Therapeutic effect of San Bi Tang combined with glucosamine sulfate capsules in cold-dampness-type knee osteoarthritis

BACKGROUND Cold-dampness-type knee osteoarthritis is a common middle-aged and elderly disease,but its pathogenesis is not fully understood,and its clinical treatment has limitations.Glucosamine sulfate capsules are commonly used for treating arthritis,and San Bi Tang is a classic formula of traditional Chinese medicine(TCM)that has the effects of warming yang,dispelling dampness,relaxing muscles,and activating collaterals.This research hypothesized that the combination of modified San Bi Tang and glucosamine sulfate capsules could enhance the clinical efficacy of treating cold-dampness-type knee osteoarthritis through complementary effects.AIM To analyze the clinical efficacy of San Bi Tang combined with glucosamine sulfate capsules when treating cold-dampness-type knee osteoarthritis.METHODS A total of 110 patients with cold-dampness-type knee osteoarthritis were selected as research subjects and randomly divided into a control group and an experimental group of 55 cases each.The control group received only treatment with glucosamine sulfate capsules,while the experimental group received additional treatment with modified San Bi Tang for a duration of 5 wk.The patients’knee joint functions,liver and kidney function indicators,adverse reactions,and vital signs were evaluated and analyzed using SPSS 26.0 software.RESULTS Before treatment,the two groups’genders,ages,and scores were not significantly different,indicating comparability.Both groups’scores improved after treatment,which could indicate pain and knee joint function improvement,but the test group had better scores.The TCM-specific symptoms and the clinical efficacy of the treatment in the test group were higher.Before and after treatment,there were no abnormalities in the patients’liver and kidney function indicators.CONCLUSION The combination of modified San Bi Tang and glucosamine sulfate capsules is superior to treatment with sulfated glucosamine alone and has high safety.

Clinical effect of scraping therapy in the treatment of knee osteoarthritis

Objective:The objective of this study is to investigate the effect of scraping therapy in the treatment of knee osteoarthritis.Materials and Methods:A total of eighty patients with knee osteoarthritis were assigned to the moxibustion group and the scraping therapy group according to the random numerical table method,with forty cases in each group.Patients in both two groups received functional exercise and moxibustion therapy,and those in the scraping therapy group were supplemented with scraping therapy.The serum indexes of interleukin‑1(IL‑1),IL‑6,tumor necrosis factor‑alpha(TNF‑α),and superoxide dismutase(SOD)were detected before and after the treatment.The clinical syndrome integral and Visual Analog Scale(VAS)on pain of patients were assessed.The clinical therapeutic efficacy was evaluated and compared between the two groups.Results:Patients in the scraping therapy group received better outcomes of serum IL‑1,IL‑6,TNF‑α,and SOD compared with those in the moxibustion group at 2 months after treatment(P<0.05).The scores of clinical syndrome integral and VAS on pain were decreased in two groups at 2 months after the treatment and were lower in the scraping therapy group than those in the moxibustion group(P<0.05).The overall effective rate in the scraping therapy group was higher than that in the control group(87.50%vs.67.50%,P<0.05).Conclusion:The scraping therapy is potentially effective to ameliorate the clinical symptom and pain degree of patients with knee osteoarthritis.

Application of five-element music therapy in pain coping skills training in patients with knee osteoarthritis

Objective:The objective of this study is to assess the application effect of five elements music therapy introduced in the pain coping skills training of knee osteoarthritis(KOA).Materials and Methods:Totally,80 patients with KOA were selected and randomly divided into the experimental group(39 cases)and the control group(41 cases).The control group was only given routine nursing measures,and the experimental group was additionally treated with five-element music therapy on the basis of the control group,twice a day,28 days in total.The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)was used to evaluate the functional status of the knee joint of the two groups.The clinical efficacy of the two groups was evaluated by Guiding Principles for Clinical Research of New Chinese Medicine in the Treatment of Osteoarthritis.Results:WOMAC score statistically significantly decreased in the experimental group(35.92±9.48 vs.16.17±5.43,P<0.01)and the control group(36.73±6.42 vs.22.53±7.51,P<0.01)after 28 days of intervention when compared with that before intervention;WOMAC score in the experimental group was lower than that of the control group after 28 days of intervention(16.17±5.43 vs.22.53±7.51,P<0.01).The total effective rate of the experimental group was statistically higher than that of the control group(82.0%vs.51.2%,χ2=11.97,P=0.003).Conclusion:The combination of five-element music therapy and routine nursing measures has better effect in relieving pain and bad emotions of patients with KOA when compared with routine nursing measures alone.

