| BackgroundMoxibustion is developed gradually with the discovery and use of fire.It is a thermotherapy.And moxibustion therapy is indirect or direct smoking skin,acupoints and lesion of the body by burned finished products of folium artemisiae argyi.It is a method to prevent disease through drug action,combustion products and warm stimulation.Originally,the ancient people used stones,trees and other convenient materials as moxibustion materials,but there were problems such as uneven heating and short duration.Later,through continuous practice,it is known as the best materials to replace other materials with its own easy,inflammable,high-temperature and combusted properties and it is still use today.Moxibustion is suitable for many kinds of diseases,such cold syndrome,heat syndrome,deficiency syndrome and empirical syndrome.However,the effect of moxibustion is influenced by many factors,such as disease,duration of moxibustion,picking time,the amount of Moxibustion,the time of Moxibustion,the temperature of Moxibustion,the method of moxibustion and the distance of Moxibustion.In addition,the origin of moxibustion materials is also one of the key factors that affect moxibustion effect.《Ben cao pin hui jing yao》said Qizhou is the genuine area of mugwort leaves.And mugwort leaves from Qizhou is widely popular among people,and has been considered to be "treasure" and "elite."Osteoarthritis(OA),or Osteoarthropathy,is a chronic disease,characterized by the deformation of articular cartilage,destruction and osteogenic hyperlplasia.It sometimes accompanied by synovitis.And as we all know,it is most often occur in the active joints,like knee,hand,foot,spine and ect.The disease is more common in more than 50 years old crowd and women are slightly higher than men.Osteoarthritis of the knee(KOA)is the most common form of Osteoarthritis(OA),which manifest mostly pain and stiffness in the joints,such as sore joints,pain while up and down the stairs and having trouble with squats.At the same time,these symptoms can affect daily life.But beyond that,some people will have swollen joints and joint effusion.All of the symptoms occur over and over,and gradually develop into persistent pain or rest pain.Finally,the joint function is limited,and even flexion deformity.So,this disease brings heavy life burden to the paints,family and society.In recent years,as the continuous development of China’s economy,physical life to be constantly enriched.Many people are overweight by poor diet.In addition,the old is on the rise.The factors contribute to a sharp increase in the incidence of KOA.Studies have shown that the prevalence of people over 75 has reached 80 percent,meaning it will be one of the main diseases which affect the health and quality of life in the elderly.The pathogenesis of OA is complicated,and there is no radical cure for it now.Current treatments just aim to relieve the clinical symptoms of patients.Among the 10 guidelines available,most recommend heat therapy.Moxibustion therapy is indirect or direct smoking skin,acupoints and lesion of the body by burned finished products of folium artemisiae argyi.It is a method to prevent disease through drug action,combustion products and warm stimulation.KOA belongs to the category of"Arthralgia syndrome" of TCM and is due to wind,cold and dampness."Moxibustion method can achieve warming channel,expelling cold and relieving pain.In fact,the function of moxibustion is closely related to the origin of material.《Ben cao pin hui jing yao》said Qizhou is the genuine area of mugwort leaves.So mugwort leaves from Qizhou are superior to those of other origins?There is no clinical evidence to support this.Nanyang is the largest Ai products processing base today.Hence,this research focuses on KOA,a predominant disease of moxibustion,and explore the clinical effect of finished products of folium artemisiae argyi from different areas(Qichun County,Huanggang City,Hubei Province VS Nanyang City,Henan Province)treating moderate or severe primary knee osteoarthritis by randomized controlled trial,and provide a clinical basis for specific action of genuine medicinal materials and choosing better moxa.Purpose:To provide a basis for the effectiveness of moxibustion to treat knee osteoarthritis and explore the clinical effect of finished products of folium artemisiae argyi from different areas(Qichun County,Huanggang City,Hubei Province VS Nanyang City,Henan Province)treating moderate or severe primary knee osteoarthritis by randomized controlled trial,and provide a clinical basis for specific action of genuine