The Clinical Effect Of Acupuncture On Patients With Knee Osteoarthritis And Influence Of Acupuncture On The Superficial Microcirculatory Blood Perfusion Of Knee Joint

ObjectiveTo evaluate the clinical efficacy of puncturing at acupoints and non-acupoints for treating knee osteoarthritis(KOA)respectively,and to investigate changes of the local superficial microcirculatory blood perfusion(SMBP)of knee joint in KOA patients induced by acupuncture treatment so as to partly explore the mechanism of acupuncture treatment for KOA.MethodsIn this study,72 patients with KOA were randomly divided into acupoint group and non-acupoint group with 1:1 ratio.The acupuncture treatment was performed once per day,five times for a week,and totally for 2 weeks in each group,with a 2-day rest between the two courses.Primary outcomes were the changes of the Visual analogue scale(VAS)and the Western Ontario and Mc Master Universities Osteoarthritis Index(WOMAC)before and after treatment.At the same time,the SMBP changes of the 5 Regions of Interest(ROI)in the knee joint was detected using the laser speckle technique before and after 2 week’s treatment in each group.Results1.A total of 65 KOA patients finished the trial,including 33 cases in the acupoint group and 32 cases in the non-acupoint group.2.There were no significant differences in demographic data(including gender,age,height,weight,BMI),baseline disease severity related data(including duration,VAS score,WOMAC total and subscale scores)and local SMBP of 5 ROIs in knee joint between the two groups(p>0.05).3.The therapeutic effect of the two intervention methods on KOA patients:(1)The within-group analysis showed that,the VAS score and WOMAC total and subscale scores of the patients in both two groups were significantly decreased after treatment(p<0.05).(2)The between-group analysis showed that,the changes of VAS score after treatment between acupoint group and non-acupoint group showed significant difference(p<0.05),while there was no significant difference in the changes of WOMAC total and subscale scores(p>0.05).4.The influence of the two intervention methods on SMBP of knee joints:(1)The within-group analysis showed that,the SMBP of ROI2,ROI3,ROI4,ROI5 in knee joints of KOA patients in acupoint group were significantly increased after treatment(p < 0.05),while there was no statistical difference in the SMBP of ROI1,ROI2,ROI3,ROI4,ROI5 in knee joint of KOA patients in non-acupoint group after treatment(p>0.05).(2)The between-group analysis showed that,the changes of the SMBP of ROI2,ROI3,ROI4,ROI5 of knee joints between the two groups were significant differences;while there was no significant difference in the change of SMBP improvement value of ROI1 of knee joints between two groups(p>0.05).Conclusion1.Both puncturing at acupoints and non-acupoints can effectively relieve the knee pain and improve the activity function of knee joint in patients with KOA.Puncturing at acupoints is more effective in relieving knee pain of patients with KOA than nonacupoints.2.Puncturing at acupoints can significantly increase the local SMBP of knee joint in KOA patients when compared with non-acupoints.Regulating the local SMBP of knee joint may be part of the mechanism of acupuncture treatment for the patients with KOA.