Clinical effect of extracorporeal shockwave therapy for knee osteoarthritis: A meta analysis

Objective:To provide evidence-based evidence for the clinical use of shockwave therapy in KOA.Methods: Two researchers independently searched the randomized controlled study of shockwave therapy for KOA in the databases of CNKI、VIP、WanFang Data、 Sinomed and PubMed. Jadad rating scale was used for literature quality evaluation, and the extracted data was meta-analyzed by RevMan5.3 software.Results: A total of 15 randomized controlled trials involving 1248 patients were included. The results of meta-analysis showed: The clinical effective rate of shock wave therapy for knee osteoarthritis was reliable[RR=1.12, 95%CI(1.03, 1.20), p=0.005], and the efficacy was reliable in reducing the visual analogue scale [MD=-1.73, 95%CI(-2.31, -1.14), p<0.00001] , Lequesne osteoarthritis severity index[MD=-1.60, 95%CI(-2.55, -0.64), p<0.00001] and WOMAC[MD=-6.03, 95%CI(-9.49,-2.57) p=0.0006] of KOA patients, without serious adverse reactions.Conclusion:At present, the evidence shows that shock wave can effectively improve the pain and other related symptoms in KOA patients, and the curative effect is reliable.

Systematic evaluation and Meta-analysis of acupuncture and collaterals cupping therapy for Knee Osteoarthritis

Objective:In order to obtain the best treatment program for Knee Osteoarthritis(KOA),to alleviate the pain of patients with KOA,and to systematically evaluate the efficacy of acupuncture cupping therapy for KOA.Methods:we used computer to search the databases of CNKI(1989-2018.10),Wanfang(1989-2018.10),VIP(1989-2018.10),PubMed(1966-2018.10),EMbase(1986-2018.10)and Cochrane Library(the 3rd issue of 2018).And the literature quality was evaluated by Jadad scale.Results:A total of 19 eligible RCT studies were included,and a total of 2,088 patients participated in the eligible clinical study.Meta-analysis results showed that the total effective rate OR combination=2.85[OR=3.98,95%CI(2.98,5.32),P<0.00001].The results showed that the curative effect of acupuncture and collaterals cupping in the treatment of KOA was superior to other therapies.Conclusion:Acupuncture and cupping therapy of traditional Chinese medicine is effective and safe in treating KOA.Due to the impact of the original study on Meta-analysis results,more large samples and high-quality clinical trials are still needed to verify.

Effectiveness of Maitland and Mulligan mobilization methods for adults with knee osteoarthritis:A systematic review and metaanalysis

BACKGROUND As a serious global problem,knee osteoarthritis(KOA)often leads to pain and disability.Manual therapy is widely used as a kind of physical treatment for KOA.AIM To explore further the efficacy of Maitland and Mulligan mobilization methods for adults with KOA.METHODS We searched PubMed,the Cochrane Library,EMbase,Web of Science and Google Scholar from inception to September 20,2020 to collect studies comparing Maitland and Mulligan mobilization methods in adults with KOA.The quality of the studies was assessed using the Physiotherapy Evidence Database Scale for randomized controlled trials.Data analyses were performed using Review Manager 5.0 software.RESULTS A total of 341 articles were screened from five electronic databases(PubMed,the Cochrane Library,EMbase,Web of Science and Google Scholar)after excluding duplicates.Ultimately,eight trials involving 471 subjects were included in present systematic review and meta-analysis.The mean PEDro scale score was 6.6.Mulligan mobilization was more effective in alleviating pain[standardized mean difference(SMD)=0.60;95%confidence interval(CI):0.17 to 1.03,P=0.007;I2=60%,P=0.020]and improving Western Ontario and McMaster Universities function score(SMD=7.41;95%CI:2.36 to 12.47,P=0.004;I2=92%,P=0.000).There was no difference in the effect of the two kinds of mobilization on improving the range of motion(SMD=9.63;95%CI:-1.23 to 20.48,P=0.080;I2=97%,P=0.000).CONCLUSION Mulligan mobilization technique is a promising intervention in alleviating pain and improving function score in KOA patients.

