A randomized controlled trail on the treatment of knee osteoarthritis with acupotomy therapy based on the meridian sinew theory

Objective: To compare the clinical efficacy differences of acupotomy therapy guided by the meridian sinew theory and acupotomy therapy guided by the anatomy theory of western medicine in the treatment of knee osteoarthritis.Methods: Sixty-three patients were randomly divided into the acupotomy group of the meridian sinew theory(Group A, n = 32) and the acupotomy group of the anatomy theory(Group B. n = 31). For Group A, with positive reaction points such as the tenderness points of three yang meridians and three yin meridians of the foot, and funicular nodules as the points of needle insertion, the needle-knife, after disinfection and anesthesia, gives priority to longitudinal dissection after insertion, and then carries out subcutaneous sweeping maniplation. For Group B, with 8 points for needle insertion, including the origins and terminations of the medial and lateral collateral ligaments, the origins and terminations of the patellar ligament, the terminations of the quadriceps femoris tendon, and pes anserinus bursa point, the treatment was performed in strict accordance with the four-step procedures of acupotomy(positioning,orientating, pressurizing to separate, and puncturing) after disinfection and anesthesia. The treatment was conducted once a week and three times in total. Statistical analysis was conducted with the Western Ontario and McMaster Universities(WOMAC) Osteoarthritis Index and Visual Analogue Scale(VAS)for overall pain before treatment and at week 2 and 4 during treatment, and the adverse reactions of patients were observed and recorded to evaluate the curative effect.Results: During the treatment period, the overall response rates(ORRs, that is markedly effective + effective) were compared between the two groups. The ORR of Group A was 90.63% and that of Group B was 87.09%. There was no statistical significant difference between the two groups(P>0.05).After treatment, the WOMAC function score of Group A was significantly lower than that before treatment(17.28 ±10.22 vs 32.75 ± 14.88, P <0.001), and that of Group B was lower than that before treatment(24.87 ±16.48 vs 30.90 ±16.64, P< 0.05). there was a statistical significant difference between the two groups(P<0.05). As for the comparison of VAS pain scores, in Group A, there was statistical significant difference(4.48 ± 1.60 vs 5.05 ± 1.60. P< 0.05) between at Week 2 and before treatment, and statistically significant difference(1.88 ± 1.03 vs 5.05 ± 1.60, P<0.001) between at Week 4 and before treatment.In Group B, there was no significant difference(P>0.05) between at Week 2 and before treatment, and there was statistically significant difference(3.31 ± 1.56 vs 4.77 ± 1.68, P<0.001) between at Week 4 and before treatment. The VAS pain score of Group A was significantly lower than that of Group B(P< 0.001),and 2 cases of mild adverse reactions occurred in Group A and 3 in Group B.Conclusion: Both acupotomy therapies guided by the meridian sinew theory and by the anatomy theory of Western medicine have good curative effect on knee osteoarthritis, but acupotomy guided by the meridian sinew theory has more superiorities in operability, safety and effectiveness, which is easy to be generalized in grass-roots and community hospitals.