| BackgroundKnee osteoarthritis is refers to the knee joint cartilage appears primary or secondary a degenerative changes, along with patella softening and bone hyperplasia, resulting in pain and dysfunction, and even deformed degenerative disease. Research shows that in chronic disabling disease, osteoarthritis after cardiovascular disease. Foreign clinical epidemiological studies have shown that, in view of the middle-aged and old people, KOA arrange the fourth on the spectrum of women, men are arranged on the eighth. Increased with aging and obesity, increasing number of cases. Although the clinical treatment of knee osteoarthritis, but the final purpose or relieve the clinical symptoms, improve joint function in patients with, slow down and stop further deterioration. Therefore, how to raise the clinical curative effect of treatment of KOA, reduce the patient’s pain and disability, reduce the medical expenses of related disease, becomes the focus of the world’s medical researchers.Acupoints direct current drug iontophoresis treatment not only can realize the non-invasive, can also import has a therapeutic effect in vivo drug ingredients, fusion point, drugs and electrical effects at an organic whole, to the disease. In recent years, the treatment in the clinical treatment of knee osteoarthritis is becoming more and more be taken seriously, is simple, exact curative effect, low cost, less adverse reaction, and many other advantages. This study in rhizoma ligustici wallichii, kusnezoff monkshood root, for imported drugs, observation point direct current iontophoresis treatment clinical curative effect for the treatment of knee osteoarthritis.Objective1. From the modern medicine understanding of knee osteoarthritis, traditional Chinese medicine understanding of knee osteoarthritis, and direct current drug iontophoresis on knee osteoarthritis clinical research progress of the three angles of literature review, lay a theoretical foundation for follow-up study.2. Using a randomized controlled trial law, this research in rhizoma ligustici wallichii, kusnezoff monkshood root, for imported drugs, observation point direct current iontophoresis treatment clinical curative effect for the treatment of knee osteoarthritis.Methods1. Literature researchFrom the perspective of modern medicine, systematic review of the knee osteoarthritis definition, epidemiology, etiology, pathology, pathogenesis and common treatment. From the medical point of view, a systematic review knee osteoarthritis disease, etiology and pathogenesis of TCM, and to summarize the clinical application of the Chinese medicine iontophoresis in recent years2. Lontophoresis fluid of Ligusticum chuanxiong Hort. and prepared kusnezoff monshood root quality control researchTo measure soaking time effecting on lontophoresis fluid of Ligusticum chuanxiong Hort. and prepared kusnezoff monshood root alcohol-soluble extract content by weight loss. Determine the best time to soak and the lowest limit alcohol soluble extract of lontophoresis fluid of Ligusticum chuanxiong Hort. and prepared kusnezoff monshood root. Determination the soaking time effect on the content of ferulic acid in lontophoresis fluid of Ligusticum chuanxiong Hort. by high performance liquid chromatography, and determine the best soaking time and lowest limit of ferulic acid. Determination the soaking time effect on the content of total aconitine in lontophoresis fluid of prepared kusnezoff monshood root by uv-vis spectrophotometry, and determine the best soaking time and lowest limit, of total aconitine.3. Clinical researchInto the 90 accord with standard of knee osteoarthritis patients. Using the random number table method were randomly divided into three groups. With simple direct current iontophoresis (n= 30), including pure (n= 30), iontophoresis plus cupping treatment (n= 30).Observed before and after treatment in patients with McGill pain scale (MPQ) week, Lysholm knee scores, knee joint diameter, etc., to compare between the three groups of clinical curative effects.Results1. The baseline dataThree groups of subjects in age, sex, weight, McGill pain scale (MPQ), Lysholm knee scores, knee weeks diameter etc were not statistically significant, comparable.2. Lontophoresis fluid of Ligusticum chuanxiong Hort. and prepared kusnezoff monshood root quality control researchThe content of alcohol-soluble extract in lontophoresis fluid of Ligusticum chuanxiong Hort. and prepared kusnezoff monshood root increase with the increasing of immersion time, but growth rates continue to decrease. Soak 40 days, growth rates of alcohol-soluble extract almost unchanged, so they can be soaked in 40 days, alcohol-soluble extract content of Ligusticum chuanxiong Hort. should not be less than 4.50%; Kusnezoffii extract content of prepared kusnezoff monshood root should not be less than 1.70%. Ferulic acid in lontophoresis fluid of Ligusticum chuanxiong Hort. increase with the increasing of immersion time, but growth rates continue to decrease. Soak 40 days, growth rates of ferulic acid content almost unchanged, so they can be soaked in 40 days, ferulic acid content of lontophoresis fluid of Ligusticum chuanxiong Hort. should not be less than 38.01μg/mL. total aconitine in lontophoresis fluid of