medicinal materials and choosing better moxa.Method:85 patients who met the criteria of moderate or severe primary knee osteoarthritis were divided into three groups randomizely.There were 34 patients in 1 group and 2 group,and 17 in3 group.Patients in 1 group and 2 group were treated with moxa sticks from Qichun and Nanyang respectively,and 3 group were treated with Yinchen.But acupuncture points among the tree groups were all the same:Dubi(ST35),Neixiyan(EX-LES)and Heding(EX-LE2).If the unilateral knee joint was destroyed of the same patient,then only the affected side was treated.Otherwise,the heavier side was treated with moxa sticks.When the moxibustion began,the researcher would adjust the tube to make the end of the burning tip 2-2.5cm above the acupuncture point.As a result,the local skin of acupoints could reach thermalgesia in 5 minutes.Then,ignited the moxa sticks.A litter while,adjusted the end of the burning tip to make the patient comfortable,when the patient felt heat.In the process of moxibustion,the researcher removed ash every 5min.Patients received the treatment once every other one day or three times a week.The course of treatments in three groups was 2 weeks,then 4 weeks followed up.The VAS and Pain in WOMAC(Western Ontario and Master Universitiees(WOMAC)Osteoarthritis Index)were evaluated at the time that before the treatments,at the end of the treatments and 4 weeks after the end of the treatments.And also,the scores of three aspects in WOMAC including total points,stiffness and function of joint were evaluated at the time that before the treatments,at the end of the treatments and 4 weeks after the end of the treatments.Result:1、85 patients who met the criteria were included and 74 finished the trial with 11 cases dropping.32 patients completed the moxibustion with moxa sticks from Qichun and only 2 fell off in 1 group.At the same time,28 patients completed the moxibustion with moxa sticks from Nanyang and 6 fell off in 2 group.In 3 group,14 patients finished the treatment with Yinchen and 3 fell off.2、After 2weeks treatment,the score of VAS in 1 group decreased significantly from 75.63±13.84 to 50.47±25.66(p<0.01).However,there was no significant difference found among 1 group and 2 group,3 group(p>0.05).The score of Pain in WOMAC in 1 group decreased from 10.41 ± 1.86 to 6.59±2.71(p<0.01).Similarly,there was no significant difference among score changes in 1 group and the other two groups(p>0.05).The score of stiffness in WOMAC in 1 group decreased from 3.75± 1.57 to 2.78±1.56(p<0.01).Difference was found between the decrease of stiffness in WOMAC score in 1 group and 2 group(p<0.05),but there was no significant difference found between 1 group and 3 group(p>0.05).The score of function of joint in WOMAC in 1 group decreased observably from 40.03±5.28 to 26.81±8.55(p<0.01).Difference was also found between the decrease of function of joint in WOMAC score in 1 group and 2 group(p<0.05),but there was no significant difference found between 1 group and 3 group(p>0.05).The total score of WOMAC in 1 group decreased significantly from 54.19±6.01 to 36.19±11.61(p<0.01).Like the score of stiffness in WOMAC,difference was also found between the decrease of total points in WOMAC in 1 group and 2 group(p<0.05),but there was no significant difference found between 1 group and 3 group(p>0.05).In the follow-up four weeks after treatment,there was significant decrease in the score of VAS,Pain、Stiffness、function of joint、Total points in WOMAC in 1 group.And there was significant difference found among 1 group and 2 group,3 group(p<0.05).However,in the score of Pain and Stiffness in WOMAC,there was no significant difference found among 1 group and the other two groups(p>0.05).In the score of function of joint and total points in WOMAC,difference was found between the decrease of the two aspects in 1 group and 2 group(p<0.05),but there was no significant difference found between 1 group and 3 group(p>0.05).Only one patient was allergic to moxa smoke.Conclusion:1、Moxa sticks from Qichun and Nanyang,besides Yinchen,could relieve the pain of patients and improve function of joint of them who had severe primary knee osteoarthritis in the short term,and it is persistent.Moreover,Moxa sticks from Qichun was able to ease patients stiffness in the near and forward future.2、Moxa sticks from Qichun could relieve the pain of patients,which had the equal effectiveness with Moxa sticks from Nanyang、Yinchen,but it is superior to them after 1 month and had long-term effect. |
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