不同针灸方式对虚寒型膝骨关节炎患者WOMAC评分及疼痛症状的影响比较

目的:研究比较不同针灸方式对虚寒型膝骨关节炎(CTKO)患者骨性关节炎指数(WOMAC)评分及疼痛症状的影响。方法:选择CTKO患者162例,按数字表法为患者分成观察组及对照组各81例,观察组通过温针灸方式治疗,对照组不进行艾灸。对比两组疗效,WOMAC评分以及疼痛症状。结果:观察组显效率是62.96%,总有效率是98.77%,均分别明显高于对照组的46.91%及90.12%(P<0.05)。治疗后两组的WOMAC评分均分别较治疗前明显降低,且观察组的WOMAC评分明显较对照组更低(P<0.05)。治疗后两组的主诉疼痛分级(VRS)及数字评价量表(NRS)评分均分别较治疗前明显降低,且观察组明显较对照组更低(P<0.05)。结论:利用温针灸治疗CTKO患者可产生较好的疗效,还可有效降低其WOMAC评分及疼痛症状。

针刀结合康复训练治疗膝骨性关节炎疗效观察

目的:观察针刀结合康复训练对膝骨性关节炎(Knee osteoarthritis.KOA)临床疗效。方法:将59例患者按照随机数字表法分为两组,对照组29例采用传统针刀治疗,治疗组30例在传统针刀治疗基础上结合康复训练,在疗程结束后比较临床综合疗效;疼痛改善程度;膝关节功能障碍改善情况及股四头肌积分肌电值(IEMG)和中位频率(MF)差异。结果:两组治疗后VAS评分均低于治疗前且治疗组疼痛改善程度优于对照组(P<0.05);两组患者股直肌和股外侧肌的IEMG和MF值与治疗前比较显著升高,且治疗组优于对照组(P<0.05),股内侧肌治疗前后无显著差异(P>0.05)。2星期后随访,对照组总有效率为75.9%,治疗组总有效率为87.7%,治疗组优于对照组(P<0.05)。两组Lequesne指数积分均优于治疗前且治疗组的改善优于对照组(P<0.05)。结论:传统针刀疗法和针刀结合康复训练两种疗法在治疗膝关节骨性关节炎中均有很好的疗效,综合疗效显示针刀结合康复训练治疗膝关节骨性关节炎疗效显著,值得临床应用。

Acupuncture and Blood-letting for 30 Cases of Rheumatic Gonitis

We have treated 30 cases of rheumatic gonitis by using acupuncture and the pricking method, with satisfactory therapeutic results reported as follows.

CLINICAL OBSERVATION ON THE TREATMENT OF KNEE OSTEOARTHRITIS BY ACUPUNCTURE IN BA-HE TECHNIQUE

Objective: To observe the clinical therapeutic effect of Ba-He techniqu e of acupuncture in the treatment of knee osteoarthritis. Methods: A total of 90 cases of knee osteoarthritis were evenly randomized into Ba-He technique group (observation group) and common technique group (control group), with 45 cases in each group. Zusanli (足三里 ST 36), Heding (鹤顶 EX-LE 2) and Dubi (犊鼻 ST 35 ) were punctured respectively in Ba-He technique and common technique in the two gr oups. The therapeutic effects of the two groups were compared after one course o f treatment (10 sessions) in accordance with Japanese assessment criteria for kn ee-joint functions. Results: After treatment, among the 74 and 7 1 affected knees in the observation and control groups, the therapeutic effect was excellent in 42 (56.8%) and 26 (36.6%) knees, fine in 14 (18.9%) and 20 (28.2%), OK in 10 (13 .5%) and 11 (15.5%), and poor in 8 (10.8%) and 14 (19.7%) respectively. The ther apeutic effect of the observation group was significantly better than that of co ntrol group (P<0.01). Conclusion: The Ba- He technique of acupuncture applied to the above-mentioned three acupoints exerted remarkable therapeutic effect for k n ee osteoarthritis, which is obviously better than that of the common needling te chnique.

Knee osteoarthritis treated with acupuncture based on syndrome differentiation:a randomized controlled trial

