| Background:Osteoarthritis (osteoarthritis, OA) is a common clinical disease, chronic disease, progressive onset. The main pathological changes of the disease for the degenerative changes of articular cartilage, subchondral bone sclerosis and often accompanied by secondary bone hyperplasia. When the abnormal load, causing joint pain, activity limitation and other symptoms. The most common in osteoarthritis is the majority of patients with knee osteoarthritis, knee involvement. China has entered the aging society, the global social aging population increasing, the incidence of this disease increased significantly. According to WHO statistics, the prevalence rate for osteoarthritis disease:the population over the age of 50 the prevalence rate was 50%, over the age of 55 is as high as 80% to 60 years old, almost all patients suffering from osteoarthritis in different degrees. At present the world a total of 355000000 patients with osteoarthritis disease. Acupuncture treatment of KOA has a long history, and has the advantages of simple operation, no side effect, and has the advantages of good curative effect. Through literature review found that the treatment of KOA of needling blood letting less warm acupuncture combined with research, with different types of the lack of. The purpose of this study was to observe the warm acupuncture combined with pricking blood therapy clinical KOA, and explore the differences on the effect of different types of.Objective:1 By comparing the change of warm acupuncture combined with bloodletting and acupuncture treatment for KOA patients with clinical signs and symptoms, evaluate the clinical efficacy of acupuncture treatment for KOA, further optimize and improve the acupuncture therapy in the treatment of KOA.2 Through the observation of warm acupuncture combined with bloodletting on patients with different syndromes of KOA, seek warm acupuncture combined with blood letting puncture the scientific basis for the treatment of KOA effectively, and to provide ideas and methods for more novel methods of acupuncture on KOA.3 Prove safety thorn phlebotomy treatment of KOA with warm needling.Method:In 2014 May-2015 year in March in Beijing Chinese Medicine Hospital from Shunyi hospital acupuncture clinic KOA patients as the research object, using a computer random scheme will meet the 72 patients were randomly divided into standard into two groups, including 36 cases of treatment group,36 cases in the control group, the control group with routine acupuncture treatment, treatment group on the basis of the control group combined with bloodletting therapy of acupuncture and moxibustion, the knee osteoarthritis index assessment scale (WOMAC) as indicators of efficacy, respectively before treatment, after treatment,1 months after the end of treatment were followed up. According to the WOMAC score, according to the nimodipine method was used to evaluate the curative effect.Results:The two group included 72 patients,2 patients were excluded and 5 cases of loss, the other 65 cases, all according to the established plan to complete the treatment, including 32 cases of treatment group,33 cases in the control group. Two groups of gender, age, course of disease, syndrome differentiation, treatment KOA severity index, WOMAC score comparison, the difference was not statistically significant, comparable between groups. The end of the two group after treatment,65 patients completed 1 months of follow-up.1 Between the two groups before and after treatment WOMAC score:both the treatment group and the control group, before and after treatment, the WOMAC score: comparison of pain, stiffness, difficulty in daily life, the total score, the difference was statistically significant (P<0.05); WOMAC scores between the two groups after the treatment, the differences were statistically significant (P<0.05). That improvement of treatment group and control group in terms of pain, stiffness, and daily life difficult symptoms, the treatment group than the control group.2 Comparison of two groups of different syndromes before and after treatment WOMAC score:between the various syndromes before treatment compared with after treatment, WOMAC score decreased significantly, the same pattern of differences before and after treatment, with statistical significance (P<0.05). Different syndromes before and after treatment between groups of comparison, arthralgia, blood stasis obstructing syndrome before and after treatment between the two groups there were statistically significant difference, (P<0.05). Liver and kidney deficiency syndrome before and after treatment, no significant difference, no statistical significance (P>0.05), and the syndrome type of a limited number of patients (7 people). That warm acupuncture combined with bloodletting therapy on KOA of arthralgia, blood stasis obstructing syndrome, liver and kidney deficiency syndrome have the curative effect, and arthralgia syndrome, blood stasis obstructing effect is better than the control group, and can not prove to liver and kidney deficiency syndrome than in the control group effective.3 Comparison of KOA severity index score after treatment in two groups:group comparison, the two groups before and after treatment were compared, there was statistical significance (P< 0.05), that combined with warm acupuncture in acupuncture combined with pricking blood therapy is effective in treating KOA. The comparison between the two groups, the two groups before and after treatment were compared, there was statistical significance (P< 0.05), that combined with warm acupuncture in acupuncture combined with pricking blood therapy can improve the clinical curative effect.4 Comparison of the efficacy of the two groups after treatment:treatment group clinical cure in 4 cases (12.50%),13 cases (40.63%), effective in 12 cases (37.50%), invalid in 3 cases (9.38%), the total efficiency of 90.63%; control group, clinical cure in 2 cases (6.06%),9 cases (27.27%), effective in 15 cases (45.45%),7 cases (21.21%), the total efficiency of 78.79%. The total efficiency of two groups, there were significant differences (P< 0.05).5 Comparison of follow-up WOMAC score:the WOMAC score of treatment group before treatment was 60.28±5.46,24.54±2.37 after treatment, follow-up 27.41 ±3.64; the control group before treatment,58.65±6.21,32.89±3.12 after treatment, follow-up 36.23±3.08. The treatment group before treatment and follow-up WOMAC score comparison, the difference was statistically significant (P< 0.05); after treatment and follow-up WOMAC score comparison, the difference was not statistically significant (P> 0.05); follow-up treatment group compared with the control group, there was statistical significance (P<0.05).6 Security analysis:The clinical trials of patients without treatment, needle, needle breakage, hematoma, treatment and after treatment did not appear physiological indexes (such as blood pressure, heart rate, respiration, pulse, abnormal sleep), that pricking blood therapy for treatment of knee osteoarthritis with warm acupuncture combined with safety.Conclusion:1 Acupuncture is better than simple acupuncture and blood letting therapy for osteoarthritis of the knee joint of warm acupuncture combined with clinical symptoms and signs, can significantly improve the KOA.2 Different types of effects are different, the treatment of arthralgia syndrome, blood stasis stagnation, liver and kidney deficiency syndrome have the curative effect, and the wind dampness syndrome, blood stasis obstructing syndrome curative effect is better than that of simple acupuncture treatment, but the test is not proof of the liver and kidney deficiency syndrome curative effect is better than simple acupuncture treatment.3 Pricking blood therapy for treatment of knee osteoarthritis with lasting effect of warm acupuncture combined with January, follow-up after treatment had no obvious change, is superior to that of simple acupuncture therapy.4 Warm acupuncture and moxibustion combined with pricking blood therapy in the treatment of knee osteoarthritis is a safe, effective. |
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