| Objective: according to a control study of needle knife and Intra articular injectionof sodium hyaluronate in the treatment for the knee osteoarthritis model of rabbits, anda clinical control study of needle knife with ultrasound guided and acupuncture in thetreatment for60cases of knee osteoarthritis(KOA), We investigate the pathway and theadvantage of needle knife in the treatment of this disease, to provide the basis for theselecting therapy of KOA, at the same time, to explore and summarize standard ofdiagnosis and treatment of acupotomy visualization from ultrasound guided.Method:1.zoopery:20adult rabbits were randomly divided into4groups with5rats in each group: blank control group(A), model group second(B), needle knifegroup(C), joint cavity injection group (D),The anterior cruciate ligament and partialmedial meniscus of the left knee of the other15rabbits except A group were sectionedto produce model of KOA with The improved Hulth method. All animal0f C and Dgroup were respectively intervened with joint cavity injection or acupotomy in fifth,sixth, seventh, eighth weeks,.All the rabbits were killed at ninth weeks, and take thetibia platform and the medial femoral condyles to make into specimen, which wasobserved with ordinary microscope, and immunohistochemical method to detect thevascular endothelial growth factor (VEGF) lever.2.The clinical experiment: The60clinical cases were randomly divided into2groups, namely needle knife under theultrasound guided group and electro acupuncture(EA) group, treated for3weeks.1week later at the end of treatment, compared the scores(ADL score, HSS index, VASscore), before and after therapy, to observe the degree of improvement in clinicalsymptoms and the changes of the dates of knee from infrared thermal imaging detection.Results:1.The animal experiment:â‘ under the light microscope, the articularcartilage degeneration of rabbit in the needle knife group is less than sodiumhyaluronate group, and far better than the model group.â‘¡compared with the control group,, expression of VEGF in the articular cartilage and subchondral bone in in themodel group was significantly higher than that of normal articular cartilage (P<0.01),and sodium hyaluronate group can effectively reduce the expression of cartilage inVEGF(P<0.01), Acupotomy group showed more significant curative effect than sodiumhyaluronate group.â'‰Clinical studies:â‘ Both the needle knife group and EA group,compared before and after treatment, the temperature from infrared thermal imagingdetection have the obvious change (P<0.01). It indicates the obvious improvement ofvenous stasis in two groups. Comparison between the two groups, P=0.38, had nosignificant differences.â‘¡In the ADL score, the excellent and good rate of needle knifegroup was higher than that of EA group, there is no significant difference in efficiency;â‘¢Both needle knife group and the EA group, HSS index have the obvious changebefore and after treatment (P<0.01). And compared with amplitude of variation of thetwo groups, it has the remarkable difference (P<0.01).â‘£Both needle knife group andthe EA group, pain index have the obvious change before and after treatment (P<0.01),and compared with amplitude of variation of the two groups, it has the obviouschange(P<0.01), indicate that Acupotomy in improving the pain of osteoarthritis hasmore advantages than EA.Conclusion:1. treatment of needle knife and intra-articular injection of sodiumhyaluronate on experimental KOA can reduce the degeneration of articular cartilage andsubchondral bone, the curative effect of the former was higher than that of the latter.2.the expression of VEGF in the Cartilage and subchondral bone in needle knife groupwas lower than model group and sodium hyaluronate group, which Indicated treatmentof needle knife may be achieved by reducing venous stasis.3. Needle knife and EA hasa good therapeutic effect on KOA, needle knife in improving the function of knee andreducing pain, has more advantages, but in the improvement of infrared thermalimaging had no significant difference than EA.4.the Acupotomy withultrasound-guided is safe and efficacious, which is worthy of being promoted. |
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