| ObjectiveThrough the acupuncture threatment of patients with knee osteoarthritis(KOA),observing the changes of Index of severity for osteoarthritis(ISOA),visual pain simulation score(VAS),synovial thickness and synovial effusion were compared before treatment,2 weeks after treatment and 4 weeks after treatment,the purpose was to evaluate the improvement of functional status of knee joint,synovial thickening and synovial sac hydrops in this study.MethodsThis study combined with KOA Chinese and Western diagnostic criteria,strictly included 30 patients with KOA complicated with synovial inflammation.Acupoints:local acupoints:Yin Ling Quan,Yang Ling Quan,A Shi points(knee swelling position);distal acupoints:Ji Mai,Bi Guan,Xuan Zhong,San Yin Jiao.Method of operation:The patient takes the supine position,slightly bends the knee,fully exposes the acupuncture site,and routinely disinfects the acupuncture site of the patient and the hands of the doctors with 75%alcohol.The needle are made of Andy brand,which are disposable sterile acupuncture needles.The specifications are 1.5 inches(25mm × 40mm)and 2 inches(30mm × 50mm).Specific operation method:local swelling of the knee joint edge,using 1.5-inch needle,oblique thorn,30°angle with the skin,punctured to the point of the tendon,the depth is about 0.57?0.8 inch;the 2 inch needle is used for the Ji Mai and Bi Guan acupoints,Straightly stabbing into about 1?1.5 inches,besides,Yin Ling Quan,Yang Ling Quan,Xuan Zhong,San Yin Jiao use 1.5 inch needles,straightly stabbing into about 0.5-1 inches.All acupoints should be filled and drained evenly to get the sense of Deqi.The knee joint was irradiated and the needles were retained for 25 minutes.Acupuncture treatment:3 times a week,once every other day,4 weeks for a course of treatment,12 times treatment totally.Observation index and evaluation time:ISOA scores,VAS scores,changes of synovial thickness and bursa effusion were recorded before treatment,2 weeks after treatment,and 4 weeks after treatment.The occurrence of shedding and adverse events during acupuncture treatment were recorded.Results1.Overall efficacy:After 2 weeks of treatment:0 people was cured,accounting for 0.00%;2 people were treated markedly effective,accounting for 8.33%.13 people were treated effectively,accounting for 54.17%.9 people were treated invalidly,accounting for 37.50%.The total effective number was 15,accounting for 62.50%.After 4 weeks of treatment:4 people were cured,accounting for 16.6%.8 people were treated markedly effective,accounting for 33.33%.12 were treated effectively,accounting for 50.00%.The total effective number was 24,and the total effective rate was 100.00%.After 4 weeks of treatment,compared with 2 weeks after treatment,the difference in efficacy was significant(p=0.00<0.01).2.Comparison of ISOA scores:(1)Comparison of total scores of ISOA scores:comparison of total scores of ISOA scores before and after treatment,treatment 2 Weeks,treatment for 4 weeks and before treatment,there was a significant difference,P<0.01;treatment 4 weeks and treatment 2 weeks,the difference was statistically significant,P<0.05.(2)Comparison of ISOA scores:After 2 weeks of treatment,compared with before treatment,the rest pain scores decreased significantly,the difference was statistically significant,P<0.05.The scores of exercise pain,tenderness,swelling,stiffness,walking ability decreased.The decrease was significant and there was a significant difference,P<0.01.After 4 weeks of treatment,compared with before treatment,the resting pain score decreased significantly,the difference was statistically significant,P<0.05;exercise pain,tenderness,swelling,stiffness,walking ability scores were significantly reduced,both have significant differences,P<0.01.After 4 weeks of treatment and after 2 weeks of treatment,the rest pain and stiffness scores were not significantly decreased,the difference was not statistically significant,P>0.05;the exercise pain and walking ability scores were significantly decreased,the difference was statistically significant,P<0.05.Tenderness and swelling scores were significantly decreased,all had significant differences,P<0.01.3.Comparison of VAS scores:Comparison of VAS scores before and after treatment,treatment 2 weeks,treatment 4 weeks compared with before treatment,and treatment 4 weeks compared with 2 weeks of treatment,there was a significant difference,P<0.01.4.Comparison of musculoskeletal ultrasound results:comparison of synovial thickness before and after treatment,treatment 2 weeks before treatment,and treatment 4 weeks and treatment 2 Weekly,the difference was not statistically significant,P>0.05.The difference was statistically significant at 4 weeks of treatment compared with before treatment,P<0.05.The depth of bursa effusion before and after treatment was compared.Compared with before treatment,and after treatment for 4 weeks,the difference was statistically significant,P<0.05.Compared with before treatment,treatment was extremely significant difference,P<0.01.Conclusions:1.From the perspective of the tendon,the local plus distal acupoints for the overall treatment of KOA complicated by synovial inflammation,the effect is significant.The overall functional status of the knee joint was improved,especially the exercise pain,tenderness,swelling.And walking ability were significantly improved after 2 weeks of treatment.The effect was more remarkable with the increase of acupuncture time.2.After 2 weeks of treatment,the sac effusion can be significantly improved.With the increase of acupuncture time,the thickness of the synovial membrane is also improved after 4 weeks of treatment,and the improvement of bursa effusion is also more significant.3.Musculoskeletal ultrasound objectively reflects the changes of synovial inflammation,It can be used as an observation index or therapeutic evaluation index of KOA complicated synovial inflammation,and be promoted in the clinic. |
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