Clinical Effect Of Traditional Chinese Spinal Orthopedic Manipulation In Treatment Of Chondromalacia Patellae

[Objective]To evaluate the clinical effect and the treatment effect of traditional Chinese spinal orthopedic manipulation(TCSOM)in treating chondromalacia patellae(CP)in comparison with Celecoxib Capsules.[Methods]60 cases of CP patients were observed in this study,and all of whom were recruited from the outpatient department of Zhongda Hospital between 2013 and 2015.This study was approved by The Medical Ethics Committees of the Southeast University.All persons signed their informed consent prior to their inclusion in the study.The patients were randomly assigned to two groups according to the random method,and each group has 30 cases.One group was treated with Traditional Chinese Spinal Orthopedic Manipulation(TCSOM)and the other with a pharmaceutical drug.The study group was treated with the above mentioned spinal manipulation methods,once two days before the two weeks,and once 3 days after the two weeks.All the patients in the study group were treated with 10 times.The control group was treated with celecoxib capsules for 200 mg once daily for 4 weeks.The Kujala functional knee scoring system(KFKSS)and the visual analog scale(VAS)were performed before the first treatment,after 4 weeks of treatment and after the end of treatment 3 months later.The efficacy was determined by symptom improvement rating(SIR),and recorded in the two groups of adverse reactions.The data obtained from this study was processed using the Statistical Product and Service Solutions(SPSS)package 13.0(IBM Corporation,Armonk,NY,USA).The measurement data were analyzed by variance analysis or t test.The chi-square test was used to analyze the counting data.The test level is a =0.05.[Results]The study group(n=30)included 9 men and 21 women,with ages ranging from 18 to 60 years[(42±11)years].The control group(n=30)included 11 men and 19 women,with ages ranging from 19 to 58 years[(42± 10)years].There were no significant differences in gender,age,course of disease,severity of disease between the two groups(P>0.05).All 60 patients completed the 4 weeks treatment protocol and 3 months follow-up.After 4 weeks of treatment and 3 months follow-up,the KFKSS score of the study group(TCSOM group)was significantly higher than that of the control group(celecoxib group)(P<0.01),VAS score was significantly lower than the control group(celecoxib group)(P<0.01).According to the SIR,which was based on the VAS and KFKSS,the TCSOM group included 10 cases with excellent results,13 cases with good result,3 cases with fair and 4 cases with poor result,and the effective rate is 86.7%.The Celecoxib group had 4 cases with excellent results,8 cases with good results,5 cases with fair results and 13 cases with poor results,and the effective rate is 56.7%.The effective rate was significant difference between the two groups(P<0.01).The improvement of symptoms in the study group(TCSOM group)was significantly higher than that in the control group.There were no adverse reactions in the study group(TCSOM group),and 2 cases of mild discomfort in the control group(celecoxib group).[Conclusion]TCSOM had greater efficacy than Celecoxib for relief of the symptoms of CP.Thumb pressing manipulation on jiaji points and the obliquely pulling manipulation in the lumbar region,applied mostly from L1 to L3,can correct the displacement of inter-vertebral discs and/or vertebra,resolving the stimuli caused by pressure being exerted on the nerves which pass through the intervertebral foramen.TCSOM also can dredge the meridians,promote flow of qi and blood circulation,replace and/or reduce displaced anatomic sites to relieve knee joint pain.