Electroacupuncture combined with thunder-fire moxibustion for knee osteoarthritis of cold-damp type:A randomized controlled trial

Objective:To observe the clinical effect differences of knee osteoarthritis(KOA)with cold-damp type between electroacupuncture(EA)combined with thunder-fire moxibustion and medication.Methods:A total of 72 cases of KOA patients with cold-damp type were randomly divided into a combined treatment group of EA and thunder-fire moxibustion(combined treatment group)and a medication group,36 cases in each group.In the combined treatment group,the acupoints for EA were Dubi(犊鼻ST35),Neixiyan(内膝眼EX-LE4),Zusanli(足三里ST36),Yanglingquan(阳陵泉GB34),Yinlingquan(阴陵泉SP9),Xuehai(血海SP10),Liangqiu(梁丘ST34)and Heding(鹤顶EX-LE2).During the period of EA,the suspending thunder-fire moxibustion was applied to Shenque CV8)and Guanyuan(关元CV4).In the medication group,diclofenac sodium double release intestine-sol capsule and Fugui gutong capsules were prescribed for oral administration.The treatment for 14 days was taken as one course and the consecutive 2 courses of treatment were required in each group.Before and after treatment,as well as in the follow-up visit,the pain score(visual analogue scale,VAS),the knee function score(Western Ontario and McMaster University,WOMAC,the expressions of interleukin 6(IL-6)and transforming growth factorβ1(TGF-β1)in the joint fluid as well as the difference in the clinical therapeutic effect were observed in the two groups separately.Results:(1)The pain score:compared with those before treatment,the VAS scores were all reduced after treatment and in the follow-up in the two groups(all P<0.05).After treatment and in the follow-up,VAS scores in the combined treatment group were lower than those in the medication group(both P<0.05).(2)The knee function score:WOMAC score of each item,i.e.pain,stiffness and function,as well as the total score after treatment and the follow-up were all lower than those before treatment in the patients of the two groups(all P<0.05).The score of each item,i.e.pain and function,as well as the total score in the combined treatment group were all lower than those in the medication group after treatment and the follow-up respectively(all P<0.05).(3)The expressions of IL-6 and TGF-β1:the level of IL-6 in the joint fluid was reduced after treatment as compared with that before treatment in either group and the level of TGF-β1 was increased,indicating the statistical differences(all P<0.05).After treatment,the level of IL-6 in the combined treatment group was lower than that in the medication group and the level of TGF-β1 was higher than that of the medicating group,indicating the statistical significance(both P<0.05).(4)The total effective rate in the combined treatment group was 97.1%,higher than 78.8%in the medication group,indicating the statistical significance(P<0.05).Conclusion:The clinical effect of the combined treatment of electroacupuncture and the thunder-fire moxibustion is remarkable on knee osteoarthritis of cold-damp type.The combined treatment presents a more advantageous at the sustainability of the therapeutic effect as compared with medication.