Clinical Observation Of The Treatment Of Knee Osteoarthritis With Acupotomy Release Combined With Exercise Therapy

Objective Knee osteoarthritis(KOA)was treated with acupotomy release combined with exercise therapy,and the clinical efficacy of the treatment with simple acupotomy release and simple exercise therapy was observed to determine clinical curative effect of difference,which determine clinical therapeutic effects of acupotomy release combined with exercise therapy,and gradually standardize the treatment in the clinical process,for the clinical treatment of Knee osteoarthritis provides a new way of thinking and new methods.Methods 101 patients with knee osteoarthritis in the Department of Orthopaedics,Shanxi Provincial Hospital of Traditional Chinese Medicine from December 2017 to December 2018 were randomly collected and randomly divided into groups.The experimental group was treated with acupotomy release combined with exercise therapy in 34 cases.The contrast group A was treated with simple acupotomy in 34 cases,and the control group B was treated with simple exercise therapy in 33 cases.Treatment method: Firstly,each patient was given health education guidance for knee osteoarthritis;the patients in the experimental group were first treated with a acupotomy to release the suprapatellar bursa point,subpatellar fat pad,the pes anserinus point,the outside genu eye,medial and lateral collateral ligaments,medial and lateral femoral condyles and the inner and outer points of the tuberositas tibiae were a total of ten parts.Exercise therapy the next day: isometric contraction training,isotonic contraction training,supine position cycling training.The control group A was treated with a single acupotomy release,and the control group B was treated with exercise therapy alone.Visual analogue pain score(VAS),Lequesne scoring index and WOMAC scale scoring criteria were used before,4 weeks after and 8 weeks after treatment,respectively,to compare and evaluate the improvement of knee pain symptoms and patients’ overall quality of life before and after treatment among the three groups and within each group.Result1.Final inclusion case number analysis: a total of 101 patients were included according to the inclusion criteria and divided into 3 groups,including 2 patients in the experimental group who lost follow-up,2 patients in the control group who lost follow-up,and 1 patient in the control group B who lost follow-up.A total of 96 patients were included in the final result analysis.2.Baseline data analysis results: basic data of three groups of patients before treatment of gender,age,height,weight,knee joint,course of diseases,visual analog pain score(VAS),Lequesne score index,WOMAC rating scale standard,almost the same level,compare the difference is not significant(P>0.05),test comparable.3.Comparison of VAS score,Lequesne score and WOMAC scale score among the three groups: after 4 weeks and 8 weeks of treatment,the three scores of patients in the acupotomy combined with exercise therapy group were significantly lower than those in the acupotomy group and the exercise therapy group alone,and the difference was statistically significant(P<0.05).VAS score,Lequesne score and WOMAC scale score in the acupotomy group at 4 weeks and 8 weeks after treatment were lower than those in the exercise therapy group after treatment,respectively,and the difference between the two groups was statistically significant(P<0.05).4.Comparison of scores before treatment,4 weeks after treatment,and 8 weeks after treatment in each group: VAS score,Lequesne score and WOMAC score were significantly decreased after 4 weeks and 8 weeks compared with those before treatment,and the difference was statistically significant(P<0.05).There was no significant difference in the score between the acupotomy combined with exercise therapy group after 8 weeks of treatment and 4 weeks of treatment(P>0.05).There was no significant difference in scores between the acupotomy group and the exercise therapy group after 4 weeks of treatment and 8 weeks of treatment,respectively(P>0.05).5.Comparison of overall effective rate: through the three groups of final evaluable case samples,that is,each group of 32 cases were compared with the per protocol set,the total effective rate of the experimental group was 93.75% and the apparent effective rate was 48.93%;the total effective rate of control group A was 78.12%,and the apparent effective rate was 44.79%;the total effective rate of control group B was 66.67%,and the apparent effective rate was 25.00%.6.Safety analysis: no severe adverse reactions were found in the three groups after treatment,and no local skin infections,itching,allergic reactions or other special conditions were encountered.In the experimental group and the control group A,1 patient in each group experienced fainting acupotomy reaction caused by tension,and the patients were given recumbent rest and warm water in time and other treatments,and no other adverse reactions occurred after treatment.Conclusion Acupotomy release combined with exercise therapy can effectively reduce the pain of patients with knee osteoarthritis symptoms,improve joint activity function obstacle,improve the patients quality of life,are better than the overall clinical efficacy of acupotomy in treatment group and the pure exercise therapy in treatment group,and the overall safety,convenient operation,not only easy to clinical promotion,also is beneficial to enrich the conservative treatment of knee osteoarthritis.However,it is still necessary to strengthen the observation of its long-term clinical effects and further clarify the mechanism of its role,so as to ultimately improve the clinical efficiency of the treatment of patients with knee osteoarthritis.