Clinical Study Of Acupoint Herbal Application Plus Electro-acupuncture Therapy In Treatment Of Degenerative Arthritis Of Knee Joints

Aim:Sixty cases of degenerative arthritis of knee joints were enrolled. After taking the treatments of acupoint herbal application plus electro-acupuncture, the improvement of symptoms such as the knee joint pain and the movement was observed, which provide the necessary basis for the clinical methods in the treatment of degenerative arthritis of knee joints.Methods:Sixty cases of degenerative arthritis of knee joints were randomly assigned into treatment group and control group, with 30 cases in each group. All cases were from the-out-patient department of acupuncture, the First Affiliated Hospital, Guangzhou University of Chinese Medicine. In the treatment group, acupoint herbal application plus electro-acupuncture therapy was taken. Main points include Neixiyan (EX-LE4), Waixiyan (EX-LE5), Xuehai (SP10), Yanglingquan (GB34), Zusanli (ST36) and Heding (EX-LE2). Modification:For the pain due to wind pathogen, Fengshi (GB31) and Quchi (LI11) were added; for the pain due to the cold pathogen, Dazhui (GV14) was added; for the pain due to the damp pathogen, Zhongwan (CV 12) and Qiuxu (GB40) were added; for the dual deficiency of liver and kidney syndrome, Taixi (KI3) and Sanyinjiao (SP6), etc, were selected. Manipulations:After routine disinfection,1.0-1.5 cun filiform needles were swiftly inserted, with the depth about 1.0 to 1.5 cun. After the arrival of qi, electro-acupuncture with sparse-dense wave was applied for 20 minutes, with the tolerance of the patients. After withdrawal of the needles, acupoint herbal application was applied. The herbs applied are mainly for unblocking the meridians and collaterals, which were grounded into powder and mixed with ginger juice and finally made into the corns, with the diameter as 2 cm and the thickness as 0.5 cm. After routine sterilization, the herbs mixed with plasters were applied onto the acupoints. The acupoints include two groups. One group includes Shenshu (Bilateral) (BL23), Yaoyangguan (GV3), Xiguan (LR7) and Liangqiu (ST34), the other group includes Mingmen (GV4), Zhishi (Bilateral) (BL52), Xiyangguan (GB33) and Ququan (LR8). The two groups were applied in turn. The time applied is generally 4 hours. If the patients felt uncomfortable, it could withdraw in advance. The treatments were taken three times every week (once every other day) continuously for 3 weeks. In the control group, simple electro-acupuncture therapy was applied. The indexes for the evaluation of the clinical efficacy are the Insall Knee Scoring Table (See Attached Table 1) and Lysholm Knee Joint Scoring Standard (See Attached Table 2).Results:1. In the treatment group,6 cases were male and 24 cases were female, with the ages ganged from 43 to 75 years old and the duration ranged from 6 months to 6 years. In the control group,6 cases were male and 24 cases were female, with the ages ganged from 46 to 75 years old and the duration ranged from 6 months to 8 years. There was no significant difference of sexes, ages and duration between the two groups, indicating comparability (P>0.05).2. With T test, there was no significant difference of the indexes for the assessment of the clinical efficacy (P>0.05), indicating comparability.3. After the treatments, with the Insall Knee Scoring Table and Lysholm Knee Joint Scoring Standard, in the treatment group,4 cases were clinically healed,10 cases were apparently improved,14 cases were improved and the total effective rate was 93.33%. In the control group, none case was clinically healed,4 cases were obviously improved,18 cases were improved and the total effective rate was 73.33%. With Npa analyses, the therapeutic efficacy in the treatment group is superior to that in the control group (P<0.05), which indicated that there was significant difference of therapeutic efficacy between the acupoint herbal application plus electro-acupuncture and simple electro-acupuncture in the treatment of degenerative.Conclusion:Degenerative arthritis of knee joints is commonly happened among the middle and old ages. Based on the deficiency of liver, kidney, qi and blood, the healthy qi is deficient. With the wind, cold, dampness pathogens, etc, attacking, the meridians and collaterals are obstructed and the qi and blood flow slows. Consequently, the muscle, tendons and bones around the knee joints manifest as pain, numbness, burning pain, difficulty in extension and flexion, even swelling and deformation of the joints. With the herbs absorbed through the skin and the regulation of the acupoints, the acupoint herbal application therapy has the functions of diminishing the inflammation of the joints, eliminating the edema, tonifying kidney and strengthening the tendons and bones; The electro-acupuncture could promote the local flow of qi and blood, which has the functions of activating blood, eliminating blood stasis, unblocking collaterals and checking pain. With the integration of the two methods, the therapeutic efficacy is much more obvious.