Efficacy of Slow Reversal Hold and Isometrics in Improving Muscle Strength, Increasing Range of Motion, and Reducing Pain in Patients with Osteoarthritis of Knee

Osteoarthritis of knee is a common problem in the elderly population worldwide. Physical therapy has been shown to be useful in decreasing pain and increasing mobility in this population. The aim of this study was to study the effectiveness of slow reversal hold and isometric exercise techniques in reducing pain, increasing muscle strength, and increasing range of motion for knee flexion in patients with osteoarthritis of knee. The other aim of this study was to compare the relative effectiveness of these two interventions. 60 subjects participated in this study and were randomly assigned either to the slow reversal hold group (n = 30) or, to the isometrics exercise group (n = 30). All subjects performed their respective exercises for 3 weeks. Pain scores using the visual analog scale, muscle strength using manual muscle testing of quadriceps and hamstrings, and range of motion (ROM) for knee flexion using a goniometer were recorded both pre-treatment and post-treatment for both left and right knees. Both the interventions showed a significant decrease in pain scores, an increase in muscle strength, as well as an increase in the ROM. However, ROM was significantly increased in the slow reversal hold group as compared to the isometrics group in both knees. It was concluded that both exercise techniques could be useful in patients with osteoarthritis of knee for decreasing pain and increasing muscle strength. Slow reversal hold technique might be a better technique than isometrics for increasing ROM for knee flexion.

The effect of hot intermittent cupping on pain,stiffness and disability of patients with knee osteoarthritis

Objective:The aim of this study was to investigate the effect of hot intermittent cupping on pain,stiffness and inability of patients with knee osteoarthritis(KO).Methods:The present study was a clinical trial,which was performed on 38 patients with KO referring to Gonabad Rheumatology Specialty Clinic.Based on permutation block method,the research units were divided into cupping therapy and control groups.For the cupping therapy group,four sessions of cupping therapy were performed every four days.To collect data,the form of demographic information,Visual Analogue Scale(VAS)and the Western Ontario and McMaster(WOMAC)osteoarthritis scale were used,and the data were analyzed by SPSS software v.16 using descriptive statistics and independent t-test,paired t-test,Chi-square test and Fishers exact test with a significance level of P<0.05.Results:Findings showed that there was no significant difference between the cupping therapy and control groups in terms of demographic characteristics and they were homogeneous.Findings indicated that,based on VAS,the mean pain intensity in the left(P<0.001)and the right knees(P<0.001),as well as based on WOMAC,stiffness(P=0.006),pain intensity(P<0.001)and disability(P<0.001)in the cupping therapy group significantly decreased compared to the control group.Conclusion:Findings showed that hot intermittent cupping therapy reduced the pain intensity,stiffness and disability in patients with KO.

Clinical Effect of Acupuncture Treatment in 109 Cases of Knee Osteoarthritis

Knee Osteoarthritis, a retrograde disease, is mainly characterized by pain in the knee joints and limitation of the movement. It is a common and frequently occurring disease affecting the health and life quality of old people. In recent years, acupuncture treatment of knee osteoarthritis with satisfactory therapeutic results has been repeatedly reported,2-3, 5-6 but there has been few report on the observation of long-term therapeutic effects after treatment. With acupuncture as the main therapy, 109 cases of knee osteoarthritis were treated in this series. 91 cases with good therapeutic results were followed up for 6 months. A report is presented in the following.

Analysis of Anthropometric Measurements and Dietary Intake in Patients Undergoing a Multi-Professional Osteoarthritis Education Program (PARQVE-Project Arthritis Recovering Quality of Life by Means of Education)

Background: Osteoarthritis (OA) has a major impact on mobility and the loss of productivity of patients, especially knee OA (KOA). Obesity is one of the main risk factors for the incidence and prevalence of KOA. Weight loss alone decreases pain and improves quality of life and functional scores. Objective: To use BMI, body fat, and calorie intake to measure the effect of a multi-professional educational program on patients with KOA and correlate these measurements with subjective questionnaire results. Methods: A total of 198 patients undergoing standard treatment for KOA were randomized to 4 groups. All groups received written and video information regarding KOA. Three groups (1, 2 and 3) also attended two days of lectures 1, 2 and 3 months apart, respectively, whereas group 4 did not. Each group was divided into subgroups A (bimonthly telephone calls) and B (no telephone calls). All patients were evaluated at baseline and at one year for BMI, waist-hip ratio (WHR), percentage of body fat, and calorie intake and with the WOMAC, LEQUESNE, VAS and SF-36 questionnaires. Results: The WHR showed 89.4% of android obesity at baseline and 87.9% at one year without improvement (p = 0.38). Body fat decreased by 0.44% regardless of group or subgroup. Calorie intake was different between groups (p = 0.019) according to phone calls and follow-up (p = 0.03). BMI and body fat percentage were correlated with the WOMAC, WOMAC pain, VAS and LEQUESNE scores at baseline and at reassessment. Weight was correlated with the baseline results of the WOMAC pain (r = 0.175, p = 0.014), VAS (r = 0.155, p = 0.029), LEQUESNE (r = 0.161, p = 0.023), SF-36-PCS (r = ?0.186, p = 0.009) and SF-36-MCS (r = 0.155, p = 0.029) scores and with the one-year results of the WOMAC (r = 0.155, p = 0.029) and WOMAC pain (r = 0.151, p = 0.034) scores. Conclusion: The multi-professional treatment program had very little impacts on the percentage of body fat. This improvement was independent of classes, telephone calls, or improvements in pain, function and quality of life. Calorie intake improvement was influenced by telephone calls and classes but was not associated with objective measurements of/or changes in weight, BMI, or body fat percentage or with subjective improvements.

