Clinical Study Of Integrated Blood-letting Therapy On Knee Osteoarthritis

Knee osteoarthritis is also named hypertrophic arthritis or degenerative arthritis. It is generally considered that the onset of this disease is from the degenerative changes of the knee articular cartilages to the sclerotin under cartilage, synovial membrane and articular capsule, etc. The process of renovation and compensation is an inflammatory procedure. The principal changes of this disease in pathomorphology include local and progressive destroy of articular cartilage, as well as formation of osteophyma at the edge of joints. The main symptoms are pain, stiffness and malfunction of knee joint, and it is a kind of commonly-seen disease in bone and traumatology department in the clinic. With the development of the aging of population in our country, the morbility of knee osteoarthritis would further increase, which may greatly affect the society and economy. Therefore, the integrated blood-letting therapy with the charateristics of obvious effects, short course, little expension, few side-effect and convenient manipulation should be used, so as to provide the best therapy for the pain of knee osteoarthritis.1. Literature study1.1. Recognition of traditional medicine to knee osteoarthritisTraditional medicine thinks this disease is caused by the deficiency of liver and kidney, long-term strain and external wind and cold. Kidney is in charge of bones, and liver controls tendons, while the deficiency of liver and kidney is enable to nourish tendons and bones. It was said in Su Wen·Xuan Ming Wu Qi Lun that persistent looking consumes blood, persistent lying consumes qi, persistent sitting consumes muscles, persistent standing consumes bones, and persistent walking consumes tendons, all of which are called the hurt due to five kinds of consumptive diseases. Long time of strain and external injuries may lead to this disease.1.2. Recognition of modern medicine to knee osteoarthritisIn modern medicine, knee osteoarthritis is thought to be caused by the degenerative changes of knee articular cartilages and the formation of new bones at the edge of the joint surfaces. Its etiological factors include mechanical and biological factors. The biological stress on the joint surface is inbalanced, which may cause further damage of the cartilage, articular capsule and synovial membrane of knee. A malignant cycle is formed, and the disease aggravates gradually.1.3. MethodThe therapeutic methods of knee osteoarthritis are generally divided into operation treatment and non-operaticn treatment. Among non-operation treatment, acupuncture, blood-letting, massage, physical therapy, blockade, internal and external use of chinese medicine are commonly used. Blood-letting method is often adopted in the clinic to deal with pain due to all kinds of diseases. However, the report of using integrated blood-letting therapy (i. e. combination of blood-letting method, scattered needling and point puncture) to treat knee osteoarthritis is seldom to be seen.2. Clinical study2.1. Objective:Through the clinical study of various integrated blood-letting therapy on knee osteoarthritis, the relative standards and manipulation specifications are to be further specified, its clinical effects and safty to human body are to be synthetically evaluated, so as to promote the application and development of this method in the clinic.2.2. Method:The patients of knee osteoarthritis that accord with the bring-in standard were randomly divided into 3 groups by random digits table, integrated blood-letting group (blood-letting group in brief), traditional acupuncture group (acupuncture group in brief) and point manipulation group (manipulation group in brief).(1) Blood-letting group: Disposable blood taking needle was used, blood-letting method was applied on the abnormal superficial venules and lymph vessels on the affected side, scattered method was adopted to the Ashi point on the swelling and pain areas, and point puncture method was used in Weizhong point. About 2 kinds of methods were selected each time to induce blood-letting, cupping therapy was combined after the automatic stop of blood.(2) Acupuncture group: Point selection: Dubi, Liangqiu, Xuehai, Weizhong, Weiyang, Yingu, Heding, Zusanli, Yinlingquan, Yanglingquan. Select 5 points each time., and alternate. Cupping therapy was combined on the primary point for 5min after withdrawing needles. (3) Manipulation group: Pushing, pressing and kneading manipulations were adopted, and the point selection was the same to traditional acupuncture. Select 5 points each time, and alternate. Cupping therapy was combined on the primary point for 5min after manipulation.(4) The therapeutic effects of the 3 groups were evaluated by the Effect Standard of State Administration of Traditional Chinese Medicine, McGill Pain Questionnaire (MPQ), Judgement Standard of Therapeutic Effect (JOA), Lequesne MG Score Table of the Severity Level of Knee Osteoarthritis.2.3 Results:(1) Effective rate: All of the groups had effects, and the total effective rate of blood-letting group is higher than that of the other two groups (p＜0.05).(2) Founction of relieving pain. The clinical observation indicated that all of the 3 groups had curative effects on the knee pain of patients. The clinical recovery rate of blood-letting group is high to 60%, which is better than that of the other two groups (p＜0.05). The difference has significant statistical meaning.(3) As to the results of MPQ score table, JOA effect judgement standard, Lequesne MG, it also showed that the effects of the 3 groups before and after treatment had significant difference (P＜0.05), and it has statistical meaning.3. Conclusion:The above results indicated that blood-letting therapy has obvious functions of promoting qi circulation, activating blood and relieving pain. It could better relieve the pain of knee osteoarthritis, especially under the combined treatment of various kinds of blood-letting methods. It resulted in fast effect, and it had good improvement for the quality of life of patients. This study could initially reveal the etiological mechanism of knee osteoarthritis in traditional Chinese medicine, and carry forward the effect of blood-letting therapy.