| BackgroundOsteoarthritis Knee (KOA) is a chronic degenerative osteoarthritis of the knee. Due to the influence of age and other factors, the joint synovial inflammation and injury, and then the destruction of the cartilage and synovial tissue, the ultimate dysfunction. Osteoarthritis of the knee is one of the main causes of joint pain, swelling and deformity. Articular cartilage damage and degeneration is the main manifestation of the disease early, late reactive hyperplasia of bone, then osteophyte formation, resulting in knee joint pain, stiffness, swelling, joint activities is limited and can be severe and disabling. The disease is more common in the elderly, and women are more common. The prevalence of the disease increases with the increasing of the population aging and the increase of the number of obese people.The etiology and pathogenesis of KOA are still unknown, so it is difficult to fundamentally block the development of the disease. Current treatment for KOA in order to relieve pain and improve joint function as the goal. Advocated by the American College of Rheumatology, the latest treatment scheme is based in education, exercise and weight loss, and adjunctive topical non steroidal anti-inflammatory drugs, if invalid, plus oral non steroidal anti-inflammatory drugs, acute attack feasible sugar corticosteroid injection in articular cavity, serious consideration joint replacement. For most clinical mild to moderate knee osteoarthritis, generally with non operative treatment, including publicity and education, physiotherapy, exercise and weight loss, protection and drugs have oral or topical anti-inflammatory analgesic drugs, intra-articular injection of drugs such as, but long-term use of painkillers or hormone drugs, on the body side effect is big. Some new treatment methods are also emerging, such as immune agents, biological agents, gene therapy, etc., but these technologies are not mature, cost is too high, still can not be popularized in clinical.As a non drug therapy, acupuncture treatment has a better curative effect on KOA. The efficacy of acupuncture in the treatment of KOA is positive, safe, non-toxic side effects, for patients with severe pain, there is a clear analgesic effect. The development of modern science and technology is driving the development of acupuncture therapy, and the tool of acupuncture therapy is also more and more diversified, among which the specific electromagnetic spectrum (TDP) is widely used in clinical practice. TDP through the heat radiation of far infrared, the elevated temperature of the focus, accelerate the blood circulation, improve metabolism, play to relieving pain, promoting tissue repair, the curative effect is good, safe and reliable. Moxibustion is a traditional thermotherapy and its combustion heat in the temple area, with cold dispelling pain, Qi and warming Yang, Xiaoyusan node, using the abundance in the cold syndrome and wind syndrome, arthralgia, its efficacy for a long time has been recognized by the doctors of traditional Chinese medicine (TCM and the folk is widely used. But due to the moxibustion greater smoke, smell strong, at the same time the human cost, in the clinical operation easy because of negligence cause burns, part of the medical staff for the pursuit of simple and safe, TDP as a warm therapy tool, with TDP irradiation lesions to locally elevated temperature and auxiliary needle acupuncture treatment. Moxibustion therapy is the essence of the traditional medicine, TDP is the crystallization of science and technology, both in clinical very common, but concerning moxibustion and TDP to contrast the efficacy of the literature rarely involved, and relevant literature test results from lack of reference value, so the difference of moxibustion and TDP curative effect discussion there has been no conclusion. In this study, we observed the therapeutic effect of moxibustion and TDP assisted acupuncture on mild and moderate KOA, and compared the curative effect between two and TDP.ObjectiveComparising the therapeutic effect of moxibustion and TDP in the treatment of mild to moderate KOA.MethodAccording to the method of random grouping of 66 cases of KOA patients, according to the computer, the method was divided into Electroacupuncture plus moxibustion group and Electroacupuncture plus TDP group,33 cases in each group. Electroacupuncture plus moxibustion acupuncture group within the knee eyes, the knee eyes, Liangqiu, Xuehai, Yin Ling Quan, Yanglingquan, Xiyangguan, commission, Zusanli, Sanyinjiao, Taixi, electroacupuncture on, respectively imposed on the eye of the knee and knee eyes, Yin Ling Quan and Yanglingquan, use dense wave,2/100 Hz, lit two moxibustion moxibustion box is arranged in the knee above, the patients feel comfortable and warm slightly hair hot for the degree, treatment time of 30 minutes, once every other day, three times a week were treated 10 