| Objectives1. Using the internationally recognized randomized controlled trial report to unified standard CONSORT statement in combination with the standard of moxibustion clinical trials of interventions (hereinafter referred to as the standard of moxibustion, reference STRICTA5 acupuncture intervention in clinical trials of international standard drafting), evaluation of moxibustion and moxibustion combined with other interventions to treat KOA report quality of clinical randomized controlled trials.2. Using system evaluation and research methods of Meta analysis, evaluation of moxibustion treatment the curative effect of knee osteoarthritis (KOA), comparing moxibustion, moxibustion combined, with other treatments and other therapy for knee osteoarthritis of the effectiveness of the difference, as this study every monkshood cake noxibustion with common acupuncture treatment of liver and kidney deficiency type KOA provide a solid theoretical basis.3, With oral diclofenac sodium zyban contrast, observe every monkshood eake of ordinary acupuncture and moxibustion for the treatment of liver and kidney deficiency type the clinical curative effect of KOA patients.Hethods1.Rtefering the literature to analysis of research status at home and abroad.2.Widespread retrieval literature database at home and abroad, with computer electronic retrieval is given priority to, supplemented by manual retrieval, access to moxibustion and moxibustion combined with other interventions clinical randomized controlled trials for the treatment of KOA. Adopt the CONSORT of article 25 standard and basis for interventions in acupuncture clinical controlled trials report standard (STRICTA standards), since the proposed six moxibustion evaluation standards (hereinafter referred to as the moxibustion standard) to evaluate quality of literature reports, calculating the CONSORT and moxibustion in the standard of each entry segment report number and percentage. Application of statistical software STATA/SE version 12.0, perform Bardburn et al., in 1998, in view of the Cochrane collaboration specially developed "metan" (Meta analysis command), heterogeneity inspection and Meta analysis, draw the forest figure, etc.3. Using clinical randomized controlled trial design, will be included in the standard of the subjects of 64 cases with computer random number table method is divided into two groups treatment group and control group,32 cases in each group, the treatment group used bread of ordinary acupuncture and moxibustion for the treatment of lateral root of aconite, 1 times a day, a pin 5 days,2 days off day on Saturday,10 times 2 weeks for one period of treatment, treatment of two period of treatment; Control group with oral diclofenac sodium zyban 75 mg treatment,1 times a day, one tablet each time, take 10 days for 1 course of treatment, the treatment of two consecutive period of treatment, the clinical curative effect was observed.Result1. For the most part into the literature did not mention the sample size estimation and small sample size, choose what randomization scheme didn’t explain the test, no complete and reliable randomized allocation scheme, pure moxibustion implement blind method is easy to operate, but the implementation of the comprehensive therapy is unlikely and most of the unreasonable operation, most of the literature on auxiliary interventions, moxibustion therapists, reports on the rationality of control measures have not enough attention, therefore the conclusion is not reliable.2. Meta analysis showed that moxibustion vs. western medicine:clinical control, (Z= 4.01, P= 4.01), (RR=1.67,95%CI (1.30,2.15)]. Efficient, (Z= 4.79, P= 4.79), (RR= 1.15,95%CI (1.09,1.22)]. Signs and symptoms score, (Z= 3.19, P= 3.19), [SMD= 0.40,95% CI. (0.65,0.15)]. WOMAC osteoarthritis index (Z= 7.07, P= 7.07), [SMD= 1.919,95% CI (1.387, 2.451)]. Moxibustion VS moxibustion:clinical control, (Z= 2.23, P= 2.23), [RR= 1.76% CI (1.07,2.90)]. Efficient, (Z= 2.21, P= 2.21), [RR=1.153% CI (1.016,1.308)]. JOA knee rating, (Z= 10.01, P= 10.01), [SMD= 7.040,95% CI (5.663,8.418)]. Moxibustion VS acupuncture clinical control, (Z= 2.36, P= 2.36), (RR= 2.524,95% CI (1.170,5.442)]. Lysholm knee rating, (Z= 2.29, P= 2.29), [SMD= 0.568,95% CI (0.082,1.053)]. Moxibustion VS immersion bath:Chinese medicine clinical control, (Z= 2.58, P= 2.58), (RR=14.000,95% CI (1.888,103.794)]. Moxibustion plus a fairy bone remains capsule versus oral faeries bone remains capsule: VAS pain rating scale, (Z= 7.70, P= 7.70), [SMD= 1.652,95% CI (2.073, 1.232)]. Moxibustion plus diclofenac sodium zyban VS oral diclofenac sodium zyban:efficient, (Z= 2.10, P= 2.10) [RR= 1.350,95% CI (1.021, 1.786)]. Moxibustion plus massage versus oral diclofenac sodium zyban: score, KOA symptoms and signs (Z= 2.18, P= 2.18), [SMD= 0.553,95% CI (1.050,0.056)].3. Clinical observation on the results(1)Curative effect comparison:two groups of patients after 1 month of two period of treatment and follow-up visit to compare the rank and test analysis, the results showed that after the second course of treatment group total effective rate was 93.33%; The control group total effective rate was 70.00%; Comparison between the two group patients curative effect, P= 0.04< 0.05, the difference was statistically significant. After one month follow-up treatment group, the total effective rate was 90.00%; The control group total effective rate was 46.70%; Comparison between the two group patients curative effect, P= 0.00< 0.01, the difference was statistically significant; Within the two groups after treatment and follow-up, treatment group (P= 0.44> 0.05, there was no statistically significant difference; The control group (P =0.04< 0.05, the difference was statistically significant.