Clinical Dynamic Research On Acupoints Pressure Pain Sensitization On Knee Osteoarthritis

Objective To investigate the difference of pressure pain threshold between knee osteoarthritis patients and healthy people,and explore the dynamic time and spatial distribution of superficial sensitized acupoints of patients with knee osteoarthritis(KOA)during different time period;to analyze the regularity of pressure sanitization and its relationship with dynamic disease state of knee osteoarthritis;therefore,to provide experimental evidence for the treatment of knee osteoarthritis from a new perspective.Methods Using the method of epidemiological investigation and using WAGNER pressure pain instrument,the acupoint pain threshold of patients and healthy subjects are detected by literature mining combined with clinically used common acupoints in treating knee osteoarthritis.Meanwhile,the severity and symptom scores of patients were measured once a week for 4 consecutive weeks,and the data obtained were analyzed statistically.Results 1.The threshold of pressure pain in patients was lower than that in healthy subjects.There was no difference in pressure pain value at other acupoints except Qiuxu point(p < 0.05),but there was no difference in pressure pain threshold at other acupoints between patients and healthy subjects(p < 0.05).The thresholds of all patients were lower than those of healthy people.2.By comparing the sensitization of acupoints between KOA patients and healthy people,it was found that the sensitization of the patients was higher than those of healthy people(p < 0.01),and there were significant differences in the sensitization of the patients with KOA and those of the healthy people(p < 0.01).Sensitization rate of Neixiyan,Yanglingquan,Yaoyangguan and other acupoints is greater.3.Comparing the measured values of acupoint pressure pain at different time period,it was found that there were statistical differences among the 4 times measured values of pressure pain at all sensitized acupoints(p < 0.05).There were statistical differences between the second,third and fourth pressure pain measurements of most sensitized acupoints and the first pressure pain measurement(p < 0.05),in which Xuehai,Liangqiu,Dubi,Zusanli,Yanglingquan and Dazhu were all significantly different(p < 0.01).4.Comparing the sensitization rate of pressure pain at different time,it was found that the sensitization rate of four times pressure pain of most sensitized acupoints showed an increasing trend with the increase of measuring times.5.By comparing the sensitivities of dynamic acupoint pressure pain in different regions,the sensitivities in 5 and 9 regions were relatively high for four times,reaching 88.55% in area 2 and 88.55% in area 6 respectively,but all regions were more than 70%.6.The four sensitization rates of the Three-Feet-Yang meridians were relatively higher,the highest was 87.5%,while the four sensitization rates of the Three-Feet-Yin meridians were relatively lower and the lowest was 68.5%.7.Comparing the sensitization rate of dynamic acupoint pressure pain in different regions,the four times sensitizing rate of lumbar back acupoints are relatively higher,the highest is 84.05%,while the fourth sensitizing rate of local acupoint and distal acupoint is relatively lower,but they are allhigher than 70%.8.Wald tester was used to analyze the correlation between acupoint dynamic pressure pain sensitization rate and time,age,sex,Womac score,McGill score;we found time variables are correlated with changes of acupoint pressure pain sensitization rate,such as Xuehai,heding,Dubi,Neixiyan,Liangqiu,etc.The longer the time is,the more easily sensitization occurs.The sex variable was related to the sensitization rate of the Neixiyan,Shenshu,Dazhu(right side),Mingmen and Yaoyangguan points,and acupoints in female are more susceptible to sensitize than that in the male;There was correlation between Womac score variable and sensitization rate of Xuehai,Heding,Dubi,Weiyang,etc.The higher the score,the more susceptible to sensitization.There was a correlation between the McGill score variable and the sensitization rate of Zusanli acupoint.The higher the score,the more easily the sensitization occurred in the Zusanli point.Conclusions 1.The sensitization rate of acupoint pressure pain in patients with KOA was higher,which indicated that the sensitization of acupoint pressure pain was universal.2.There was a positive correlation between acupoint pressure pain sensitization and time change,and the degree of sensitization showed an upward trend with duration of time.3.Under the condition of dynamic development of disease,the rule of pressure pain sensitization is related to the area of acupoint,meridian and position.4.According to the analysis of the incidence and related factors of dynamic pressure sensitization at acupoints s,Heding,Xuehai,Dubi and Zusanli(Zusanli)can be used as the dominant acupoints for pressure pain sensitization of KOA.