| Objective:The pain of the knee osteoarthritis(KOA)was treated with Thumb-tack Intradermal Needle and Emulsion of Votalin respectively through clinical randomized controlled study.The pain.VAS.gravity index,the muscle strength of quadriceps femoris and WOMAC scores were compared before and after treatment in order to evaluate the curative effect of Thumb-tack Intradermal Needle and Votalin on the pain of knee osteoarthritis,and to clarify the clinical effect and advantage of the treatment of knee osteoarthritisMethods:1 Source of casesA total of 66 patients with knee osteoarthritis who met the inclusion and exclusion criteria were included in this study.All patients were treated in the outpatient service of the First Department of Orthopedics,Wangjing Hospital of China Academy of Chinese Medical Sciences from October 2017 to February 20182 Cluster of casesA total of 66 patients with KOA who met the inclusion and exclusion criteria were randomly grouped by random number table.The two groups were the experimental group(Thumb-tack Intradermal Needle group)and the control group(Votalin group)3 Methods of treatment3.1 The experimental group(Thumb-tack Intradermal Needle group)To select the obvious tenderness point(soft tissue injury point)around the knee joint and 2-3 reaction points(nodule,mass,cord)of the patients by palpation as treatment point.To disinfect the treatment point routinely and use disposable sterile Thumb-tack Intradermal Needle(specification:0.25x2.0mm),to open the package and take out the product(take off the paper).The needle body is pricked quickly into the skin of the treatment point.To peel off the paper again after sticking up.and then finish the treatment operation after gently press the adhesive tape from above.The experimental group was treated once every other day and continued for 48 hours.After the next treatment,the Thumb-tack Intradermal Needle would be taken out.The experimental group was treated three times a week for 2 weeks.A course of treatment was given in the experimental group.During the treatment,the patients were instructed to do exercise about the muscle strength of quadriceps femoris.The treatment should pay attention to asepsis operation.3.2.Control group(Votalin group)Emulsion of Votalin was rubbed at the skin position of the pain at the knee.According to the size of the painful area of the knee joint,to select the appropriate Votalin,of which usually select the length of 3-5 cm.To rub the affected area with your fingers gently and assist to make this product into the skin,direct to the affected area.Votalin group was treated 3 times a day,2 weeks a course of treatment,a total of treatment for a course of treatment.During the treatment,the patients were instructed to do exercise about the muscle strength of quadriceps femoris.3.3 The treatment period and the follow-upThe Thumb-tack Intradermal Needle group and Votalin group were treated both 2 weeks.The patients in two groups were observed and recorded the adverse events at 2 time points before and after the treatment respectively and follow-up were performed 1 month after the end of treatment to observe the efficacy,incidence of adverse events and evaluate safety.4 Diagnostic criteriaClinical diagnostic criteria are based on the diagnostic criteria of knee osteoarthritis established by the Rheumatology Branch of the Chinese Medical Association in 2010.Kellgren-Lawrence(K-L)was selected as the criteria for imaging diagnosis of osteoarthritis.5 Measures of therapeutic effect observationThe tenderness,bipedal back and forth load,and the muscle strength of quadriceps femoris were measured by biomechanics.The gravity index was calculated by computational formula of the gravity index.The VAS score and WOMAC scores were performed to observe.6 Standard for clinical efficacy evaluationThe clinical effect was judged according to the relevant criteria in 22 Chinese medical treatment plans of 95 diseases in 22 specialties and according to the changes of WOMAC scores.7 Statistical methodsSPSS 19.0 software was used to analyze the data.The ?2 test was used for the comparison of sex.location of disease,and Kellgren-Lawrance imaging grade in two groups of patients.Age,course of disease,body mass index,the muscle strength of quadriceps femoris.gravity index,tenderness value,VAS score and WOMAC scores were compared with t test.The level of examination was a=0.05.Results:1 General informationThere were 66 patients in this trial,all of w hom were admitted to the Department of Orthopaedic Surgery of Wangjing Hospital,Chinese Academy of Traditional Chinese Medicine,who met the criteria for diagnosis,inclusion and exclusion of knee osteoarthritis,The membership period is from October 2017 to February 2018.There were 33 cases in the experimental group,including 15 males and 18 females.The left knee was 17 cases and the right knee was 16 cases.Age 45-69 years with an average age of 59.55±6.84 years;The course was from 3 to 72 months with an average duration of 20.88±13.69 months.The control group consisted of 33 cases,including 13 males and 20 females.The left knee was 14 cases and the right knee was 19 cases.Age 45-69 years with an average age of 58.55±7.00 years;The course was from 3 to 70 months with an average duration of 21.70±13.37 months.One case in the experimental group and two cases in the control group were lost.Sixty-three patients completed treatment and received follow-up,including 32 in the experimental group and 31 in the control group.No adverse reactions were found.The sex,age,side,course of disease,BMI,Kellgren-Lawrence scores were not statistically significant.indicating that the two groups had the same baseline,and were comparable.2 Overall EfficacyAfter two weeks of treatment,the curative rate and the total response rate were 75.00%and 93.75%in the trial group,which in control group were 58.06%and 83.87%.There was no significant difference between the two groups(Z=-1.180,P=0.238),suggesting that both Thumb-tack Intradermal Needle and Votalin had similar clinical efficacy in the treatment of KOA patients.3 Comparison between the pre-treatment and post-treatment in two groups,and the treatment group and control group after therapy.3.1 comparison of the results in the two groups before and after treatmentBy comparing the muscle strength of quadriceps femoris,gravity index,tenderness value,VAS score and WOMAC scores of the two groups before and after treatment,we found that two groups of patients with knee osteoarthritis after treatment,there were significant differences in quadriceps muscle strength,gravity index,tenderness value,VAS score and WOMAC scores(P=0.000<0.01).3.2 comparison of the results between the two groups after treatmentThe comparison of knee joint tenderness between the two groups before and after treatment showed that there was significant difference between the two groups(t=2.438,P=0.018<0.05),indicating that the improvement in the tenderness of press for patients with osteoarthritis of the knee treated by Thumb-tack Intradermal Needle was better than that by Votalin.The VAS score before and after treatment was compared between the two groups.The results showed that there was significant difference between the two groups(t=-2.237,P=0.029<0.05),indicating that the improvement in the tenderness of press for patients with osteoarthritis of the knee treated by Thumb-tack Intradermal Needle was better than that by Votalin.The muscle strength of quadriceps femoris before and after treatment was compared between the two groups.The results showed that there was significant difference between the two groups in the improvement of the muscle strength of quadriceps femoris(t=2.563,P=0.013<0.05),indicating that the improvement in the muscle strength of quadriceps femoris for patients with osteoarthritis of the knee treated by Thumb-tack Intradermal Needle was better than that by Votalin.The gravity index before and after treatment was compared between the two groups.The results showed that there was significant difference between the two groups(t=0.068.P=0.946>0.05).The WOMAC scores before and after treatment was compared between the two groups.The results showed that there was significant difference between the two groups(t=-1.627,P=0.109>0.05).Conclusions:1 Both the Thumb-tack Intradermal Needle therapy and Votalin emulsion have the same curative effect in the treatment of knee osteoarthritis.They can improve the level of bipedal back and forth load and improve the pain,the muscle strength of quadriceps femoris and function of the affected knee.2 The treatment of Thumb-tack Intradermal Needle is superior to Votalin emulsion in analgesia and improving the muscle strength of quadriceps femoris.3 The treatment of Thumb-tack Intradermal Needle has no side effects,is simple,easy to operate and has high safety,and is suitable for further clinical application. |
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