| Background:Knee Osteoarthritis(KOA)is a common clinical degenerative osteoarthropathy,which often occurs in middle-aged and elderly people over 40 years old.The prevalence rate increases linearly with age,and the disease is irreversible,which is one of the important factors causing disability in the elderly.The main clinical manifestations are pain,swelling,stiffness and dysfunction,with recurring symptoms that seriously affect the quality of life of patients.Pain is the first symptom of KOA and the main reason for seeking medical treatment,so pain relief is often the most important request of patients.At present,medication is still the primary way of pain relief.In recent years,The OARSI guidelines recommend topical non-steroidal anti-inflammatory drugs(NSAIDs)as the first choice for analgesia due to obvious side effects of oral drugs.However,topical drugs still have certain irritants,so the drug users are largely restricted.On the other hand,exercise and behavioral assisted therapy may aggravate pain in the early stage,making it difficult for patients to adhere.Surgical treatment is only suitable for severe KOA patients,and the process is painful and the cost is high,so it cannot be popularized.Therefore,there is an urgent need for a safe,effective and widely used treatment to relieve pain and improve joint function.With the development of TCM therapy,acupuncture has played a huge advantage in the treatment of KOA,gaining international recognition for its high safety and proven clinical efficacy.At present,acupuncture treatment of KOA is no longer limited to simple forms of acupuncture,electric acupuncture,fire acupuncture,warm acupuncture and other simple treatment.Clinical studies of compound acupuncture manipulation for KOA are gradually increasing,which can effectively improve the symptoms and signs of knee joint,reduce the severity of KOA,and the curative effect lasts for a long time.Canggu Tanxue acupuncture is one of the compound acupuncture techniques,which is widely used in clinic and is often used to treat pain syndrome,arthralgia and post-stroke dysfunction.There are relatively few clinical studies on the clinical application of Canggu Tanxue acupuncture in the treatment of KOA,and there is a lack of reasonable control measures,and the quality of evidence-based medical evidence is low.Therefore,clinical studies with rigorous experimental design are needed to provide high-quality evidence to verify the clinical efficacy and safety of Canggu Tanxue acupuncture in the treatment of KOA.Professor Ye Xinqing,the late old expert of our department,used the golden needle to treat knee joint disease in his early years.During the operation,he paid attention to ultiple points are pricked with one needle,emphasized the qi sensation,selected points less and more precise,and had remarkable clinical effect.However,due to the difficulty in the operation and promotion of golden needles,Professor Han Biying,a disciple of Ye Xinqing,chose ordinary needles and used Canggu Tanxue acupuncture method to pick needles in multiple directions and layers,which also achieved remarkable efficacy.At the same time,with the gradual development of modern sports rehabilitation medicine,a deeper understanding of the coxa knee joint has been gained,and the theory of "coxa knee homology" has received more and more attention and recognition.However,no clinical studies have been found on the improvement of knee osteoarthritis symptoms based on the theory of "coxa knee homology" combined with Canggu Tanxue acupuncture method.Based on the above research status,a prospective randomized controlled design was adopted in this study to verify the effectiveness and safety of Canggu Tanxue acupuncture in improving knee osteoarthritis pain through a scientifically rigorous experimental scheme,in order to promote clinical promotion of Canggu Tanxue acupuncture in the treatment of KOA,and to provide a high quality therapeutic basis for such clinical studies.Purpose:To evaluate the effectiveness and safety of Canggu Tanxue acupuncture in improving knee osteoarthritis pain.Methods:Using a prospective randomized parallel controlled design,52 KOA patients who met the inclusion criteria were randomly divided into two groups of 26 patients in each group.The observation group was treated with Canggu Tanxue acupuncture and the control group was shallowly penetrated into the skin,taking Heyang and Juliao for 2 weeks,and follow-up for 4 weeks.The VAS score,the total score of WOMAC scale,the score of each dimension of WOMAC scale were recorded before treatment,after the 1 st week of treatment,after the 2nd week of treatment,after the 4th week of followup,after the 6th week of follow-up,and the hip and knee joint mobility were measured before treatment,after the 1st week of treatment,and after the 2nd week of treatment in the two groups.By comparing VAS score and difference,to evaluate the effectiveness of Canggui Tanxue acupuncture method in improving knee osteoarthritis pain,and to evaluate the therapeutic effect of Canggui Tanxue acupuncture method in improving knee osteoarthritis joint function by comparing the total score and difference of WOMAC,the score and difference of each dimension,and the motion and difference of hip and knee joint.The safety of the treatment was also assessed according to the occurrence of adverse reactions during the patients’ treatment.Adopting SPSS 25.0 software for statistical analysis.The measurement data must be tested for normality.If normal distribution was satisfied,the results were expressed as mean ± standard deviation(x±s).Paired sample t-test was used for intra-group comparison,and independent sample t-test was used for inter-group comparison.If normal distribution was not satisfied,the results were expressed by median(upper and lower quartile)[M(QL,QU)].Using the Wilcoxon test for intra-group comparison,and