Clinical Observation On Sensitization Points Acupuncture In The Treatment Of Knee Osteoarthritis

Objective:to compare the clinical efficacy of high pain sensitive acupoints and non/low pain sensitive acupoints acupuncture in the treatment of knee osteoarthritis through the clinical randomized trial method,thus providing a new idea for the clinical acupoints selection of acupuncture in the treatment of Knee Osteoarthritis.Methods:a total of 60 patients with knee osteoarthritis admitted to the outpatient department of the acupuncture and moxibustion department of Wuhan First hospital from April to December 2018 and recruited by advertisement were screened.The patients met the diagnostic criteria and inclusion criteria.After enrollment,the patients were randomly grouped by the central random system in order of sequence.There were 30 patients in the high pain sensitive group and 30 patients in the non/low pain sensitive group.After each patient was enrolled,the mechanical pain threshold of 13 locally fixed acupoints and pain points on the affected side of the knee were measured with the Von Frey pain meter.After all points were measured,the second time was measured at an interval of two minutes,if the difference between the two measured values is greater than 15,measure the third time and takethe two data with small difference to get the average value and the mean value of the two measured values was calculated.The mean value of all points was ranked from high to low.The five points with the lowest mean value were taken as acupuncture points in the high pain sensitive group,and the five points with the highest mean value in the non/low pain sensitive group were taken as acupuncture points.The acupuncture points in the two groups remained unchanged during the treatment.Both groups were treated with acupuncture for30 minutes each time,once every other day,three times a week,and two days’ rest a week for four weeks.At baseline,4 weeks after treatment,8 weeks and 12 weeks after enrollment,various scores and total scores of WOMAC scale,SF-12 scores were recorded in detail.Statistical software(version 21.0)was used to analyze the differences in various scores and total scores of WOMAC,SF-12 scores,and treatment efficiency between the two groups,and a conclusion was drawn.Results:1.Baseline data: there were no statistically significant differences between the two groups in gender,age,course of disease,baseline pain,stiffness score,difficulty in daily activities score,WOMAC total score and SF-12 score(P>0.05),indicating that the two groups were comparable.2.Intra-group comparison of patients in the two groups:compared with the baseline period,the pain,stiffness,difficulty in daily activities,WOMAC total score in the two groups were significantly reduced after 4 weeks of treatment,and the SF-12 scores were significantly improved,with statistically significant differences(P<0.01).3.Comparison between the two groups after treatment:acupuncture in the high pain sensitive group was better than that in the non/low pain sensitive group in improving pain and stiffness of KOA patients,and the difference was statistically significant(P<0.05);However,in terms of improving difficulties in daily activities and the quality of life,the two curative effects were similar,and the difference was not statistically significant(P>0.05).4.Clinical efficiency:4 weeks after treatment,high pain sensitive group of 30 cases of patients with clinical control in2 cases,5 cases were markedly effective,18 patients effectively,invalid in 5 cases,total effective rate was83.33%;Among the 30 patients in the non/low pain sensitive group,there were 0 cases of clinical control,2 cases of significant effect,16 cases of effective effect,12 cases of ineffective effect,and the total effective rate was 60%.The total effective rate of high pain sensitive group was obviously higher than that of non/low pain sensitive group,the difference was statistically significant(P<0.05).5.Long-term curative effect:at 8 and 12 weeks after enrollment,high pain sensitive points acupuncture has good efficacy in improving pain,stiffness,difficulty in daily activities and life quality score(P<0.05),and the efficacy is better than non/low pain sensitive points(P<0.05).Conclusion:Acupuncture at high pain sensitive points can significantly reduce pain and stiffness symptoms in KOA patients,improve the degree of difficulty in daily activities and the quality of lifescore,and the efficacy in alleviating pain and stiffness is significantly better than the non/low pain sensitive group.Although the two groups have similar efficacy in improving the degree of difficulty in daily activities and quality of life score,the long-term efficacy of acupuncture at high pain sensitive points in alleviating pain,stiffness,difficulty in daily activities and improving the quality of life score is better than non/low pain sensitive group.In general,the therapeutic effect of acupuncture at pain sensitive points on KOA is better than that at non/low sensitive points,which can provide a new idea for the clinical selection of acupuncture points for KOA treatment.