The Clinical Research On Knee Osteoarthritis With Chinese Tuina And Restitution

AimKnee osteoarthritis is a regressive pathological change of the articular cartilage of knee,and it causes the relevant diseases in subchondral cartilage, edge of joint,and synovium and peri-joint regions.It is the most common arthritis among middle-aged and elderly people,especially women after menopause.This disease often causes pain and malfunction of knee joint. Generally,the therapy is to reduce pain and discomfort and to improve the movement function of the knee joint.According to the previous study of knee osteoarthritis,the clinical characteristics of this disease were mainly the joint pain and joint movement dysfunction which are also the major syndromes that cause the pain for patients.The purpose of this research is to assess the advantages of Chinese Tuina and restitution therapy in treating knee osteoarthritis,increasing the activity level of joints,reducing the pain, improving the patient's quality of the life and shortening the course of treatment and to provide theoretical basis for KOA treatment with Tuina and restitution.Methods:Literature review synthesizes the opinions of modern and ancient Chinese Medicine experts on the etiology,pathogenesis and treatment of KOA;clinical research development and function mechanism of Chinese Medicine external treatment therapies;stress the current clinical research status with Tuina and acupuncture;KOA morbidity mechanism and treatment with modern medicine and comment and prospect based on that.The author chooses 60 cases of KOA patients in clinic and randomly groups them into 2 groups according to inclusion and exclusion criteria.The treatment group takes 36 cases and the controlled group 24 cases.Tuina and restitution therapies are adopted in the treatment group and the acupuncture therapies are adopted in the controlled group.Grade on symptoms like pain,joint swelling and distension,movement dysfunction,etc.before treatment and 4 and 8 weeks after treatment.Efficacy evaluation is given on the deduction before and after treatment.OA Index and Lequesne' s AFI are adopted as judgment criteria.The Taiwan-version of WHOQOL-BREF Questionnaire is adopted to investigate the patients' life quality improvement and compare the differences of each group before and after treatment.Result:1.Literature Review ResultLiterature review shows that in KOA treatment,modern medicine is mainly adopted;Chinese Medicine treatment has certain advantages,especially Chinese Medicine external treatment which has definite clinical efficacy. Tuina and acupuncture treatment avoid the side effects of medication and have multiple targets and comprehensive adjustment,so are the good external therapy.2.Clinical Research Result(1) After 4 week' s treatment,in the Treatment Group,18 cases' excellence, 13 cases' utility and 5 cases' failure.The total utility rate is 86.1%. After 8 weeks,21 cases' excellence,12 cases' utility and 3 cases' failure.The total utility rate is 91.7%.In the controlled group,after 4 weeks' treatment,8 cases' excellence,12 cases' utility and 4 cases' failure.The total utility rate is 83.3%.After 8 weeks' treatment,13 cases' excellence,8 cases' utility and 3 cases' failure.The total utility rate is 87.5%.(2) The result analysis of investigation with Taiwan-version of WHOQOL-BREF Questionnaire shows that the grades of two groups before and after treatment don' t have significant difference(P>0.05),so is that after treatment.(3) WOMAC KOA Scale index on general situations:in the treatment group,the indexes have significant difference(P<0.01) 4 and 8 weeks after treatment; in the comparison group,the indexes have statistical difference(P<0.05) 4 weeks after treatment and have significant difference(P<0.01) 8 weeks after treatment.The indexes after treatment in the two groups don' t have significant difference(P>0.05).WOMAC KOA Scale Index Total Score:in the treatment group,the indexes haven' t statistical difference(P>0.05) 4 weeks after treatment;it has statistical difference 8 weeks after treatment (P<0.05);in the comparison group,the indexes haven' t statistical difference (P>0.05) 4 and 8 weeks after treatment.There' s also no statistical difference (P>0.05) between the 2 groups 4 and 8 weeks after treatment.(4) Lequesne AFI result shows that in the treatment group,the indexes have statistical difference(P<0.05) 4 weeks after treatment and have significant difference(P<0.01) 8 weeks after treatment.In the comparison group,the indexes haven' t statistical difference(P>0.05) 4 and 8 weeks after treatment.Conclusion:The Chinese Medicine Tuina and Restitution Therapy and Acupuncture have significant efficacy on regressive arthritis treatment which avoid the side effects of medication and are the ideal curative methods.The Chinese Medicine Tuina and Restitution Therapy and Acupuncture have equivalent effect in Taiwan-Version of WHOQOL-BREF Questionnaire score.In WOMAC KOA Scale index of general situation and total score,Chinese Medicine Tuina and Restitution has significant change compared with that before treatment,while acupuncture not significant.In Lequesne AFI,Chinese Medicine Tuina and Restitution has significant change compared with that before treatment,while acupuncture not significant.These show that in KOA treatment,Chinese Medicine Tuina and Restitution has certain advantages and should be further promoted and researched.