using the Mann-Whitney U test for inter-group comparison.Counting data were described by frequency or percentage,and using Chi-square test for inter-group comparison.Depending on the results of statistical analysis to select pearson accurate method or continuous correction test method.P<0.05 was considered statistically significant.Results:1 Comparison between groups:(1)VAS:VAS score of the observation group was significantly lower than that of the control group after 1st week and 2nd week of treatment,and the difference was statistically significant(P<0.01),indicating that Canggu Tanxue acupuncture method is effective in improving KOA pain,which is better than control group.The VAS score of the observation group was significantly lower than that of the control group at the 4th and 6th week follow-up,and the difference was statistically significant(P<0.05),indicating that Canggu Tanxue acupuncture method had sustained therapeutic effect on pain improvement.(2)WOMAC:The total WOMAC score at each time point in the observation group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05),indicating that the Canggu Tanxue acupuncture method has certain advantages in improving joint function and is superior to the control group;The WOMAC pain score of the observation group was significantly lower than that of the control group at each time point,and the difference was statistically significant(P<0.05),indicating that Canggu Tanxue acupuncture method could improve joint pain,which was consistent with VAS score.The WOMAC stiffness score of the observation group was significantly lower than that of the control group at each time point,and the difference was statistically significant(P<0.05),indicating that Canggu Tanxue acupuncture method has certain advantages in improving joint stiffness,which is superior to control group.The dysfunction score of the observation group was significantly lower than that of the control group after the 1 st and 2nd week of treatment and the 4th week follow-up,and the difference was statistically significant(P<0.05),at the 6th week of follow-up,there was no significant difference(P>0.05),indicating that Canggu Tanxue acupuncture method had certain advantages in improving joint dysfunction in the first 4 weeks,but at the 6th week,the two groups had similar efficacy.(3)Hip and Knee range of motion:There was no significant difference in hip range of motion between the observation group and the control group at each evaluation point(P>0.05),indicating that the two groups had similar efficacy in improving hip range of motion;There was no significant difference between the observation group and the control group in knee extension activity at each evaluation point(P>0.05),the curtsy activity increased significantly after the 2nd week of treatment compared with the control group,and the difference was statistically significant(P<0.05),indicating that Canggu Tanxue acupuncture method can increase knee flexion and motion,but the two groups have similar efficacy in knee extension.(4)During the treatment,adverse reactions occurred in both groups,and there was no statistically significant difference in the occurrence of adverse reactions(P<0.05).No adverse events occurred in either group.2 Comparison within two groups:(1)In the observation group,VAS scores were reduced at all evaluation time points compared with pre-treatment,and the differences were all statistically significant(P<0.01)after 1 st week treatment compared with pre-treatment,and VAS scores were reduced at both time points after 2nd week treatment and at the follow-up period compared with pre-treatment,and the differences were statistically significant(P<0.05).This indicates that both acupuncture techniques can improve pain.(2)In the observation group,the total WOMAC score,pain,stiffness and dysfunction scores were lower at all evaluation time points compared with those before treatment,with statistically significant differences(P<0.05).In the control group,at all evaluation time points,the total WOMAC score,pain and dysfunction scores were lower than pre-treatment,with statistically significant differences(P<0.05);stiffness scores were lower after 2nd week treatment and at the follow-up period,with statistically significant differences(P<0.05).(3)After 1st week of treatment,the adduction,flexion and extension range of hip joint increased in the observation group,and the difference was statistically significant(P<0.05),the control group had no significant improvement in all aspects of hip motion(P>0.05);After the 2nd week of treatment,all aspects of hip motion increased in the observation group,and the difference was statistically significant(P<0.05),the control group increased the range of motion in adduction,flexion,extension and internal rotation of the hip joint,the difference was statistically significant(P<0.05).(4)After the 1 st and 2nd week of treatment,there were no significant changes in the extensor knee motion in the two groups compared with before treatment,and the difference was not statistically significant(P>0.05),the curtsy activity of both groups increased compared with before treatment,and the difference was statistically significant(P<0.01).Conclusion:1 Heyang and Juliao apply Canggu Tanxue acupuncture method to improve knee osteoarthritis pain is effective,safe,and effective quickly,has a certain continuous treatment effect.2 Canggu Tanxue acupuncture method has certain advantages in improving stiffness and joint function of knee osteoarthritis,and has certain sustained therapeutic effect,which has good clinical prospect and research significance.In the future,relevant clinical studies on joint function can be carried out to further verify the effectiveness of Canggu Tanxue acupuncture method in improving knee osteoarthritis stiffness and joint function. |
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