Clinical Study On Treatment Of Knee Osteoarthritis Of Yang Deficiency And Cold Type By Warming Needle Moxibustion

Objective: The investigation is to observe the therapy effect on warm needle moxibustion for knee osteoarthritis of yang deficiency and cold type, meanwhile to compare the result treating KOA with the treatment of warm needle moxibustion and other two treatments, including the treatment of acupuncture and the treatment of medium frequency electrotherapy. Moreover to expound the changes of interleukin-1 (IL-1 ),matrix metalloproteinase-3 (MMP-3) before and after treatment ,in order to discuss warm needle moxibustion mechanism on KOA,in order to provde a better way to treat KOA.Methods: (1)Received object: According to the diagnosis standard made by Rheumatism Association of American and the latest clinic diagnosis standard had already reported, the data have 90 cases of orthopedics, include clinical and hospitalized patients, were selected from 2006.10-2007.8 of the second traditional Chinese medicine hospital of fujian. 38 male patients and 52 female patients, age from 46 to 75 years, average age is 61 years. (2)Cases subgroup: 90 cases of patients with knee osteoarthritis were randomly allocated into three different therapeutic groups: warm needle moxibustion group(A group),acupuncture group( B group) and medium frequency electrotherapy group(C group).(3)Operation Method: A group selects neixiyan and waixiyan as chief acupoints and combines with warming needle moxibustion on the two acupoints;B group adopts only acupuncture ;C group adopts medium frequency electrotherapy. The patients of three groups were all treated one time everyday and 10 days were a course of treatment and they had take a rest for 2 days between two courses,three courses in total. All patients are prohibited to use any other KOA medicine during treatment period.(4)Detect marker: Before the treatment and after three courses of treatment,we evaluated respectively the clinic symptoms scores of two groups,meanwhile measure the contents of synovial fluid IL-1,MMP-3 before and after treatment. Then we analyze the clinic symptoms scores,pain intensity and synovial fluid IL-1,MMP-3 concentrations throuth statistics,in order to observe the therapeutie effcacy on warm needle moxibustion for KOA and change situation of synovial fluid IL-1,MMP-3.(5)Data processing: Experimental data are analyzed with software Spss.13.0.Results:(1)After three course of therapy, three methods all can improve KOA clinical symtoms. But by contrast,A group was better than B group and C group in improving clinical symptoms(P<0.01);(2) Comparision of pain intensity scores ,Three treatments all can ease pain .But by contrast,A group was better than B group and C group in improving clinical symptoms(P<0.01); (3) A relevant analysis of the clinic symptoms scores and synovial fluid IL-1 concentrations of the three groups,there was a significantly positive inter-relationship between the clinic symptoms scores of patients with knee osteoarthritis and synovial fluid IL-1 concentrations ,(related coefficient is 0.850, P<0.05); (4)A relevant analysis of the clinic symptoms scores and synovial fluid MMP-3 concentrations of the three groups,there was a significantly positive inter-relationship between the clinic symptoms scores of patients with knee osteoarthritis and synovial fluid MMP-3 concentrations ,(related coefficient is 0.647, P<0.05);(5)Statistics comparison of the contents of synovial fluid IL-1 before and after treatment, three methods all can decrease synovial fluid IL-1 concentrations effctively. But by contrast,A group was better than B group and C group (P<0.05);Three is no significant difference between B group and C group(P>0.05); (6)Statistics comparison of the contents of synovial fluid MMP-3 before and after treatment, three methods all can decrease synovial fluid MMP-3 concentrations effctively. But by contrast,A group was better than B group and C group (P<0.05);Three is no significant difference between B group and C group(P>0.05).Conclusion:(1)The efficience of warm needle moxibustion with Nei/WaiXiYan,YangLingQuan is 96.67%, the result demonstrates that warm needle moxibustion is better than other two groups; (2) warm needle moxibustion can obvious improve KOA clinical symptoms and alleviate/stop knee pain. It is a better way to treat KOA of yang deficiency and cold type.(3) KOA synovial fluid IL-1,MMP-3 level are correlatable with KOA clinical symptoms (4)Through measuring the contents of synovial fluid IL-1,MMP-3 before and after treatment,the result demonstrates that three ways all can decrease synovial fluid IL-1,MMP-3 level,but warm needle moxibustion is better than other two groups. According the effective therapy by warm needle moxibustion, we maybe achieve the purpose of protecting articular and recovering KOA of yang deficiency and cold type.