Clinical Observation On The Treatment Of Knee Osteoarthritis By Ginger-separated Moxibustion Combined With Electro-acupuncture

OBJECTIVETo observe the clinical effect of ginger-separated moxibustion combined with electroacupuncture on osteoarthritis of knee joint(knee osteoarthritis,KOA),and to explore the therapeutic mechanism of this therapy in order to form an accurate and effective clinical treatment standard.METHODSIn this study,60 patients with KOA who met the inclusion criteria in our department were selected and single blind method was used.According to the order of treatment,they were randomly divided into three groups:ginger-separated moxibustion treatment group,common moxibustion treatment group and routine electroacupuncture control group(20 cases in each group).Ginger-separated moxibustion was performed at the same time of routine electroacupuncture treatment of knee joint ginger-separated moxibustion,once every other day,three times a week for a total of 4 weeks.The common moxibustion group was treated with routine electroacupuncture and moxibustion box moxibustion,once every other day,3 times a week for 4 weeks.The control group was treated with electroacupuncture at conventional acupoint once a day,6 times a week for 4 weeks.The three groups were named A,B and C,respectively.After the qi sensation,the patients in the three groups were treated with electroacupuncture(dense wave,2~100 Hz,according to the patient’s tolerance),and the needle was retained for 20 minutes.VAS,Lysholm WOMAC scale was used to determine the clinical efficacy of the three groups before and after treatment,and the recurrence rate was counted 6 months after the end of treatment.Statistical method was used to analyze the observation indexes,and the efficacy and safety of ginger-separated moxibustion combined with electroacupuncture in the treatment of KOA were evaluated.RESULTS1.VAS score:the VAS scores of the three groups before and after treatment were statistically analyzed,p_A,p_B,p_C were<0.001.There was statistical difference,indicating that the three treatment methods are effective to improve pain.After treatment,the difference of VAS score between group A and group B was statistically analyzed.There was significant difference between group A and group B(p≤0.013<0.05).Compared with group C,p≤0.027<0.05 in group A,which was statistically significant.It shows that ginger-separated moxibustion combined with electroacupuncture is obviously superior to ordinary moxibustion and conventional electroacupuncture in relieving pain.2.Lysholm scale:Before and after treatment,Lysholm scores of the three groups were statistically analyzed by t test:p_A=0.001,p_B<0.001,and p_C<0.001,which proved that group A,group B and group C were effective in improving Lysholm score.The difference of Lysholm score between the three groups was compared.After pairwise comparison,the difference between group A and group B was different,p=0.002<0.05;the difference between group A and group C was different,p<0.001;and there was no difference between group B and group C,p=0.066>0.05.It is reasonable to think that group A is superior to group B and C in improving Lysholm score.3.WOMAC scale(1)Pain index:The WOMAC pain score of the three groups before and after treatment was statistically analyzed,p_A,p_B,p_C were<0.001.There was statistical significance,indicating that the three treatment methods are effective to improve pain.After treatment,the difference value of WOMAC pain score in the three groups was statistically analyzed.After pairwise comparison,there was a difference between group A and group B,p=0.014<0.05,The difference value between group A and group C was different(p=0.037<0.05),and that between group B and group C was different(p=0.023<0.05).It was proved that group A was superior to group B and C in reducing WOMAC pain score,and group B was better than group C.(2)Stiffness index:The WOMAC stiffness index of the three groups before and after treatment was statistically analyzed.P_A=0.003,P_B<0.001,P_C=0.002,p<0.05,and there was significant difference between the three groups.It shows that the three treatment methods are effective in improving joint stiffness.After treatment,the difference value of WOMAC stiffness index in the three groups was statistically analyzed.After pairwise comparison,the difference between group A and group B was different.p=0.034<0.05;The difference between group A and group C was different,p=0.029<0.05,but there was no difference between group B and group C,p=0.076>0.05.The results showed that group A had more advantages than group B and C in improving rigidity.(3)Range of motion of knee joint:There were significant differences between the three groups before and after treatment,p_A=0.001,p_B<0.001 and p_c=0.001,which indicated that the three treatment methods were effective to improve the range of motion of the joint.After treatment,the difference value of daily range of motion of knee joint between group A and group B was different,p=0.013<0.05,and the difference between group A and group C was different,p=0.025<0.05.the difference between group B and group C was different,p=0.019<0.05.The results showed that the effect of group A was better than that of group B and C,and the effect of group B was better than that of group C.4.Recurrence rate:The recurrence rates of the three groups were 12.5%,35.71%and 28.57%,respectively.the recurrence rate of group A was lower than that of group B and C.It is reasonable to believe that ginger-separated moxibustion combined with electroacupuncture is more effective than ordinary moxibustion and conventional electroacupuncture in long-term curative effect.A total of 60 cases were included in this sample,all of which completed the course of treatment for 4 weeks.In the recurrence rate statistics,due to personal reasons,there were 4 patients in group A,6 patients in group B and 6 patients in group C,which were unable to complete the follow-up.CONCLUSIONSThrough observation,it is found that ginger-separated moxibustion、ordinary-moxibustion with electroacupuncture,and conventional electroacupuncture have certain therapeutic effects on KOA,and ginger-separated moxibustion is more effective than conventional moxibustion and conventional electroacupuncture in the treatment of KOA.The feedback of long-term therapeutic effect was also better than that of the other two groups.