Chinese Medical Study On External Treatment Of Knee Osteoarthritis

BackgroundAs our aging population is aging, cases of knee osteoarthritis have been gradually increasing. Symptoms and complications can cause serious impact on elderly patients'quality of life. Because of knees arthritis, some of them become physically handicapped and lose the ability of self-care. Looking for effective and safe plans to treat knee osteoarthritis and improve patients' quality of living become currently significant issues of public health.ObjectivesThis study is to compare the therapeutic effects of moxibustion and external application of Chinese herbal medicine, with and without manipulation. Moreover, it is also to reveal the characteristics of the two methods so that researchers could derive standardized treatment of knee osteoarthritis for Chinese Medical Therapy.Methods(1) Observation objects:There were altogether 60 cases. They were outpatients of Chui Man Fat Chinese Orthopaedic Clinic between Jan,2010 and March, 2011. All cases accorded with "Treatment Guidelines Diagnostic Criteria" from Zhonghua Orthopaedic Association formulated in 2007 and the Kellgren/Lawrence knee osteoarthritis imaging classification≤3 level. There were 25 males and 35 females, aged between 40 and 73, average age: 58.(2) Case grouping:using simple random principle to divide the 60 cases into Manipulation Group:treated with traditional manipulation method together with moxibustion and application of Chinese herbal medicine externally. 30 cases. Control Group:moxibustion as well as application of Chinese herbal medicine externally.30. cases.(3)Operation Method:Treatment Group:treated with traditional manipulation together with moxibustion and applied herbal medical externally 5 times per week. Control Group moxibustion and application of Chinese herbal medicine externally 5 times a week. During treatment, the patients should maintain good mood, avoid sour, spicy food, seafood and beef. One month before and during treatment, patients should not use other knee osteoarthritis drugs or therapeutic methods, which might affect the result of this study. The intervention process of both groups is four weeks (1 treatment cycle). Interviews were carried out every two weeks. After the treatment, there was an evaluation.(4) Detection index:before and after the treatment, knee osteoarthritis WOMAC scale integration, quality of life questionnaire, records and comparision between Treatment group and Control Group the improvement of the knee symptoms.(5)Data processing:using SPSS13.0 to analysis the statistical data.Results(1)Comparing the WOMAC total scores of two-week and four-week treatments, patients of both groups have recorded a decrease in their scores. Both of them have a significant difference (P<0.05).(2) 2 weeks after treatment began, both groups claimed that they experienced less pain (Manipulation Group, P=0.000, Control Group, P=0.003). However, comparing the scores after 4-week treatment, there was obvious difference between the two groups. (P=<0.05). Even though improvement in pain relief was found in both groups, manipulation Group could achieve a better results.(3)Comparing the WOMAC scores in stiffness of two-week and four-week treatments, patients of both groups have recorded a decrease in their scores. There was no difference between the two groups in stiffness relief (p=0.07>0.05) after 2 weeks'treatment. By the end of the 4 weeks, significant improvement was noted in both groups. (4) Comparing the 3 sets of WOMAC scores in functional activities of two-week and four-week treatments, patients of both groups have recorded a decrease in their scores. Nevertheless, Comparing the 2-week treatment group with the 4-week treatment group, there was significant difference. (P<0.05).Conclusion(1) Overall therapeutic effect:Clinical effect could be seen after 2-week treatment by traditional manipulation together with moxibustion and external application of herbal medicine. There was significant effect after 2 more weeks'treatment. As for moxibustion with external application of herbal medicine only, therapeutic effect could be detected 4 weeks since treatment began. Comparing the two groups after 2 weeks' treatment, the group with traditional manipulation demonstrated a much more satisfactory result. The difference was even more significant two weeks later.(2) Pain Relief:therapeutic effects of the group with manipulation could be recorded two weeks after treatment began. Much more satisfactory results were found by the end of the 4-week treatment. However, It took 4 weeks for patients of the Control Group to experience therapeutic effects. Moxibustion and external application of herbal medicine together with manipulation performed better in pain relief than without.(3) Lessening stiffness:both groups demonstrated therapeutic effects on lessening stiffness after 2-week or 4-week treatment.(4) Functional activities:therapeutic effects of the group with manipulation could be recorded two weeks after treatment began. Much more satisfactory results were found by the end of the 4-week treatment. It took 4 weeks for patients of the Control Group to experience therapeutic effects. Comparing the two groups after 2 weeks'and 4 weeks'treatment, the group with traditional manipulation demonstrated a much more satisfactory result. The results of this study reveal that manipulation together with moxibustion and external application of herbal medicine has significant and more instant therapeutic effects on clinical symptoms of osteoarthritis patients. As overall performance of the group with manipulation was better, it is recommended clinically especially in improving patients'functional activities. However, due to the small number of subjects, there may be limitations in accuracy of the study and generalization of the results.