The Correlation Between Acupoint Sensitization Phenomenon And The Common Constitution Of TCM In Patients With Knee Osteoarthritis

Objective: In this study,patients with knee osteoarthritis(KOA)were taken as the research object.By observing the common constitutions of traditional Chinese medicine in KOA patients including Qi deficiency,Yang deficiency,phlegm dampness and blood stasis,the infrared temperature and pressure pain threshold(PPT)were assessed at each acupoint,and the distribution,manifestation and incidence of acupoint sensitization in KOA patients of different constitutions were analyzed in order to find the correlation between acupoint sensitization and common TCM constitution types in KOA patients.Methods: 120 knee osteoarthritis patients aged 40-80 years who met the diagnostic criteria of knee osteoarthritis in the 2007 Guidelines for the Diagnosis and Treatment of Osteoarthritis were selected and divided into four groups according to the scores of TCM Constitution Questionnaire.The changes of PPT and body surface temperature were detected by Fotric226 Platform Thermography and WAGNER pressure gauge(WAGNER INSTRUMENTS)to analyze the correlation between acupoint sensitization in KOA patients and common TCM constitution.Results: 1.The acupoints with the highest thermal sensitization rate of KOA patients with Qi deficiency are Yaoyangguan,Shenshu R,Shenshu L,and the acupoints with the highest pain sensitization rate are Heding,Yanglingquan,Xuanzhong,Yinlingquan,Xiguan,Mingmen,Shenshu R,Liangqiu,Qiuxu and Dazhu R;2.The acupoints with the highest thermal sensitization rate of KOA patients with yang deficiency constitution are Xuehai,Shenshu R,Heding,Shenshu L,Dubi;the acupoints with the highest pain sensitization points are Xuanzhong,Yinlingquan,Yanglingquan,Dazhu L,Shenshu L,Dubi,Mignmen,Neixiyan,Heding,Shenshu R,Zusanli.3.The acupoints with the highest thermal sensitization g rate of KOA patients with phlegm dampness constitution are Xuehai,Yaoyangguan,Heding,Dubi;the acupoints with the highest pain sensitization points are Xuanzhong,Dubi,Heding,Ququan,Neixiyan,Qiuxu,Yanglingquan,Dazhu R.4.The acupoints with the highest thermal sensitization rate of KOA patients with blood stasis constitution are Shenshu R,Xuehai,Yaoyangguan,Shenshu L,Yanglingquan,Heding,and Dubi;the acupoints with the highest pain sensitization are Xuanzhong,Dazhu L,Yinlingquan,Yanglingquan,Neixiyan,Dubi,Zusanli,Liangqiu,Qiuxu,Dazhu R.5.Acupoints of Xuehai and Ququan,bilateral Shenshu,Mingmen and Yaoyangguan,Yingu,and Heding of four constitutions of KOA patients also showed high temperature and PPT rate.6.The sensitization rates of acupoints at the back(Shenshu,Yaoyangguan)and local points at the knee joint(Xuehai,Heding,Dubi)of the patients with four constitutions were higher;the sensitization rates of distal acupoints(Xuanzhong),local acupoints at the knee joint(Heding,Yinlingquan,Yanglingquan,Dubi)and lumbar and dorsal acupoints(Dazhu L,Shenshu L)were with higher sensitization values.Conclusions 1.In the treatment of KOA patients with Qi deficiency,the thermally sensitized acupoints which can be selected with priority are Yaoyangguan,Shenshu R and Shenshu L.Pain sensitized acupoints selected with priority could be Heding,Yanglingquan,Xuanzhong,Yinlingquan,Xieguan,Mingmen,Shenshu R,Liangqiu,Qiuxu and Dazhu R.2.Acupoints in patients with yang deficiency has the highest hyperalgesia sensitization rate,followed by blood stasis type.When selecting thermal sensitive acupoint for clinical treatment,we can give priority to Xuehai,Shenshu R,Heding,Shenshu L,Dubi;and select pain-sensitized acupoints with priority for Xuanzhong,Yinlingquan,Yanglingquan,Dazhu L,Shenshu L,Dubi,Mignmen,Neixiyan,Heding,Shenshu R,Zusanli.3.The Phlegm dampness constitution of KOA patients have the lowest sensitization.In the treatment of clinical acupoints,the heat-sensitive acupoints with priority are Xuehai,Yaoyangguan,Heding,Dubi;pain-sensitized acupoints with priority are Xuanzhong,Dubi,Heding,Ququan,Neixiyan,Qiuxu,Yanglingquan,Dazhu R.4.The Blood stasis constitution of KOA patient has the highest thermal-sensing rate,and the yang deficiency constitution rankes the second.In the clinical selection of acupoints,the heat-sensitive acupoints with priority are Shenshu R,Xuehai,Yaoyangguan,Shenshu L,Yanglingquan,Heding,and Dubi;the painsensitized acupuncture points with priority are Xuanzhong,Dazhu L,Yinlingquan,Yanglingquan,Neixiyan,Dubi,Zusanli,Liangqiu,Qiuxu,Dazhu R.5.For 4 physique types KOA patients,the acupoints with high heat-sensing rate are Shenshu,and the Yaoyangguan takes the second;the acupoints with high sensitization rate are Yanglingquan and Xuanzhong.6.Among the four constitutions of KOA patients,acupoint hyperthermia and pain sensitization are common,and acupoint pain sensitization is a more obvious form of sensitization.7.Shenshu,Dubi and Heding are the dominant acupoints of KOA patients with different constitutions.