(2)Lequesne KOA severity index (ISOA):two groups of patients before and after the first course treatment, after the two period of treatment, and follow-up after the end of the first course of treatment,1 month compared with before treatment (P value were 0.00< 0.05, differences were significant statistically significant; After one month follow-up compared with after two course of treatment, treatment group (P= 0.47> 0.05, there was no statistically significant difference, the control group (P= 0.04< 0.05, the difference was statistically significant. After one course of comparison between the two way, P= 0.49> 0.05, there was no statistically significant difference; After the second course of P== 0.050.05, the difference was statistically significant; After one month follow-up, P= 0.01< 0.05, the difference was statistically significant.(3)Pain score values:two groups of patients before and after the first course treatment, after the two period of treatment and the end of the first course of treatment, after one month follow-up compared with before treatment (P value were 0.00< 0.05, differences were significant statistically significant; After one month follow-up compared with after two course of treatment, treatment group (P= 0.42> 0.05, there was no statistically significant difference; The control group (P= 0.00< 0.05, the difference was statistically significant. After one course of comparison between the two way, P= 0.04< 0.05, the difference was statistically significant. After the second course of P= 0.61> 0.05, there was no statistically significant difference; After one month follow-up P= 0.02< 0.05, the difference was statistically significant.(4)Rigid degree score values:one course of treatment group patients before and after treatment, after the two period of treatment and the end of the first course of treatment, after one month follow-up compared with before treatment (P value were 0.00< 0.05, differences were significant statistically significant; Control group patients before and after the first course treatment, after the two period of treatment and the end of the first course of treatment, after one month follow-up and treatment before and after one month follow-up compared with after two course of P values were 0.01,0.04,0.00,0.04< 0.05, differences were significant statistically significant treatment group after 1 month follow-up compared with two after treatment, P= 1.00> 0.05, there was no statistically significant difference. After one course of comparison between the two way, P= 0.87> 0.05, there was no statistically significant difference; After the second course correction= 0.05, P= 0.05 difference was statistically significant; After one month follow-up correction P=0.03<0.05, the difference was statistically significant.(5)Daily activities difficulty score values:two groups of patients before and after the first course treatment, after the two period of treatment and the end of the first course of treatment, after one month follow-up compared with before treatment (P value were 0.00<0.05, differences were significant statistically significant; After one month follow-up compared with after two course of treatment, treatment group (P=0.46>0.05, there was no statistically significant difference; The control group (P=0.00<0.01, the difference was statistically significant. After one course of comparison between the two way, P=0.07> 0.05, there was no statistically significant difference; After the second course, P=0.02<0.05, the difference was statistically significant. After one month follow-up P=0.00<0.05, the difference was statistically significant.Conelusion1.The moxibustion and moxibustion combined with other treatments for patients with KOA RCT report to evaluate the quality of the low. Suggested that the future of clinical randomized controlled trials can do strict according to internationally recognized standards (CONSORT statement and complete standard of moxibustion) normalize reports, so as to improve the correctness and rationality of clinical trial design and credibility, to provide the true useful help clinical decision theory basis.2. Meta analysis showed that moxibustion treatment of KOA compared with oral western medicine, acupuncture, etc have improved symptoms and curative effect advantage, part and moxibustion can enhance the clinical curative effect of single therapy. Moxibustion, compared with traditional Chinese medicine with immersion bath has an advantage in clinical control.3.Two groups of treatment all can improve the patient’s clinical signs and symptoms, can reduce joint pain, improve the degree of joint stiffness, decrease the difficulty of daily activities within a certain range and improved with the increase of the number, the more obvious, curative effect and the effect of stability treatment group were better than the control group. Secondly control pain speed is better than that of the treatment group, but increases the number of the analgesic effect in the two groups. |
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