| Objective:The knee is one of the most common sites of osteoarthritis, as a common disease, increasing attention has been paid on. Chinese medicine and modern medicine in the prevention of knee osteoarthritis have their growing understanding of profound. For knee osteoarthritis by Meridian-Muscle Syndrome Differentiation, our group has been committed to the direction of the research. Our studies had shown that from process of Meridian-Muscle theumatism development to Bone theumatism, Meridian-Muscle plays an important role, we believe that Meridian-Muscle theumatism is a necessary stage in the development of knee osteoarthritis, Bone theumatism is the extension of the development process of the Meridian-Muscle theumatism. In recent years, epidemiological studies of the knee have shown that bone marrow edema (BME) is a risk factor for osteoarthritis exacerbations. Bone marrow edema is very common in osteoarthritis. Through clinical trials, we had tried to explore knee osteoarthritis by Meridian-Muscle Syndrome Differentiations and Bone marrow edema. Bone marrow edema and knee osteoarthritis of through Meridian-Muscle Syndrome Differentiations can be an effective and objective evidence to provide the basis of clinical. Proved once again that knee osteoarthritis Meridian-Muscle theumatism is Bone theumatism s basic, Bone theumatism is an extension of Meridian-Muscle theumatism, Meridian-Muscle and Bone are also importance!Method:To explore the relationship between them, in the second part of the paper, we selected108patients with knee osteoarthritis, Knee rheumatism disease (knee osteoarthritis) in accordance with the State Pharmaceutical Management Department of Medical Administration22professional95disease TCM in treatment programs, According to the Chinese Academy of Sciences issued by the Meridian-Muscle Diagnostic criteria cases dialectical type, type the knee osteoarthritis, to analyze the distribution pattern and relationship with knee osteoarthritis and Bone marrow edema lesions. At the same time, analysis knee osteoarthritis X-ray stage with Bone marrow edema in clinical pain symptoms, thus re-examine the role of Bone marrow edema lesions in the knee osteoarthritis by Meridian-Muscle Diagnostic that has been ignored. In the third part of the paper,105patients with knee osteoarthritis patients, type by the Meridian-Muscle Diagnostic, treat with Meridian-Muscle Treatment, and with WOMAC score, Bone marrow edema score before and after comparison, to explore through the bars therapy treatment effectiveness. The results analysis statistically with SPSS13.0package, P<0.05considered to be statistically significant.Result:In the second part,108patients with knee osteoarthritis X-ray, through Bone marrow edema and Meridian-Muscle typing analysis their correlation. Severe X-ray findings accounted for90%of the patients with pain, show that patients with moderate to severe X-ray more pain than patients with mild X-ray, but pain ratings and X-ray classification contingency table x2test show that, Knee pain grading unrelated with X-ray grade (x2=3.791, P=0.435). Rank Sum Test results of numbers of independent samples show that X-ray classification of the three pain groups was not statistically significant (P=0.341). Severe Bone marrow edema in severe pain accounted for93.24%, patients with mild pain, only29.4%of patients with bone marrow edema. In patients with moderate to severe pain,75.8%of patients in the presence of one or more degree bone marrow edema, pain and bone marrow edema chi-square test tips show that the degree of pain relate with bone marrow edema grade (x2=20.254, P<0.01). Several independent samples comparison rank sum test results show that the three groups of patients with bone marrow edema grading have difference statistically significant (P<0.05), and research results show that:with the degree of pain has been increasing, the average rank of the bone marrow edema grading gradually increase (0degree41.01,1degree52.85,2degree66.21). It also shows that bone marrow edema relate with pain. Research results suggest that Bone marrow edema relate with pain, and with the aggravation of pain, bone marrow edema worsening trend.The Meridian-Muscle lesions in severe bone marrow edema accounted for89.13%, Meridian-Muscle typing and bone marrow edema chi-square test, prompted that Meridian-Muscle typing relate with bone marrow edema grade (x2=14.959, P<0.01), tip that bone marrow edema type by Meridian-Muscle disease. Single Meridian-Muscle disease, two Meridian-Muscle disease and triple Meridian-Muscle disease group contrast visible, the single Meridian-Muscle disease compare with the Meridian-Muscle disease have a significant difference (P<0.05). Two Meridian-Muscle disease and three Meridian-Muscle disease has no significant difference (P>0.05). Several independent samples comparison rank sum test results show that the three groups of patients bone marrow edema grading difference statistically significant (P<0.05). And research results show that:with the degree of disease has been increasing through the Meridian-Muscle’s number increased, the mean rank of the bone marrow edema grading gradually increased (0degree48.42,1degree59.74,2degree82.42), which also shows the bone marrow edema relate with Meridian-Muscle typing.Through the Meridian-Muscle therapy, including the Meridian-Muscle massage (M group) and fire needle (F group) for the treatment on patients with knee osteoarthritis through the Meridian-Muscle Syndrome Differentiations and compare with oral celecoxib group (0group), the effectiveness of the WOMAC scores (pain, joint stiffness, activity level) and