The Clinical Research On Treatment Of Knee Osteoarthritis Of The Yang Deficiency And Cold Coagulation Type By Warm Needle Moxibustion

ObjectiveBy observing clinical syndrome score before and after the treatment, as well as the content fluctuation of IL-1? and TNF-? in serum, this research evaluated the clinical curative effect of warm needle moxibustion for treating knee osteoarthritis of yang deficiency and cold coagulation type. To provide reference for further research and clinical application, the mechanism has been explored as well.Method60 cases of patients with knee osteoarthritis, who had been diagnosed with the dialectical type of yang deficiency and cold coagulation, were randomly divided into two even groups, one being warm acupuncture group and the other being western medicine group. In the warm acupuncture group, acupoints like Guanyuan(RN4),Qihai(RN6),Neixiyan(EX-LE4),Waixiyan(EX-LE5),Liangqiu(S T34), Xuehai(SP10), Yanglingquan(GB34), treatment once a day and six times a week. Patients can get rest on sunday. A course of treatment consisted of two weeks, and there are altogether two courses. The western medicine group patients were on diclofenac sodium sustained release tablets, 75 mg each time,once a day, fourteen days for a course of treatment, and there are altogether two courses. The WOMAC score, Lequesne MG score, and the content of IL-1? and TNF-? were recorded before and after treatment in these two groups. After two courses, indicators were compared and analyzed respectively with SPSS17.0,and to evaluate the clinical efficacy.Results1. Comparison of content change of IL-1? and TNF-?: Before and aftertreatment, warm acupuncture group and western medicine group in the IL-1? and TNF-? content within the group comparison there was very significant difference(P<0.01). After treatment, differences of IL-1? and TNF-? levels between two groups were statistically significant(P<0.05), suggesting that IL-1? and TNF-?levels in serum decreased in both groups, but warm acupuncture group displayed the lower degree than those of the western medicine group.2. WOMAC score comparison: Before and after treatment, the two groups WOMAC total score, pain score, stiffness score and functional activity score within group compared with the difference was very significant(P<0.01). After treatment, the two groups of pain score between the groups was not statistically significant(P>0.05), the two groups of the total score, stiffness score, function activity score between the groups were compared with a very significant difference(P<0.01). The result proved that both methods can alleviate patients' joint pain, stiffness, and functional disability. As both methods have played an equal role in alleviating the pain, warm acupuncture group was superior to the western medicine group in reducing the joint stiffness and boosting functional activities. Thus, the curative effect of warm acupuncture method was better than that of the western method.3. Lequesne MG score comparison: Before and after the treatment, both groups showed a manifest difference in Lequesne MG scale system(P<0.01).After treatment the difference was statistically significant(P<0.05) between the two groups, which justified the fact that both methods can lower the Lequesne MG score, alleviate the symptoms. However, the effect from warm acupuncture group was better.4. Comparison of efficacy: The total effects from warm acupuncture group and the western medicine group were 90.00% and 73.33% respectively. There was statistic difference in the total efficiency of both groups(P<0.05), indicating that the overall effect of the warm acupuncture group was better than that of thewestern medicine group.Conclusions1. In treating the knee osteoarthritis of yang deficiency and cold coagulation type, the overall effect of warm needling moxibustion is better than the western medicine of diclofenac sodium sustained release tablets.2. Warm needle moxibustion can effectively relieve symptoms of pain,stiffness and dysfunction in patients, the efficacy of warm needle moxibustion and diclofenac sodium sustained release tablets is fairly in the relief of the symptoms of pain3. Warm needle moxibustion can significantly reduce the content of IL-1?and TNF-? in serum, which may be the mechanism of warming needle moxibustion in treating knee osteoarthritis;4. Warm needle moxibustion treatment played an significant role in treating the knee osteoarthritis of yang deficiency and cold coagulation type. Given its uncomplicated manipulations and no side-effect, it is worthy of further clinical application.