Objective: By comparing the efficacy of Acupuncture combined with bloodletting at Heding Point and Intra-articular injection of sodium hyaluronate with oral meloxicam,Provide a better,convenient and safe treatment for Blood stasis block Knee osteoarthritis.Methods: 90 cases of osteoarthritis of knee joint with stasis and blood block were divided into control group(articular injection of sodium hyaluronate and oral meloxicam tablet group)and experimental group I(acupuncture group)according to the random number table method.30 cases in the experimental group II(acupuncture combined with bloodletting at the top of the crane acupoint).The control group was injected with sodium hyaluronate injection once a week for 8 consecutive weeks,and meloxicam was orally administered at 7.5 mg twice daily for 1 to 2 weeks.The experimental group I used simple acupuncture once a day for 2 weeks as a course of treatment.After each course of treatment,the patients were rested for 3 days and treated continuously for 8weeks.Acupuncture combined with bloodletting at Heding acupoint was used in the experimental group II.The method and course of acupuncture were the same as those in the experimental group I.The bleeding was performed 2times a week for 8 consecutive weeks.VAS score and WOMAC score were used to evaluate the improvement of pain and arthritis in the three groups after the 4th and 8th weeks of treatment.At the 8th week of treatment,physical examination(joint tenderness,swelling,activity)scores were used.Assess theimprovement of joint signs.Assess the efficacy and safety of TCM syndrome scores.Result:(1)VAS scale pain score:Patients in the control group,experimental group I,and experimental group II before treatment were 7.23,7.20,and 7.53,respectively.There was no significant difference between the groups(P>0.05).After the fourth week of treatment,the average scores of the three groups were 5.47,6.07,and 5.50.Compared with the pre-treatment,the scores of the three groups were lower than before(P <0.05),and there was no significant difference between the groups(P> 0.05).After the 8th week of treatment: the average scores of the three groups were: 4.50,4.47,and 2.60,of which there was a statistically significant difference between experiment II and control and experiment II and experiment I(P <0.05);Combining with the score results,in terms of pain relief,the treatment methods of the three groups on the 4th week of treatment all improved the patients’ pain,but there was no significant difference in the efficacy of each group;After the 8th week of treatment,it was shown that the acupuncture combined with the Heding acupoint bloodletting group was more effective than the acupuncture alone group,the joint cavity injection of sodium hyaluronate combined with the oral meloxicam tablet group.(2)WOMAC scale score: the average scores before treatment in the three groups were 177.70,176.60,and 180.17;there was no significant difference between the groups(P> 0.05).After 4 weeks of treatment,the average scores of the three groups were 92.03,119.63,and 115.66,which were all lower than before(P <0.05).The control group and the experimental group I(P <0.05)were compared with the experimental group II(P = <0.05).After 8weeks of treatment,the three groups were equally divided into 70.50,60.83,and 41.23.The comparison between the control group and the experimental group II(P <0.05);the comparison between the experimental group II and theexperimental group I(P <0.05),the differences were statistically significant.The average scores of the patients in the three groups were 78.23,56.97,and38.37.The differences between the control group and the experimental group I,the control group and the experimental group II,and the experimental group I and the experimental group II were statistically significant(P<0.05).Combined with the scoring results: It can be considered that after 4weeks of treatment,knee arthritis in the three groups of patients was significantly improved,and the joint cavity injection of sodium hyaluronate combined with oral meloxicam tablets group were all better than the acupuncture group alone,acupuncture combined with crane crown The acupoint group had excellent bloodletting;after 8 weeks of treatment and follow-up scores,acupuncture combined with heding acupoint was better than joint cavity injection of sodium hyaluronate combined with oral meloxicam group and acupuncture alone group.(3)Physical examination(knee tenderness,swelling,and mobility)scores: The average scores before treatment in the control group,experimental group I,and experimental group II were 12.41,12.90,and 12.57,respectively.(P>0.05).On the 8th week of treatment,the average physical examination scores were 6.62,6.32,and 4.57,respectively.Compared with the experimental group II and the control group,and the experimental group II and the experimental group I,the differences were statistically significant(P <0.05).Combined with the scoring results,it can be considered that the acupuncture combined with Heding acupoint bloodletting group is better than the joint cavity injection of sodium hyaluronate combined with oral meloxicam and simple acupuncture in improving joint tenderness,joint swelling and joint mobility group.(4)In terms of the total efficacy of the WOMAC scale,the total effective rate(97%)of the acupuncture combined with crane top bloodletting group was better than that of the joint cavityinjection of sodium hyaluronate combined with the oral meloxicam group(73%),and the simple acupuncture Thorn group(66%).(5)TCM syndrome scores: Before treatment,the average scores of TCM syndrome scores of patients in the control group,experimental group I and experimental group II were 11.40,11.27,and 11.23,respectively.There was no significant difference between the groups(P> 0.05).After the 8th week of treatment,the average scores of TCM syndrome scores of the three groups were 7.17,6.43,and 4.93,respectively.The differences between the control group and the experimental group II and the experimental group I and the experimental group II were statistically significant(P <0.05).Combining the data results,it can be considered that the TCM syndromes of the three groups were significantly improved after 8 weeks of treatment.The improvement of TCM syndromes of the acupuncture combined with Heding acupoint bloodletting group was better than the joint cavity injection of sodium hyaluronate combined with oral meloxicam tablets.And pure acupuncture group.In the total effective rate of TCM syndrome score,the acupuncture combined with crane top bloodletting group(97%)was superior to the joint cavity injection of sodium hyaluronate combined with oral meloxicam tablet group(80%)and the simple acupuncture group(78%).(6)Safety evaluation: The three groups of patients were counted the number of adverse reactions during the treatment period after the end of the 8th week of treatment: 276 in the control group,108 in the experimental group I and 134 in the experimental group II.Conclusion:1.Relieve arthritis: In the short-term effect of treatment time less than 4 weeks,the joint cavity injection of sodium hyaluronate combined with oral meloxicam tablets is better than acupuncture combined with bloodletting at Heding point and ordinary acupuncture For long-term effects> 8 weeks,acupuncture combined with bleeding from Heding acupoint is superior toacupuncture alone and intravitreal injection of sodium hyaluronate combined with oral meloxicam.2.Improve joint tenderness,swelling,joint flexion angle and other signs: Acupuncture combined with bleeding from Heding acupoint is better than acupuncture alone and sodium hyaluronate injected into the joint cavity combined with oral meloxicam.3 In the degree of improvement of TCM syndromes,acupuncture combined with crane top bleeding is better than joint cavity injection of sodium hyaluronate combined with oral meloxicam tablets and ordinary acupuncture.4 In terms of safety,the acupuncture combined with crane top bloodletting group is equivalent to the ordinary acupuncture,both of which are higher than the joint cavity injection of sodium hyaluronate combined with oral meloxicam tablet group. |