Efficacy and safety of extracorporeal shock wave therapy combined with sodium hyaluronate in treatment of knee osteoarthritis:a systematic review and Meta-analysis

OBJECTIVE:To assess the efficacy and safety of extracorporeal shockwave therapy(ESWT)combined with sodium hyaluronate(HA)for the treatment of knee osteoarthritis(KOA).METHODS:PubM ed,Embase,the Cochrane Library,Web of Science,China National Knowledge Infrastructure,Wanfang database,China Science and Technology Journal Database,and SinoMed were searched from inception to July 2020.The quality of the randomized controlled trials was evaluated independently by two reviewers according to the criteria in the Cochrane Collaboration for Systematic Reviews.The identified articles were then screened individually using EndnoteX9 for eligibility in this Meta-analysis.The heterogeneity among the articles was evaluated using I2.RESULTS:A total of 17 studies,comprising 2000 individuals,were included in this Meta-analysis.The results showed that a significant improvement was observed in knee pain and function based on the clinical efficacy of ESWT combined with HA.Statistical analysis of clinical efficacy showed that[relative risk(RR)=1.21,95%confidence interval(CI)(1.12,1.30),P<0.01].Statistical analysis of visual analog scale showed that[standardized mean difference(SMD)=-2.84,95%CI(-4.01,-1.66),P<0.01].Western Ontario and McMaster University osteoarthritis index statistical analysis showed that[SMD=-1.57,95%CI(-2.52,-0.61),P<0.01].Lysholm score statistical analysis showed that[SMD=1.71,95%CI(0.98,2.44),P<0.01].In addition,only minor side effects,such as redness and swelling of the skin,were observed.CONCLUSIONS:Medium to low quality evidence showed that ESWT combined with HA offers an inexpensive,welltolerated,safe,and effective method to improve pain and functionality in patients with KOA.However,tightly controlled,randomized,large multicenter trials are warranted to validate the current findings.

Efficacy observation on the treatment of knee osteoarthritis with warm needling and rehabilitation therapy

Objective To compare the clinical efficacies among the combined therapy of warm needling and rehabilitation, simple warm needling and rehabilitation therapy for knee osteoarthritis （OA）. Methods Ninty cases of OA were divided randomly into three groups, 30 cases in each one. In an acupuncture and rehabilitation group, warm needling was applied at the acupoints such as Xuehai （血海SP 10）, Neixiyan （内膝眼 EX-LE 4）, Dubi （犊鼻 ST 35） and Zusanli（足三里ST 36） etc.. Additionally, rehabilitation therapy was combined such as joint gymnastics, isometric exercise, stretching exercise and endurance training. In the warm needling group, warm needling was given simply. In the rehabilitation group, rehabilitation therapy was only adopted. The joint pain scale and severity index scale of knee OA were taken as the efficacy assessment indices among the groups. Results The clinical cured rate was 36.7% （11/30） in acupuncture and rehabilitation group, which was superior to 13.3% （4/30） in warm needling group and 13.3% （4/30） in rehabilitation group （both P〈0.01） separately. The results of the joint pain scale and severity index scale of knee joint OA in three groups after 1 session and 2 sessions of treatment were reduced obviously as compared with those before treatment （P〈0.01, P〈0.05）. After 2 sessions of treatment, every index in acupuncture and rehabilitation group was reduced much more obviously as compared with that in the other two groups （all P〈0,01）. Conclusion Warm needling in combination with rehabilitation therapy has good efficacy on knee OA and relieves remarkably the symptoms of it, which is superior to those in either simple warm needling or rehabilitation training therapy.