Objective To compare the efficacy differences between acupuncture and western medicine in treating osteoarthritis of knee joints.Methods One hundred and twenty cases were randomly divided into an acupuncture group and a western medication group with 60 cases in each group.In the acupuncture group,acupuncture was applied mainly at Nèixīyǎn（内膝眼 EX-LE 4）,Dúbí（犊鼻 ST 35）,Yīnlíngquán（阴陵泉 SP 9） and Yánglíngquán（阳陵泉 GB 34） plus other acupoints selected according to syndrome differentiation.In the medication group,Glucosamine Hydrochloride capsules were orally given 3 times daily with 2 capsules each time.Western Ontario and McMaster Universities Osteoarthritis Index（WOMAC）,Medical Outcomes Study 36-Item Short Form Health Survey（SF-36,Chinese version） were used to assess therapeutic effects before treatment,after 4 weeks treatment and 9 weeks after treatment,respectively.Results After 4 weeks of treatment,the total effective rates were 86.7%（52/60） and 88.3%（53/60） in the acupuncture group and the western medication group,respectively,without significant difference（P〈0.05）.In 9 weeks after treatment,the total effective rates were 83.3%（50/60） and 61.7%（37/60） in the acupuncture group and the western medication group,respectively,with significant difference between the two groups（P〈0.05）.According to WOMAC and SF-36,the scores were all improved in both groups（P〈0.05,P〈0.01）,with significant difference in follow-up visit of 9 weeks after treatment between the two groups（P〈0.05,P〈0.01）,but not after 4 weeks of treatments（both P〈0.05）.Conclusion Short-term of therapeutic effects of acupuncture and oral administration of Glucosamine Hydrochloride on osteoarthritis of knee joints are similar,but long-term efficacy in the acupuncture group is better than that in the western medication group.

Clinical Observation on Treatment of Knee Osteoarthritis by Acupuncture and Tuina Therapy

Objective： To observe the effect of acupuncture and Chinese tuina manipulation therapy in treating knee osteoarthritis, and analyze the alteration of musculus quadriceps femoris strength. Methods： A total of 80 patients were randomly assigned to a treatment group receiving acupuncture combined Chinese tuina manipulation therapy （n=40） and a control group receiving Fenbid treatment （n=40）, curative effective score, Lequene ＆ Mery assessment tests, and isokinetic evaluation were recorded before and after the treatment course. Results： The total effective rate was 90.0 % in the treatment group and 87.5% in the control group, without a significant difference between the two groups. Lequene ＆ Mery assessment tests had no significant change. Musculus quadriceps femoris isokinetic evaluation improved significantly after the treatment course in the two groups （/9〈0.05）, and there was a significant difference between the two groups （P〈0.05）. Conclusion： Acupuncture combined with tuina manipulation therapy and Fenbid treatment both can reduce knee pain and joint disability in the short term, though no improvement was shown in the severity of the disease. Acupuncture combined with tuina manipulation therapy is better than Fenbid in improving the strength, total work and explosive force of the musculus quadriceps femoris.

Clinical Study on Treatment of Knee Osteoarthritis with Combined Acupuncture and Medication

Objective： To observe the effect of treatment for proliferative knee osteoarthritis （KOA） using combined acupuncture and medicated compression. Method： All 328 cases were randomized into an observation and control group, 164 cases in each. Combined acupuncture and medicated compression were adopted in the observation group, while oral administration of Zhui Feng Tou Gu Wan （Wind-removing and Bone-penetrating Pills） were adopted in the control group. The clinical effects in the two groups were evaluated 40 days after the treatment. Result： There were significant differences in both marked and total effective rates （P〈0.05）. Conclusion Combined acupuncture and medicated compression can obtain better effect for KOA than oral administration of the Wind-Removing and Bone-Penetrating pills.

Clinical Observation on Treatment of Knee Osteoarthritis by Warm Needling Method

Objective： To observe the therapeutic effect of warm needling method for knee osteoarthritis. Methods： Three hundred cases were randomly divided into treatment group and control group, 150 cases respectively in each group. The treatment group was treated by warm needling method, and the control group was treated by simple acupuncture. Their therapeutic effects were compared after 20 sessions of treatments. Results： The effective rate was 94.0% in the treatment group and 86.0% in the control group, with a significant difference between the two groups （P〈0.05）. Conclusion： The therapeutic effect is better in the warm needling group than in the control group in the treatment of knee osteoarthritis.

Clinical Observation on Treatment of Knee Osteoarthritis with Acupuncture plus Tuina

To investigate the efficacy of specific point acupuncture and manipulative adjustment on muscle strength of the knee osteoarthritis. Method： One hundred and five patients were randomly allocated to two groups. Sixty-eight cases in the treatment group were treated by specific point acupuncture and manipulative adjustment on muscle strength of the knee joint. While 37 cases in the control group were treated with specific point acupuncture alone. Result： The total effective rate was significantly higher in the treatment group than in the control group （P〈0.05）. Conclusion： Specific point acupuncture and manipulative adjustment on muscle strength of the knee joint has a satisfactory curative effect on knee osteoarthritis.

Treatment of Infrapatellar Fat Pad Strain with Mountain-burning Fire Method

Strain of infrapatellar fat pad extensively occurs in people aged over 30 years, who often walk up hills or squat while working. The clinical manifestations are aching and weakness in the knee joints, aggravated when the knee joints are totally extended. Discomfort occurs in mild cases only when walking for long or going up and down the stairs. There is aching feeling in moderate cases when the patients are quiet. The pain is aggravated during exercises when the knee joints are half flexed and the patient can not stand up when squatting for prolonged periods of time. There are aching and weak feelings in the severe cases.