bone marrow edema rating grades inspection the Meridian-Muscle therapy. M group pre-treatment pain score was10.89±3.636, F group pre-treatment pain score was9.57±4.313,O group pre-treatment pain score was10.60±3.950, three sets of pre-treatment pain score two control, P>0.10, three groups before treatment have no difference in pain scores. M group after treatment pain score was5.74±3.257, the F treatment pain score was6.11±3.546, and the0group therapy pain score was8.11±3.948, difference between the three groups after treatment, pain score in two group, M group, F group comparison P>0.10, two groups after treatment have no different. Comparison between group M and group0, P<0.10, prompt treatment, pain score difference; Comparison between Group F and Group0, P<0.10, prompted the two groups after treatment pain score difference; M group, F group was significantly better than the0group. The M group before treatment stiff scores of4.17+2.007, the F group pre-treatment pain score was3.97±2.121,0group before treatment pain score was3.71±2.122, three groups before treatment stiffness scores two control, P>0.10, threebefore treatment, stiff rated no difference; M group treatment of stiffness after scores of3.11±1.762, F group pre-treatment pain score was3.17±1.9020group pre-treatment pain score was3.29±1.903, the stiff no difference in the ratings of the three groups after treatment. The M group before treatment activities ratings36.00±14.801, F treatment before the activity score36.69±15.231.0group before treatment activities ratings33.00±15.282; M group after treatment, the degree of activities rated21.57±10.869, F group therapy activities score was21.89±11.303,0group therapy activities score was27.89±14.481, three groups before treatment have no different P>0.05, in the ratings of three groups before treatment, activities have no difference. Activities score after treatment, M group scores21.57±10.869, F group score21.89±11.303,0group score was27.89±14.481, between the three groups score after treatment, the activities score of M group and F group comparison P>0.10, have no difference. Comparison between group M and group0, P<0.10, before treatment, activities score difference; contrast between the F group and the group0, P<0.10, prompt treatment, activities score difference; M group and F group was significantly better than the0group. The M group before therapy bone marrow edema score was2.00±0.840, F group before treatment bone marrow edema score was2.06±0.838,0group before therapy bone marrow edema score was2.17±0.822, three groups before treatment, bone marrow edema score, P>0.10, no difference in the three groups before treatment activities score. M group after treatment, bone marrow edema score of1.23±0.490, F group after treatment, bone marrow edema score was1.20±0.473,0group after treatment, bone marrow edema score was1.51±0.702; Group after treatment, bone marrow edema score between the groups, M group, F group comparison P>0.10, two groups after treatment, bone marrow edema score have no difference; comparison between group M and group0, P<0.10, prompt treatment, bone marrow edema score difference; contrast between the F group and the group0, P<0.10, prompt treatment, bone marrow edema score difference; M group, F group was significantly better than the0group.Conclusion:1. This study shows that patients with knee osteoarthritis, bone marrow edema (BME) correlated with knee pain. There was significant difference between the groups with pain of bone marrow edema incidence, with knee painincreased, bone marrow edema worsening trend. Typing knee osteoarthritis by Meridian-Muscle Syndrome Differentiations and bone marrow edema have correlation, the difference between the three through Meridian-Muscle groups and bone marrow edema have statistically significance, with increased knee pain, bone marrow edema worsening trend.2. Bone marrow edema (BME) can be used as dialectically an objective quantitative indicators for clinical knee osteoarthritis of Meridian-Muscle Syndrome Differentiations. Mechanical equilibrium of the knee tendons lesions cause damage, stress concentration knee cartilage injuries were aggravated by the tendons of the human body to adapt to the presence of high stress in the lesion, the organization will produce a corresponding change. Stress concentration so that the muscle ligaments to spasm, fascia contracture, and the fascia and muscle will produce compensatory hypertrophy. In these tendon lesions lead to the knee mechanical equilibrium the limb alignment change, resulting in knee cartilage injury, adding to the severity of knee osteoarthritis, formed and increase bone marrow edema.3. Meridian-Muscle therapy through the use of the Meridian-Muscle massage and fire needle therapy treatment of knee osteoarthritis, before and after treatment score comparison, results show that both methods by Meridian-Muscle therapy to knee osteoarthritis, the effect of the Meridian-Muscle therapy group was significantly superior to oral celecoxib group.4. By Combing the Meridian-Muscle, Release Meridian-Muscle junction points and use fire needle treat Meridian-Muscle point of the scattered thorn treatment by gluten knee osteoarthritis, are safe operation and simple method, etc. Had provide a safe and effective treatment for patients with knee osteoarthritis, has a certain clinical significance.5. Proved once again that knee osteoarthritis Meridian-Muscle theumatism is Bone theumatism basic, Bone theumatism is an extension of Meridian-Muscle theumatism, Meridian-Muscle and bone are also importance!... |
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