六自由度步态分析系统评估膝骨关节炎严重程度的客观准确性

背景:膝骨关节炎的传统评估方法是基于患者的临床症状、体格检查和影像学表现做出判断,但是这些方法不能反映膝关节的动力学动态变化,不能多维度反映出膝关节的客观状态。六自由度步态分析系统为膝骨关节炎的严重程度提供了更加客观、更为实用的一种动态评估方法,为不同患者更精准的治疗方案提供了依据,从而优化患者的治疗策略。目的:综述膝骨关节炎的相关评估系统,将六自由度步态分析与传统评估膝骨关节炎严重程度的方法进行比较,探讨六自由度步态分析在指导膝骨关节炎治疗策略制定方面的应用效果。方法:通过计算机检索Google Scholar、PubMed数据库2002年1月至2023年6月发表的相关文献,英文检索词为“knee osteoarthritis,knee osteoarthritis severity,6DOF gait analysis,evaluation methods,WOMAC,KOOS”;中文检索词为“膝骨关节炎,关节炎评估系统,六自由度步态分析”,通过纳入与排除标准,最终选择65篇文献进行归纳总结。结果与结论:①六自由度步态分析提高了评估膝骨关节炎严重程度的准确性,依据该方法制定的治疗方案显著改善了患者的预后;②基于目前的研究发现,在临床实践中应规范六自由度步态分析与传统评估方法的结合,以便客观准确地评估膝骨关节炎,从而更好地选择治疗方案及评估个体化治疗策略的长期有效性。

膝骨关节炎的运动学特征及运动治疗研究进展

膝骨关节炎(KOA)主要表现为膝关节疼痛、肿胀和活动受限等,临床治疗KOA的方法众多,但疗效各异。目前关于KOA的发病机制尚未完全阐明,可能由全身或局部因素综合引发,但目前的研究较少从其发病的运动学特征展开分析并提出相应的运动治疗措施。运动学分析是制订有效运动治疗方案的基础,尤其是针对膝关节展开的肌动学特征解析更具康复治疗的现实意义。因此,深入研究KOA的运动学特征及运动康复治疗的研究进展,可以为疾病的临床康复提供新的思路。

桂枝芍药知母汤治疗膝骨性关节炎关节镜清理术后肿痛临床观察

目的探究桂枝芍药知母汤治疗膝骨性关节炎关节镜清理术后肿痛的临床效果。方法选取南昌市洪都中医院收治的膝骨性关节炎关节镜清理术后肿痛患者69例作为研究对象,按随机数字表法分为对照组(34例)和观察组(35例)。对照组予常规治疗,观察组在对照组基础上予桂枝芍药知母汤治疗,比较两组术前及术后1 d、3 d、7 d、14 d视觉模拟量表(VAS)评分、膝关节肿胀值并评估临床疗效。结果术前,两组VAS评分、膝关节肿胀值比较,差异无统计学意义(P>0.05);术后1 d、3 d、7 d、14 d,观察组VAS评分、膝关节肿胀值均低于对照组(P<0.05)。观察组临床治疗总有效率为97.14%(34/35),高于对照组的82.35%(28/34),差异有统计学意义(P<0.05)。结论对膝骨性关节炎关节镜清理术后肿痛患者实施桂枝芍药知母汤治疗,可有效缓解疼痛、消除肿胀,提高临床效果。

Acupotomy alleviates knee osteoarthritis in rabbit by regulating chondrocyte mitophagy via Pink1-Parkin pathway