Case studies of Chinese acupuncture's comprehensive effectiveness on knee pain

Conventional Western medicine（CWM） and traditional Chinese medicine（TCM） have different approaches and lead to different practices in experimental design, research methodology, regulation, and standards. TCM emphasizes on the optimal or holistic health. In contrast, CWM is an allopathic medicine primarily based on anatomy, biology, biochemistry,molecular biology and modern technology, and rejects the concept of invisible substances and quantum entanglement.Consequently, CWM emphasizes on abnormal lab tests or obvious diseases. In the early 1970 s, TCM and acupuncture quickly emerged as an alternative to CWM as Westerners explored new TCM concepts while questioning the side effects of CWM. Many countries accept traditional acupuncture as a legal alternative medical practice. Some CWM physicians nowadays are more enthusiastic and are receptive to learning and practicing acupuncture. The common goal of CWM and TCM is to enhance human health, but problems arise over differences in approach. As a response to some Western journal papers that failed to validate the real acupuncture effect because of their incorrect methodologies and their ignorance of the holistic acupuncture approaches, the authors hereby present a group of case studies to demonstrate the real and unique effects of genuine acupuncture. The objective was to explore the clinical effects of acupuncture for knee pain.Thirty-six patients with knee pain were divided into five groups based on age. Holistic TCM diagnosis was performed at the beginning of each case and then made a personalized acupuncture treatment prescription according to the root of illness found by the diagnosis. The symptoms and signs were recorded before and after every treatment, and the treatment effects were assessed based upon the self-reported feeling and the observed changes of the patient following the numeric rating scale（NRS）. The results were summarized after the completion of the minimal 5 acupuncture treatments or the standard 10 acupuncture treatments. Among the 36 patients who participated in the cases studies, 17 patients reported a complete healing for knee pain（47.2%）. About 60 kinds of illness other than knee pain were improved（98.9%） and the complete healing rate was about 44.2%. This leads to the conclusion that TCM acupuncture is remarkably effective in treating knee pain. TCM and CWM share a common goal in promoting the health of human being. The efficacy of TCM acupuncture in treating knee pain shouldn＇t be denied or distorted.

Efficacy and safety of acupuncture for the treatment of knee osteoarthritis:a systematic review and meta-analysis

Objective:To evaluate the efficacy and safety of acupuncture for the treatment of knee osteoarthritis and to provide evidence for its use in clinical practice.Methods:Eight databases were extensively searched up to March 2018.Randomized controlled trials(RCTs)comparing the efficacy of acupuncture with sham acupuncture or no acupuncture for knee osteoarthritis were included.Study selection,data extraction and quality assessment were independently conducted by two reviewers.The Cochrane Collaboration's tool was used for assessing the risk of bias.Results:A total of 18 RCTs were included,involving a total of 3522 participants.The results showed that acupuncture was superior to sham acupuncture in relieving pain(SMD=-0.34,95%CI:-0.57 to-0.11,I^2=85%,P=0.003)and improving physical function(SMD=-0.34,95%CI:-0.57 to-0.11,I^2=85%,P=0.003).In comparison to the no-acupuncture group,the acupuncture group also showed significant advantages in relieving pain(SMD=-0.79,95%CI:-1.15 to-0.43,I^2=87%,P<0.0001)and improving physical function(SMD=-0.75,95%CI:-1.19 to-0.31,I^2=91%,P=0.0008).Sensitivity analyses suggested that the results were robust,and Egger's test found no potential publication bias.Conclusion:In the treatment of knee osteoarthritis,the acupuncture group had significant advantages over sham acupuncture or no-acupuncture groups in relieving pain and improving physical function.

Effect of modified Qing Long Bai Wei needling on the levels of IL-1β, IL-6 and INF-α in synovial fluid of knee osteoarthritis patients

Objective:To compare the modified Qjng Long Bai Wei needling method and ordinary acupuncture method in the effects of improving the levels of interleukin (IL)-1β,IL-6 and tumor necrosis factor (TNF)-α in the treatment of knee osteoarthritis (KOA),and to determine the advantage of the modified Qing Long Bai Wei needling method for KOA.Methods:One hundred KOA patients were randomized into a treatment group and a control group by using the random number table,with 50 cases in each group.The treatment group was intervened by the modified Qing Long Bai Wei needling method,and the control group was given ordinary acupuncture.The two groups were observed before and after the treatment to determine the changes in the levels of IL-1β,IL-6 and TNF-α in synovial fluid,and the clinical efficacies were compared between the two groups.Results:The total effective rate and clinical recovery rate were 97.9％ and 52.1％ respectively in the treatment group,versus 85.1％ and 25.5％ in the control group,and the between-group differences were statistically significant (both P＜0.01).After the treatment,the levels of Ib1β,IL-6 and TNF-cα in synovial fluid changed significantly in both groups (all P＜0.01);there were significant differences in the levels of IL-1β,IL-6 and TNF-α in synovial fluid between the two groups (all P＜0.01).Conclusion:The modified Qjng Long Bai Wei needling is an effective method for KOA and it can significantly improve the levels of IL-1β,IL-6 and TNF-α in synovial fluid.