| BackgroundOsteoarthritis of the Knee is a chronic degenerative osteoarthritis which seriously endangers human health.At present,there are over 110 million patients suffering from gonarthritis in China,and the prevalence rate of patients with symptoms reaches 8.1%.The prevalence rate is positively related to age,and even related to all-cause mortality,and there is difference in gender.There were about 200000 knee arthroplasty in China in 2012,which brought great pain and financial burden to patients.OA will become the fourth most disabling disease in the world by 2020.Degenerative osteoarthritis of knee joint has become a major problem of human health in the world today,which causes a heavy economic burden to society and families.Currently,the etiology of osteoarthritis is still not fully understood.The mechanism of osteoarthritis is caused by degeneration of articular hyaline chondrocytes,variation and degradation of extracellular matrix,release of inflammatory cytokines and adhesion,thus inducing arthritis reaction,finally,the articular cartilage fibrosis results in joint pain and loss of function.The causes may be related to age,gender,occupation,race,obesity,accumulated strain,endocrine and metabolic abnormalities,environmental factors and other factors.Oral medicine and surgery have been used in western medicine to treat the disease.There are oral analgesics,non-steroidal anti-inflammatory drugs,which have large side effects,often cause adverse reactions in the digestive tract;cartilage protection agent takes a long time into effect,and the effect is not good.The operative methods include intra-articular injection,arthroplasty and so on.The patients have psychological and economic burden,thus refusing the treatment.In contrast,traditional Chinese medicine therapy has more advantages.Because of its simplicity,convenience,ease,cheap and good analgesic effect,acupuncture is widely used in the treatment of knee osteoarthritis.Dr.HuangShixi has used filiform-fire needle as a new type of fire needle in his clinical work for many years,which has a remarkable effect on the treatment of osteoarthritis of the Knee.As a general practitioner of traditional Chinese medicine in the community,most of the patients are middle-aged and elderly people.The prevalence of osteoarthritis of the Knee is relatively high.The disease has caused great pain to patients because of pain and disturbance of movement.Under the guidance of Dr.HuangShixi and after out-patient follow up study,the combination of filiform-fire needle and flash cupping therapy is effective in clinical practice,thus summarizing the experience of Dr.Dr.HuangShixi,and the curative effect of this method is further verified.ObjectivesTo sum up the clinical experience of Dr.HuangShixi in the treatment of osteoarthritis of the knee,observe the clinical curative effect of the treatment of knee osteoarthritis of the knee by the combination of filiform-fire needle and flash cupping,evaluate the effect of this method scientifically and objectively,and improve the effective rate of treatment of osteoarthritis of the knee,and finally used in clinical treatment widely.MethodsThis is a randomized,parallel control study,60 patients treated at Shichahai Community Health Service Center from March 2017 to December with osteoarthritis of the knee were randomly divided into observation group(n=30)and control group(n=30).The observation group was treated with the combination of filiform-fire needle and flash cupping,while the control group was treated with the method of filiform needle combined with flash.The patients of the two groups took the same acupoints.When operating,the patients in observation group were treated with a smooth juxtaposition of the No.2 glass can,the cupping was quickly fastened around the knee joint and sucked out for 10 times,which was suitable for local skin flushing.Living acupoint(the most severe pain,cord or nodule),EX-LE4,ST35 were selected to treat with filiform-fire needle,finally punctuate with mild reinforcing-reducing method,leave the needle in for 20 minutes.The patients in control group would not be treated with filiform-fire needle,the flash cupping and filiform needle method are the same with the method used in observation group.The frequency,duration and times of treatment were the same in the two groups,all of which were treated once every other day,3 times a week,and the treatment is end after 4 weeks.Visual analogue score(VAS)was performed before,at the 1st,2nd,3rd,4th week and 1 month after treatment.WOMAC score was performed before treatment,2 weeks after the first treatment,4 weeks after treatment and 1 month after treatment,and was evaluated the therapeutic effect.Results1 Intragroup comparison(1)The VAS score of the patients in two groups before treatment,1st,2nd,3rd,4th weeks of the treatment,compared with each time before treatment,p<0.01,indicating that the two groups of treatment are effective,both the observation group and the control group have obvious analgesic effect.(2)The WOMAC scores of the patients in two groups compared with pain,stiffness and motor function before treatment,2nd weeks.4th weeks of treatment and 1 month after the treatment,(p<0.05),which indicated that the two methods were effective.2 Inter-group comparison(1)VAS score:one week after treatment,the two groups:p>0.05,the pain status of the two groups was similar,from the treatment of the 2nd week,3rd week,4th week and follow-up period,the two groups:p<0.05.it indicated that the pain degree of the observation group was lighter than that of the control group.Therefore,it can be concluded that the short term curative effect of the observation group is similar to that of the control group(within 1 week),but in the long run,the effect of the observation group is better than that of the control group,and the curative effect is stable.(2)Comparison between the two groups at each time point after treatment and follow-up.In terms of pain scores by VAS and WOMAC,p<0.05,indicating that the analgesic effect of the observation group was better than that of the control group,and the analgesic effect was significant.The WOMAC score on the degree of joint stiffness,p>0.05,showing that the curative effect is similar in two groups,as for the improvement of joint motion,(p<0.05),which indicated that the observation group was superior to the control group.3 After treatment,the total effective rate of the observation group was 93.33%and the cured and markedly efficacy rate was 44.3%,while the total effective rate of the control group was 86.67%,and the cured and markedly efficacy rate was 66.7%.The results showed that the curative effect of the observation group was better than the control group in alleviating pain and improving knee joint movement.The curative effect of the observation group is accurate and stable.ConclusionThe observation group and the control group,two methods are both effective in the treatment of osteoarthritis of the knee.The observation group was superior to the control group in alleviating pain and improving daily function,and the curative effect still existed after one month after treatment.Compared with the control group,there is only one difference in the treatment method of observation group,filiform-fire needle,which verifies the clinical experience of professor HuangShixi in the treatment of osteoarthritis of the knee,and it is worth promoting in clinic. |
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