Clinical Efficacy And In Vivo Mechanics Study Of“Tui Bin Shen Xi”in The Treatment Of Knee Osteoarthritis With Grade 0-ⅡBased On The"Tendon-Softening And Bone-Strengthening"

Background: The traditional Chinese medicine technique represented by " Tui bin Shen xi " has been widely used in the clinic,but its specific mechanism is not completely clear.Objective: To observe the clinical efficacy of " Tui bin Shen xi" manipulation in the treatment of knee osteoarthritis and to explore the changes of lower limb force lines in patients with KOA before and after treatment.Methods: 60 patients with knee osteoarthritis hospitalized from December 2019 to November 2020 were randomly div ided into experimental group and control group by computer.The control group was treated with routine acupuncture and physiotherapy,while the experimental group was treated with Tui bin Shen xi manipulation.The WOMAC,KSS,the tenderness threshold aroun d the joint,the range of motion of the knee joint and the force line of the lower limbs of the two groups before and after treatment were counted and analyzed.Results:1.There was no significant difference in all indexes between the two groups before treatment.2.In terms of WOMAC score,the WOMAC score of the two groups after treatment was improved compared with that before treatment,and the difference was statistically significant.The comparison between the two groups found that there was no significant difference in WOMAC score between the two groups(p > 0.05).3.In terms of KSS score,the KSS score of the experimental group after treatment was significantly different from that before treatment(p <0.0l),while the KSS score of the control group was not significantly different from that before treatment(p >0.05).The comparison between the two groups showed that the KSS score of the experimental group was significantly better than that of the control group,and the difference was statistically significant(p < 0.01).4.Interms of the tenderness threshold around the knee joint,there was a significant difference between the two groups(p < 0.01).There was no significant difference between the two groups at 14 days after treatment(p < 0.05).Two mo nths after treatment,the tenderness threshold around the joint in the experimental group was better than that in the control group,and the difference was statistically significant(p < 0.05).5.In terms of the range of motion of the knee joint,the flexi on range of motion of the patients in the experimental group were significantly better than those before treatment,and the difference was statistically significant(p < 0.01).The difference was statistically significant(p < 0.05),and the difference was statistically significant(p < 0.05),but there was no significant difference in straightness(p > 0.05).In the control group,there was no significant difference in the range of motion of knee joint 2 months after treatment(p > 0.05).It was found that the flexion of the patients in the experimental group were significantly better than those in the control group 14 days and 2 months after treatment,and the difference was statistically significant(p < 0.01).There was no significant difference in k nee straightness between the two groups(p > 0.05).6.In terms of lower limb force line,the HKA angle of the experimental group after treatment were significantly different from those before treatment(p < 0.05),while the PTA had no significant differenc e compared with that before treatment(p > 0.05).There was no significant difference in the lower limb force line between the control group and the control group after treatment(p > 0.05).The results showed that the HKA angle of the experimental group w ere significantly different from those of the control group(p < 0.05).There was no significant difference in PTA between the two groups(p > 0.05).7.Correlation analysis showed that the HKA angle of the two groups was positively correlated with the ten derness threshold around the joint and the flexion of the knee joint,and the correlation was significant Correlation analysis showed that the HKA angles of the two groups were positively correlated with the tenderness threshold around the joint,and the c orrelation was significant(p < 0.01).8.Through the analysis of the mechanical characteristics of the thumb force when promoting the patella movement,the variation coefficients of the force from the outside to the inside of the patella movement in the th ree axes X,Y and Z are 0.14,0.33 and 0.06,and 0.14,0.04 and 0.03 from the inside to the outside,respectively.The coefficient of variation of thumb force in the process of patellar movement from outside to inside was 0.07,while that from inside to ou tside was 0.05 respectively.Conclusion: Both " Tui bin Shen xi " manipulation and traditional acupuncture and moxibustion can relieve the pain of patients with knee osteoarthritis.The advantage of " Tui bin Shen xi " manipulation lies in increasing the range of motion of knee joint and correcting abnormal lower limb force line.In the manipulation of " Tui bin Shen xi ",when the patella is moved from outside to inside,the change of the direction and strength of thumb force is greater than that from inside to outside.