| Objective: To observe changes of clinical symptoms and signs as WOMAC and relevant serum cytokine of knee osteoarthritis (KOA)patients before and after treatment with electro-acupuncture and warm-acupuncture, to confirm the curative effects of electro-acupuncture and warm-acupuncture, to compare the disadvantage and advantage of the two treatments, to discuss the probable action mechanism of electro-acupuncture and warm-acupuncture for treating KOA.Methods:Completely random compare design was adopted,60patients up to standard were divided into electro-acupuncture treatment group and warm-acupuncture treatment group according the random assortment results with random number table. The treatment principles of the both groups were strengthening channels and dredging collaterals, smoothing qi to stop painful, acupoints selection took the method combine local choose with dialectical choose, local points as Liangqiu(ST34), Xuehai(SP10), Neixiyan(EX-LE4), Waixiyan(EX-LE5), Ashi; dialectical points as yang deficiency and blood stagnation type with Yinlingquan(SP9), Zusanli(ST36) and blood-stasis obstruction type with Yanglingquan(GB34), Xuanzhong(GB39). Powered on joint near acupoints in electro-acupuncture group and took continuous wave with frequency as3~5HZ, secondary stimulation and appropriate with patients’comfortable felling. With moxa moxibusion the main acupoints nearby the joints in the warm-acupuncture group, each time for two zhuang; and both groups treated for30minutes. Both treatment for one time every other day and ten times as a course and totally for three courses. Evaluated WOMAC index, assessment of painful with patients, total appraisement of disease condition with patients, comprehensive appraisement of disease condition with doctors, TCM syndrome grade, life quality evaluation of patients and assayed the content of IL-1、TNF-α、TGF-βand BMP in patient’s serum before and after treatment and performed statistical analysis.Results:1. WOMAC index:both electro-acupuncture and warm-acupuncture can effectively improve the WOMAC faction of patients (P<0.01), and have a quite effect (P>0.05); weight in pain, effect of electro-acupuncture is better than warm-acupuncture (P<0.05), weight in rigid, effect of warm-acupuncture is superior to electro-acupuncture (P<0.05), weight in joint dysfunction, both roles fairy (P>0.05).2. Patients’ assessment of painful:electro-acupuncture and warm-acupuncture can effectively improve patients’ assessment of painful (P<0.01), and electro-acupuncture is better than warm-acupuncture (P<0.05).3. Patients’ total appraisement of disease condition: electro-acupuncture and warm-acupuncture can both effectively improve patients’ total appraisement of disease condition (P<0.01), and electro-acupuncture is much better than warm-acupuncture (P<0.05).4. Doctors’ comprehensive appraisement of disease condition:electro-acupuncture and warm-acupuncture can both effectively improve doctors’comprehensive appraisement of disease condition (P<0.01) and have a quite effect (P>0.05).5. TCM syndrome grade:electro-acupuncture and warm-acupuncture can both effectively improve TCM syndrome grade (P<0.01) and have a quite effect (P>0.05).6. Life quality evaluation of patients: electro-acupuncture and warm-acupuncture can both effectively increase life quality evaluation of patients (P<0.01) and have a quite effect (P>0.05).7. IL-1content in patients serum:electro-acupuncture and warm-acupuncture can both decline the content of IL-1in serum (P<0.05) and electro-acupuncture is better than warm-acupuncture (P<0.05).8. TNF-a content in patients serum:electro-acupuncture and warm-acupuncture can both decline the content of TNF-a in serum (P<0.05) and have a quite effect (P>0.05).9. TGF-p content in patients serum:electro-acupuncture and warm-acupuncture can both increase the content of TGF-β in serum (P<0.05) and have a quite effect (P>0.05).10. BMP content in patients serum:electro-acupuncture and warm-acupuncture have no significance effect to change the content of BMP in patients serum (P>0.05).11. Total curative effect:total effective rate of electro-acupuncture group is70%and warm-acupuncture is76.7%, both groups have a quiet effect (P>0.05).12. Curative effect of TCM syndrome:total effective rate of electro-acupuncture group is76.7%and warm-acupuncture is73.3%and have a quite effect (P>0.05), effective rate of yang deficiency and blood stagnation type in electro-acupuncture is57.1%and blood-stasis obstruction type is93.8%, effective rate of yang deficiency and blood stagnation type in warm-acupuncture group is88.2%and blood-stasis obstruction type is88.2%. Electro-acupuncture has a better effect on blood stagnation obstruction type (P<0.05) and warm-acupuncture has a better effect on yang deficiency and blood stagnation type (P<0.05).13. WOMAC grade of60patients before treatment have a dependence with content of IL-1、TNF-α and TGF-β(P<0.05), WOMAC grade much higher more content of IL-1、TNF-α and less of TGF-p.Conclusions:1. Both electro-acupuncture and warm-acupuncture can effectively release patients’clinical symptoms and improve life equality, electro-acupuncture particular emphasis on stopping pain and warm-acupuncture emphasis on dispersing cold.2. Electro-acupuncture and warm-acupuncture can play a role in effective treatment of patients with KOA, and therapeutic effect of electro-acupuncture on patients with blood-stasis obstruction type is better than warm-acupuncture, and warm-acupuncture is much better for the patients with yang deficiency and blood stagnation.3. Both electro-acupuncture and warm-acupuncture can effectively decline the content of decomposable cytokine as IL-1、TNF-α in patients serum and increase the content of compoundable cytokine as TGF-β.4. The proper mechanism of electro-acupuncture and warm-acupuncture effectively releasing patients’symptoms and reaching the aim for treating is from the declining the content of IL-1、TNF-α and increasing the content of TGF-β. |
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