| Objective: By analyzing and summarizing the domestic and abroad studies of acupuncture and moxibustion treating for KOA between 2002 and 2017,we conclude therapies,the rules of selecting points,acupuncture characteristics and endpoints about treating KOA with acupuncture and moxibustion.In this study we are focused on providing a reference and new ideas for the clinical research and application of acupuncture treatment of KOA.Methods: This study combined computer searching and manual searching methods to screen qualified articles.Taking 2002.01~2017.07 as the time range,acupuncture and moxibustion and knee osteoarthritis as the main search terms and using.From China National Knowledge Infrastructure(CNKI),Weipu database,Chinese biomedicine literature database,Chinese academic discussion library,Chinese degree thesis library,National library of medicine(NLM),American patent comprehensive database(IFICDB),International patent document center database(INPADOC),we acquired the relevant randomized controlled study literature.Finally,we admitted 211 qualified articles through the inclusion and exclusion criteria for literature screening.We built the basic information database of acupuncture and moxibustion treating for KOA through the literature data which is extracted by the following entries,diagnostic criteria,methodology,interventions,the rules of selecting points,acupuncture methods,clinical curative effect evaluation,treatment results,etc.Then,we preprocessed the above data through the specification of the name of the disease,tacupuncture therapy,the type of syndrome,and the acupoints.In the end,this study mainly used the bibliometrics statistical method to analyze the clinical characteristics of acupuncture treatment of KOA from the following aspects: common therapies,the rules of points selecting,acupuncture technique,treatment duration and endpoint of treating KOA with acupuncture therapies.Results: 1.In this study,we admitted 211 qualified domestic and foreign literatures from 2002 to 2007,including 190 Chinese literatures and 21 English literatures.2.The main methods of acupuncture and moxibustion treating KOA include traditional acupuncture(67 articles,31.75%),warm acupuncture(60 articles,28.44%),cupping acupuncture(45 articles,21.33%),fire acupuncture(12 articles,5.69%)and moxibustion(10 articles,4.74%),etc.There are 86 articles using one intervention of acupuncture and moxibustion therapy.3.Regularities of selecting points(1)Frequency of acupoints: ST35(76.59%),EX-LE4(71.77%),GB34(57.56%),SP10(57.07%),ST36(53.66%),ST34(46.83%)and SP9(43.41%).(2)Acupoints distribution: most of points are concentrated on the Yangming Stomach Meridian of Food(388 times,31.29%,involving 10 points),the Taiyin Spleen Meridian of Food(243 times,19.60%,involving 7 points),and the Shaoyang Gallbladder Meridian of Food(154 times,12.52%,involving 7 points).(3)Most of the points are selected from Knee joint(844 times,63.06%,involving 19 points)and lower limbs(166 times,13.39%,involving 15 points),secondly in abdomen(116 times,9.35%,involving 13 points).(4)The regularity of using specific point: the He-sea points(363 times,involving 8 points)in five Shu points,secondly in the lower He-sea points(256,involving 4 points),eight influential points(155,involving 5 points)and Xi-cleft points(98 times,involving 2 points).(5)Results of correlation of acupoints compatibility: ST35?EX-LE4 and ST34 with the highest correlation(72.98%,confidence 90.44%);Secondly,EX-LE4,SP10,SP9 and ST35(72.98%,confidence 90.43%);EX-LE4,GB34,ST3 and ST35(60.35%,confidence 88.21%).4.Acupuncture operation(1)Deph of needling: The depthis 1~1.5 inches(38 articles,1013 cases)is the most common.The ST35 and EX-LE4 are concentrated between 0.5 and 1.5 inches(73 articles,1848 cases),and the SP9 is concentrated in 1~1.5(37 articles,1135 cases).(2)Reinforcing and reducing techniques: Using uniform reinforcing-reducing and reinforcing techniques as the main method treating KOA.The most commonly used technique reinforcing-reducing method is lifting thrusting and twirling(26 articles,583 cases),the second is twirling(11 articles,301 cases).(3)Needing retention: The retention time of needling is mostly between 20~45 minutes,especially 30 minutes(87 articles,2053 cases),with the interval of manipulating needle generally 15 minutes(21 articles,608 cases).5.The course of acupuncture treatment.(1)Needing frequency: One time a day is the most common choice(160 articles,75.83%).(2)Needing duration: 3 durations(64 articles,1875 cases)or more than three courses of literature accounts for the majority of the literature.A course of treatment is between 5~10 days,5 days for a period in the lead(47 articles,1397 cases).The total number of acupuncture days is concentrated in 21~35 days,especially in 26~30 days.6.The most common diagnostic criteria is American rheumatism association(51.66%).The most endpoint used is the VAS pain evaluation index(43.60%),second is WOMAC score(36.49%),third is Lysholm knee joint score(30.33%)and the Lequesne index(26.54%).Conclusion:(1)The acupuncture is the most commonly used treatment method.(2)The local points selection and the acupoint selection from involved meridians are emphasized,the application of specific acupoints,especially the He-sea points have the greatest superiorities in treating KOA.The points of ST35,EX-LE4,GB34,SP10,which near the knee joint are most commonly used.Most of points are concentrated in the Yangming Stomach Meridian of Food and the Taiyin Spleen Meridian of Food.(3)The basic rules of treating with generally acceptance is treating KOA with uniform reinforcing-reducing method and reinforcing techniques.The most commonly used technique reinforcing-reducing method is lifting thrusting and twirling.The duration of needling is mostly 30 minutes,with the interval of manipulating needle generally 15 minutes.(4)One time a day is the most common choice in needing frequency.The total number of acupuncture days is concentrated in 26~30 days.(5)The most commonly used diagnostic criteria for the treatment of KOA is the American rheumatism association diagnostic criteria.The most commonly used endpoint are the VAS pain rating scale and the WOMAC score. |
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