times. Electro acupuncture plus TDP group of acupuncture points, acupuncture, treatment and Electroacupuncture plus moxibustion group is the same, the TDP radiation on the upper part of the patient’s knee, with the patient feel warm and comfortable slightly hot for the degree. The visual analogue scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as indicators of efficacy, respectively before treatment, treatment, after treatment and after treatment for 1 month follow-up records the scores.Results(1) the test included 66 subjects, the final 61 cases according to the established plan completed the treatment and follow-up, including 31 cases of acupuncture plus moxibustion group, electroacupuncture plus TDP group of 30 cases. The total loss rate was 7.56%. There was no serious adverse reaction in the course of the study.(2) at the end of the treatment, the VAS scores in the electro acupuncture plus moxibustion group for (1.03+0.67) was significantly lower than that before treatment (2.67+0.84) score (P< 0.05); Electroacupuncture plus TDP group VAS score was 0.85+0.68), significantly lower than the before treatment (2.68+1.22) (P < 0.05).At follow-up, electro acupuncture plus moxibustion group VAS score for (+1.43 0.73), was significantly lower than that before treatment (2.67+0.84) points (P< 0.05); Electroacupuncture plus TDP group VAS score for (1.33+1.03), significantly lower than the before treatment (2.68+1.22) (P< 0.05).(3) Electroacupuncture plus moxibustion treatment group at the end of the WOMAC gross, follow-up WOMAC gross, significantly lower than before treatment gross (P< 0.05); at the end of the treatment, follow-up pain score, stiffness scores and joint dysfunction score, significantly lower than before treatment (P< 0.05) score.Electroacupuncture plus TDP group at the end of treatment, total WOMAC, follow-up WOMAC gross, significantly lower than before treatment gross (P< 0.05); at the end of the treatment, follow-up pain score, stiffness scores and joint dysfunction score, significantly lower than before treatment score (P< 0.05).Reduced compared to reduce total WOMAC compared with before treatment, acupuncture and moxibustion treatment group (18.89+1.21), and Electroacupuncture plus TDP group decreased (12.691.03+), the difference was not statistically significant (P> 0.05); pain score (4.18+276), joint dysfunction decreased (12.93+ 935), and Electroacupuncture plus TDP group decreased (3.08+2.98) and (8.73+ 691) compared to the difference was not statistically significant (P> 0.05); and stiffness score decreased (1.86+1.24), was significantly higher than that of Electroacupuncture plus TDP group decreased (1.15+1.62) (P< 0.05).Compared with before treatment, electro acupuncture plus moxibustion group follow-up total WOMAC reduces the (15.43+1.22), and Electroacupuncture plus TDP group decreased (13.12+116) compared, the difference was not statistically significant (P> 0.05); pain score decreased (3.18+2.58), stiffness score reduced (1.54+1.23), joint dysfunction score reduced (10.76+958), and Electroacupuncture plus TDP group reduced the pain of 3.09+3.33 points, reduce the stiff (1.15+1.71), joint dysfunction, decreased the (+8.318.28) compared, the difference was not statistically significant (P> 0.05);(4) in evaluating efficiency, electro acupuncture plus moxibustion group, clinical control cases (0.00%),24 cases were markedly effective (77.42%), effective in 6 cases (19.35%), invalid in 1 case (3.23%). The total efficiency was 96.77%; Electroacupuncture plus TDP group control in 3 cases (10.00%), effective in 17 cases (56.67%), effective in 7 cases (23.33%), ineffective in 3 cases (10%), effective rate was 90.00%, the total effective rate between the two groups is no significant (P< 0.05). It showed that the therapeutic effect of Electroacupuncture plus moxibustion and Electroacupuncture plus TDP in treating KOA is similar or the same.(5) follow up analysis:two groups of VAS score and WOMAC score comparison, electro acupuncture plus moxibustion group and electro acupuncture plus TDP group difference was not statistically significant (P>0.05). The long term effects of the two groups were similar or the same.(6) safety analysis:This clinical trial of patients without fainting, needle, broken needle, hematoma, etc., treatment and after treatment does not appear physiological indexes such as blood pressure, heart rate, respiration, pulse, sleep abnormalities, indicating that electro acupuncture combined with moxibustion or TDP treatment of KOA is safe.Conclusion1 Moxibustion and TDP assisted electro acupuncture therapy for KOA is safe;2 Moxibustion and TDP in the auxiliary acupuncture treatment of KOA have better clinical efficacy;3 Moxibustion to improve the efficacy of joint stiffness is better than TDP;4 Moxibustion is similar to TDP in improving the knee pain, dysfunction. |
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