| ObjectiveThis clinical study, which through the method of comparative, observe the therapy of modified Shaoyao Gancao Decoction combined with Jin’s 3-Knee Points on senile knee osteoarthritis (liver and kidney deficiency, tendon and vessel stasis type) of short-term and long-term curative effect. The study provides the basis of evidence-based medicine,which promoting the treatment KOA with combination of acupuncture. The study also provides new ideas and methods for the treatment of KOA. And regulates the concrete scheme of the combination of acupuncture with drug therapy, it makes more conveniention to master the operation, facilitation the popularization and application of this therapy. The study carries forward the combination of acupuncture with medicine of Zhang Zhong-Jing academic ideas, as well as reduces the economic burden of patients and countries to create conditions.MethodsThis study selected 90 patients with knee osteoarthritis, who were aged between 60 to 75, and were selected from May 2014 to January 2015 in Guangzhou Xinhai Hospital TCM Department, Geriatric Department, Yi Yang Yuan. The patients were accorded with the western medicine diagnostic criteria for knee osteoarthritis and syndrome differentiation of Traditional Chinese Medicine for liver and kidney deficiency, tendon and vessel stasis type. All the patients were randomly divided into treatment group and control group 1, group 2, there were 30 patients in each group. The treatment group were treated with the combination of the modified Shaoyao Gancao Decoction and Jin’s 3-Knee Points. The modified Shaoyao Gancao Decoction is made up of radix paeoniae alba 30g, Radix Glycyrrhizae Preparata 15g, radix achyranthis bidentatae 15g, radix dipsaci 15g, parasitic loranthus 15g, fructus chaenomelis 10g, radix angelicae pubescentis 12g, radix notoginseng 10 g (Fried first), angelica tail 12g. The traditional Chinese medicine were decoct twice daily 1 agent, with 200ml water. Jin’s 3-Knee Points contain acupoints of Xuehai (SP 10), Liangqiu (ST 34) and both Xiyan (extra). It’s necessary for a patient to bend the knee when related acupoints are located. After routine sterilization of each acupoints, we needled both Xiyan using a 1.5-cun needle medial toward the patella to a depth of 1-1.2 cun. Needling into the articular cavity was prohibited. The acupoints of Xuehai and Liangqiu were needled with a 1.5-cun needle to a depth of approximately 1.2 cun. The degree of depth was dictated by the need to get Qi. Each patient was treated 3 times a week,2 weeks a course. The control group 1 took the diclofenac sodium enteric-coated tablet 25 mg,3 times a day. The control group 2 accepted Jin’s 3-Knee Points treatment only. Each group were treated 2 weeks for a course. After a course of treatment and 8 weeks after treatment we evaluated the clinical effect by using symptoms quantified points tables and VAS score. At the same time, we recorded each adverse events.ResultsThe study striped off 5 cases. The group of treatment were 30 patients, and the control group 1 were 27 patients, the control group 2 were 28 patients.The gender, age, course of the disease, symptoms quantified points and VAS score had no statistical significance (P>0.05) before treatment of all the groups. It illustrates that the three groups in age, sex, course of the disease, illness severity distribution comes-from the same overall. The differences of the VAS score, symptoms quantified points before treatment, after treatment and 8 weeks after treatment were statistically significant (P< 0.05), shows that the three kinds of treatment methods can improve the function of the knee joint activities, alleviate pain symptoms. The comparison of VAS score, symptoms quantified points differential value among the three groups, the comparison between the treatment group and control group, the difference had statistical significance (P<0.05), shows that the treatment group were more effective on the knee joint activity function and alleviate pain symptoms. The comparison of the comprehensive curative, according to the State Administration of Traditional Chinese Medicine efficacy determination method of the synthetic evaluation of curative effect, the curative effect is divided into healing, powerfully and effectively, invalid four-grades. After treatment,8 weeks after treatment to evaluate curative effect of three groups, respectively, by using rank sum test shows that the treatment group and control group 1 after treatment curative effect comparison difference has no statistical significance (P> 0.017), suggesting short-term curative effect in treatment group was similar to control group 1;but 8 weeks after treatment the treatment group, control group 1 curative effect comparison difference was statistically significant (P<0.017), suggesting long-term curative effect in treatment group was superior to control group 1. After treatment,8 weeks after treatment the treatment group and control group 2 effect of comparative differences were statistically significant (P< 0.017), explain in the short-term and the long-term curative effect of treatment group were better than the control group 2. In addition, the treatment group and control group 2 had no adverse events, it means the high security. The control group 1 had 2 patients with upper abdominal pain, 1 patient with symptoms of nausea and vomiting in the process of the treatment.ConclusionsThis study suggests the therapy of modified Shaoyao Gancao Decoction combined with Jin’s 3-Knee Points on senile knee osteoarthritis (liver and kidney deficiency, tendon and vessel stasis type) has obvious effect and high safety, its short-term curative effect is similar to diclofenac sodium enteric-coated tablet;but its long-term effect is better than that of diclofenac sodium enteric-coated tablet;and both short-term curative effect and the long-term curative effect are superior to pure Jin’s 3-Knee Points treatment. It demonstrated the combination of acupuncture with medicine therapy in the treatment of senile knee osteoarthritis has more advantage. |
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