Ligusticum chuanxiong Hort. increase with the increasing of immersion time, but growth rates continue to decrease. Soak 40 days, growth rates of total aconitine content almost unchanged, so they can be soaked in 40 days, total aconitine content of lontophoresis fluid of prepared kusnezoff monshood root should not be less than 323.06μg/mL.3. The PRI score comparison after treatmentPRI score after treatment 2 period of treatment, the curative group dropped to 8.71+/-2.29, compared with before treatment was statistically significant (P< 0.01);Iontophoresis group PRI score dropped to 6.15+/-2.10, compared with before treatment was statistically significant (P< 0.01);Joint group of PRI score dropped to 5.32+/-2.18, compared with before treatment was statistically significant (P< 0.01). PRI score between the three groups after treatment, the variance analysis showed that F= 19.51, P= 0.0000, with statistical significance (P< 0.01).Visible, the joint group in lower PRI score significantly superior to electric acupuncture group and iontophoresis group.4. The VAS score comparison after treatmentVAS score after treatment 2 period of treatment, the curative group dropped to 5.11+/-1.29, compared with before treatment was statistically significant (P< 0.01);Iontophoresis group of VAS score dropped to 5.30+/-1.37, compared with before treatment was statistically significant (P< 0.05);Joint group of VAS score dropped to 4.19+/-1.22, compared with before treatment was statistically significant (P< 0.01). VAS score between the three groups after treatment, the variance analysis showed that F= 6.30, P= 0.0028, with statistical significance (P< 0.01).Visible, the joint group in lower VAS score significantly superior to electric acupuncture group and iontophoresis group.5. The PPI scores after treatmentAfter treatment 2 period of treatment, the curative group of PPI scores dropped to 4.00+/-1.18, compared with before treatment was statistically significant (P< 0.05);Iontophoresis group of PPI scores dropped to 3.90+/-1.21, compared with before treatment was statistically significant (P< 0.05);Joint group of PPI scores dropped to 2.32+/-1.30, compared with before treatment was statistically significant (P< 0.01). PPI scores between the three groups after treatment, the variance analysis showed that F= 18.01, P= 0.0000, with statistical significance (P< 0.01).Visible, the joint group in reducing PPI scores significantly superior to electric acupuncture group and iontophoresis group.6. Lysholm knee score comparison after treatmentAfter treatment 2 period of treatment, the curative group Lysholm knee score increased to 61.20+/-4.30, compared with before treatment was statistically significant (P< 0.01);Iontophoresis group Lysholm knee score increased to 64.50+/-4.50, compared with before treatment was statistically significant (P< 0.01);The Lysholm knee joint group score increased to 69.30+/-4.28, compared with before treatment was statistically significant (P< 0.01). Lysholm knee score between the three groups after treatment, the variance analysis showed that F= 18.01, P= 0.0000, with statistical significance (P< 0.01). Visible, higher Lysholm knee joint group scores significantly superior to electric acupuncture group and iontophoresis group.7. Knee weeks diameter compared after treatmentWeek of knee joint after treatment 2 period of treatment, the curative group diameter down to 37.50+/-2.05, compared with before treatment was statistically significant (P< 0.05);Iontophoresis group week of knee joint diameter down to 37.36+/-2.11, compared with before treatment was statistically significant (P< 0.01);Week of knee joint group diameter down to 35.43+/-2.16, compared with before treatment was statistically significant (P< 0.01).Week of knee joint diameter, between the three groups after treatment of variance analysis showed that F= 9.04, P= 0.0003, with statistical significance (P< 0.01). Visible, the joint group in reducing diameter is significantly superior to the knee joint weeks electric acupuncture group and iontophoresis group.8. Clincal effectAfter 2 courses of treatment, the curative group cured in 3 patients, 8 cases were markedly effective, effective 9 cases,10 had no effect, the total effective rate was 66.67%;Iontophoresis group of 4 cases were cured, 16 cases were markedly effective, effective in 5 cases, invalid in 5 cases, total effective rate was 83.33%;Joint group of 6 cases cured,18 cases were markedly effective, effective in 3 cases,3 had no effect, the total effective rate 90.00%, the Ridit analysis, R= 0.50, chi-square value= 8.37, P< 0.0392= 0.05. This suggests that the clinical curative effect of joint group is better than that of electric acupuncture group and iontophoresis group.Conclusion1. Pure electric acupuncture treatment of knee osteoarthritis clinical curative effect, can effectively improve the patient’s pain and dysfunction.2. Simple acupoint iontophoresis therapy for knee osteoarthritis clinical curative effect, can effectively improve the patient’s pain and dysfunction.3. Electric acupuncture joint acupoint iontophoresis treatment of knee osteoarthritis clinical efficacy is better than that of single treatment, in improving patients’ pain and dysfunction. |
PDF Full Text Request