There is statistically significant difference in the treatment effectiveness between the Treatment and Control groups (p<0.05). It shows that the treatment of senile knee osteoarthritis with acupuncture and cupping in combination with TDP therapy is clinically more effective than that with acupuncture only. In addition, there were with high safety and no single case with adverse effects.Conclusion:This study shows that after the treatment, clinical improvement has been observed in both the Treatment and Control groups, in terms of the degree of knee pain and swelling, knee stiffness duration and degree of flexion, pain-free, and ease of stair activity. It is clinically more effective in the Treatment group than in the Control group, mainly reflected by the mitigation in knee pain and the reduction in knee stiffness duration. As a conclusion, the treatment with acupuncture and cupping in combination of TDP therapy in knee osteoarthritis is superior to that with just acupuncture and cupping. It might be worthy to be applied clinically. |
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