Study On The Evaluation Of KOA Effect In Acupuncture Point, Point Of Pain And Traditional Meridian Point

Purpose : To explore the best therapeutic regimen for the treatment of KOA via co mparing the efficiency of focal points, irritative painful points and traditional acupoints. Then to make comparison of clinic advantage between focal points and irritative pain ful points, providing the therapeutic and clinical basis for treatment of KOA.Methods and materials: 137 patients with KOA from the First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were divided into 3 groups, 45 patients were in traditional acupoints group(group A), the rest were averagely divi ded into focal points group(group B) and irritative painful points group(group C).Th e acupoints in group A were selected according to acupuncture-moxibustion science(7t h edition) edited by Shi Xuemin. The patients were treated by Xing Lin brand 0.35mm×50mm filiform needles with uniform reinforcing-reducing method, retaining the needle s for 30 min, once a day, and 5 days as a course for 4 courses with the same efficac y. In group B, the patients were classified into different syndrome types according to muscle meridian theory and clinical pain diagnosis and treatment edited by Xue Ligo ng, and 5-7 focal points were selected to be acupunctured in each type. The patients were treated by Xing Lin brand 0.35mm×50mm filiform needles with uniform reinforci ng-reducing method, retaining the needles for 30 min, once a day, and 5 days as a cou rse for 4 courses with the same efficacy. In group C, the therapeutic points were sele cted by palpating the corresponding muscles according to the location of pain. And th e patients were treated by Xing Lin brand 0.35mm×50mm filiform needles with unifor m reinforcing-reducing method, retaining the needles for 30 min, once a day, and 5 da ys as a course for 4 courses with the same efficacy.. The VAS score and WOMAC s core were respectively observed and recorded in the period of pre-treatment, the secon d course of treatment, post-treatment and four weeks follow-up.Results: 1. Comparing the VAS score in the period of pre-treatment among these three group s, there is no statistical significance(aP>0.05). After the second course of treatment, make comparison by ANOVA(bP<0.05), there are significant differences among thes e three groups; and in the aspect of VAS score, group C is superior to group B, gr oup B is better than group A. After the treatment, comparison among these three grou ps are assessed by ANOVA(cP>0.05), there is no significant difference. However, c ompared with group A, there are significant differences in both of group B and group C in the post-treatment(eP<0.05, fP<0.05). It is proved that group B and group C are better than group A in decreasing VAS score. In the follow-up, comparing these t hree groups by ANOVA(dP<0.05), it indicates that the long-term effect in group B is superior to group C, and group C is better than group A. 2. Comparing the WOMAC score in the period of pre-treatment among these three g roups, there is no statistical significance(aP>0.05). After the second course of treatm ent, make comparison by ANOVA(bP<0.05), there are significant differences among these three groups, in the aspect of WOMAC, group C is superior to group B, group B is better than group A. After the treatment, comparison are assessed by ANOVA(c P<0.05), there are significant difference among these three groups, it proved that grou p C is superior to group B in improving WOMAC, while group B is better than grou p A. In the follow-up, comparing these three groups by ANOVA(dP<0.05), group C is superior to group B, group B is better than group A. 3. Therapeutic evaluation after the end of treatment: in group A, 3 cases are cured, 20 cases with marked effect, 15 cases are effective, 7 cases are ineffective. In group B, 6 cases are cured, 32 cases with marked effect, 6 cases are effective, 2 cases are ineffective. In group C, 7 cases are cured, 32 cases with marked effect, 6 cases are e ffective, 1 case is ineffective. The total effective rate in these three groups is respecti vely 51.1%、82.6%、84.9%. After the treatment, evaluation of efficacy: Traditional Me ridian were cured in 3 cases, 20 cases markedly effective in 15 cases, 7 cases, the total effective rate was 84.4%. Tie bar foci were cured in 6 cases, 32 cases markedly e ffective in 6 cases, 2 cases, the total effective rate was 95.7%. Myofascial trigger poi nt group of 7 cases were cured, 32 cases markedly effective in 6 cases, 1 patient, the total efficiency of 97.8%. Compared with the traditional acupoints group, aP<0.01, bP<0.01.Conclusion: 1. In the treatment of KOA: there is on significant difference between group B and group C, while both of group B and group C are effective in the treatment of KOA, these two groups are better than group A, they are worth popularizing. 2. After the second course of treatment, compared with group A and group B, the i n time-effect in group C is more significant. After the end of treatment, there is no s ignificant difference between group B and group C, while both of these two groups a re superior to group A. 3. In the treatment of KOA, the long-term effect in group B is better than that in group A and group C, and the long-term effect in group C is superior to group A.