Clinical Study On The Treatment Of Chronic Traumatic Synovitis Of The Knee Joint Based On IL-1β And TNF-α By The Massage Guided By "Doctrine Of Axis Meridians"

Objective: In order to observe the effects of by the massage theory under the guidance of doctrine of axis meridians on patients’ serum IL-1β and TNF-α levels,and to verify the clinical efficacy of the massage guided by "Doctrineof Axis Meridians" in the treatment of chronic traumatic synovitis of the knee.Methods: In this study,72 patients with chronic traumatic synovitis of the knee joint who met the diagnostic criteria were selected as the study subjects,and were divided equally into the Shujing Tui-na group which used pediatric massage therapy intervention based on the "Doctrine of Axis Meridians" guidance,and the conventional Tui-na group(36 cases each)according to the principle of random grouping.The duration of each treatment was about 20 min,with one treatment session per day and one rest day for six consecutive days,for a total of 12 treatment sessions.At the end of the treatment,the clinical efficacy of the treatment of chronic traumatic synovitis of the knee joint by the massage guided by "Doctrineof Axis Meridians" was evaluated from the changes in IL-1β and TNF-α levels in peripheral serum and VAS score,WOMAC osteoarthritis index.The final results and data obtained were statistically analyzed using SPSS 22.0.Results: A total of 72 cases were included in this study,and 3 cases were dislodged during the study,including 1 case in the massage group used pediatric massage therapy intervention based on the "Doctrine of Axis Meridians" guidance,and 2 cases in the conventional massage group,resulting in 69 cases in the final completed study.(1)Before treatment,the general data of gender,age,disease duration,affected knee,VAS pain score and WOMAC osteoarthritis index of the two groups,IL-1β and TNF-α levels in peripheral serum were statistically analyzed(P > 0.05),and the differences were not statistically significant and comparable.(2)Comparison of the degree of knee pain: The VAS pain scale was used for comparison.After treatment,the VAS pain scores of patients in both groups decreased,and the difference was statistically significant(P < 0.05);the VAS pain scores of patients in the massage group guided by "Doctrineof Axis Meridians" were lower than those in the conventional massage group,and the difference was statistically significant(P < 0.05).(3)Comparison of knee function: The WOMAC Osteoarthritis Index was used for comparison.After treatment,in terms of improving joint stiffness,the scores of patients in both groups were lower than before treatment,and the difference was statistically significant(P < 0.05);the scores of patients in the massage group which used pediatric massage therapy intervention based on the "Doctrine of Axis Meridians" guidance were lower than those in the conventional massage group,and the difference was not statistically significant(P > 0.05);In terms of improvement of joint pain,joint mobility and total WOMAC index score,the scores of patients in both groups were lower than those before treatment,and the difference was statistically significant(P < 0.05);patients in the massage group which used pediatric massage therapy intervention based on the "Doctrine of Axis Meridians" guidance had lower improvement of joint pain,joint mobility and total WOMAC index score than those in the conventional massage group,and the difference was statistically significant(P < 0.05).(4)Comparison of serum levels of inflammatory factors: The serum levels of IL-1β and TNF-α were measured by ELISA method for comparison.After treatment,the serum IL-1β and TNF-α levels in both groups decreased compared with those before treatment,and the difference was statistically significant(P < 0.05);the massage group guided by "Doctrineof Axis Meridians" was lower than the conventional massage group,and the difference was statistically significant(P <0.05).(5)Comparison of clinical efficacy: After treatment,the efficiency of the massage group which used pediatric massage therapy intervention based on the "Doctrine of Axis Meridians" guidance was 97.14%,and that of the conventional massage group was 88.24%,with no statistically significant difference(P >0.05).Conclusion(s): Both the massage guided by "Doctrineof Axis Meridians" treatment and conventional Tuina treatment have clinical efficacy on chronic traumatic synovitis of the knee joint,and two treatments can reduce IL-1β and TNF-α levels in patients’ serum,but the massage guided by "Doctrineof Axis Meridians" treatment is better than conventional Tuina treatment in relieving knee joint pain and improving joint function.