OBJECTIVE:To investigate the effect of acupotomy,on mitophagy and the Pink1-Parkin pathway in chondrocytes from rabbits with knee osteoarthritis(KOA).METHODS:A KOA model was established via the modified Videman method.Rabbits were randomly divided into a control group(CON),KOA group and KOA+acupotomy group(Acu).Rabbits in the acupotomy group were subjected to acupotomy for 4 weeks after model establishment.The behavior of the rabbits before and after intervention was recorded.Cartilage degeneration was evaluated by optical microscopy and fluorescence microscopy.The level of mitophagy was evaluated by transmission electron microscopy,immunofluorescence and enzyme-linked immunosorbent assay(ELISA).The expression of phosphatase and tensin homolog(PTEN)-induced kinase 1(Pink1)-Parkin mitophagy pathway components was evaluated by immunofluorescence,Western blotting and real-time polymerase chain reaction.RESULTS:In rabbits with KOA,joint pain,mobility disorders and cartilage degeneration were observed,the Mankin score was increased,collagen typeⅡ(Col-Ⅱ)expression was significantly decreased,mitophagy was inhibited,mitochondrial function was impaired,and factors associated with the Pink1-Parkin pathway were inhibited.Acupotomy regulated the expression of Pink1-Parkin pathway-related proteins,the mitophagy-related protein microtubule-associated protein-1 light chain-3,the translocase of the outer membrane,and the inner mitochondrial membrane 23;increased the colocalization of mitochondria and autophagosomes;promoted the removal of damaged mitochondria;restored mitochondrial adenosine-triphosphate(ATP)production;and alleviated cartilage degeneration in rabbits with KOA.CONCLUSIONS:Acupotomy played a role in alleviating KOA in rabbits by activating mitophagy in chondrocytes via the regulation of proteins that are related to the Pink1-Parkin pathway.

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 observation on acupoint pressure therapy plus electroacupuncture for post-traumatic knee osteoarthritis

Objective： To investigate the clinical efficacy of Zhang＇s acupoint pressure therapy plus electroacupuncture（EA） in treating post-traumatic knee osteoarthritis.Methods： A total of 98 eligible patients with post-traumatic knee osteoarthritis were divided into group A and B by the random number table, 49 cases in each group. Group A was intervened by Zhang＇s acupoint pressure therapy plus EA; group B was given medicinal fumigation. The clinical efficacies of the two groups were compared. Results： The markedly effective rate of group A was significantly higher than that of group B. Conclusion： Zhang＇s acupoint pressure therapy plus EA can produce a satisfactory clinical efficacy in treating post-traumatic knee osteoarthritis, and is worth promotion.

Chinese Medicine Involving Triple Rehabilitation Therapy for Knee Osteoarthritis in 696 Outpatients:A Multi-Center,Randomized Controlled Trial

Objective:To determine the effects of Chinese medicine(CM)involving triple rehabilitation therapy on the progression of knee osteoarthritis(KOA).Methods:A total of 722 patients recruited from 38 community health service centers located in China from March 2013 to March 2017 were randomly divided into treatment and control groups equally,using a cluster randomization design.Health education combined with CM involving triple rehabilitation therapy for KOA(electro-acupuncture,Chinese medicinal herb fumigating-washing,and traditional exercises)was administered in the treatment group while conventional rehabilitation therapy(physical factor therapy,joint movement training,and muscle strength training)was administered in the control group.Patients with a visual analog scale(VAS)scores>A were treated with dispersible meloxicam tablets(7.5 mg,once daily).The Lequesne index scores,VAS scores,range of motion(ROM),lower limb muscle strength,knee joint circumference,quantitative scores of KOA symptoms,and the short-form 36 item health survey questionnaire(SF-36)scores were measured for each patient at 5 checkpoints(before treatment,at the 2nd week and the 4th week during the 4-week treatment period,at 1 month and 3 months after end of treatment),and adverse reactions were observed also.Results:A total of 696 patients completed the entire process,with 351 in the treatment group and 345 in the control group.At all treatment checkpoints,the treatment group demonstrated better outcomes than the control group with regard to the total Lequesne index scores,effective rate and improvement rate of the total Lequesne index scores,VAS scores,lower limb muscle strength,knee circumference,quantitative scores of KOA symptoms,and SF-36 scores as well(P<0.05 or P<0.01).No adverse reactions were encountered in this study.Conclusions:CM involving triple rehabilitation therapy can alleviate KOA-related pain and swelling,improve lower limb muscle strength,promote flexion and activity of the knee and improve the quality of life in patients undergoing KOA.It is suitable for patients with early or mid-stage KOA.(Registration No.ChiCTR-TRC-12002538)

Application of ozone therapy in interventional medicine

Ozone therapy has been gradually accepted by doctors in various fields because it has been safe, convenient, and inexpensive since the twentieth century. It has been used in the treatment of various diseases with satisfactory results, especially in the application of interventional surgery. For lumbar disc herniation, knee osteoarthritis,tissue ischemia-reperfusion after revascularization, stroke, and cancer, ozone therapy can improve the efficacy of interventional surgery and reduce postoperative acute and chronic complications. Prospects of ozone therapy in interventional therapy and the underlying mechanisms of efficacy need further exploration.