[Efficacy of thunder-fire moxibustion combined with external applicaion of Shuangbai powder for mild and moderate knee osteoarthritis].

OBJECTIVE: To compare the therapeutic effect between thunder-fire moxibustion combined with external applicaion of Shuangbai powder and thunder-fire moxibustion alone for mild and moderate knee osteoarthritis. METHODS: A total of 70 patients with mild and moderate knee osteoarthritis were randomly divided into an observation group and a control group, 35 cases in each group. In the observation group, thunder-fire moxibustion combined with external applicaion of Shuangbai powder were applied, Thunder-fire moxibustion was applied at Xuehai (SP 10), Liangqiu (ST 34), Neixiyan (EX-LE 4), Yanglingquan (GB 34) and ashi point, external applicaion of Shuangbai powder was given to the affected knee after the treatment of thunder-fire moxibustion. Simple thunder-fire moxibustion was given in the control group. All patients in the two groups were treated once a day, 7 days as one course and the consecutive 4 courses were required, with an interval of 1 day between courses. Before and after treatment, the visual analogue scale (VAS) score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were used to assessed knee pain, stiffness and physical function in the two groups. In addition, the efficacy was evaluated. RESULTS: Compared before treatment, the VAS scores, total scores of WOMAC, pain scores, stiffness scores and physical function scores were reduced after treatment in the two groups (P<0.01), and the scores in the observation group were significantly lower than those in the control group (P<0.01, P<0.05). The total effective rate was 97.0% (32/33) in the observation group, which was superior to 91.2% (31/34) in the control group (P<0.05). CONCLUSION: Thunder-fire moxibustion combined with external applicaion of Shuangbai powder are superior to simple thunder-fire moxibustion in improving the symptoms and delaying the development of the disease for mild and moderate knee osteoarthritis.

[Effect of electroacupunture on supplementary analgesia and the levels of serum ß-endorphin and prostaglandin E2 in patients with total knee arthroplasty].

OBJECTIVE: To observe the effect on supplementary analgesia after total knee arthroplasty (TKA) treated with electroacupunture, and explore it's mechanism. METHODS: A total of 40 patients with severe knee osteoarthritis were randomized into an observation group and a control group, 20 cases in each one. During the operation, patients were given epidural anesthesia in the two groups, conventional patient controlled epidural analgesia and oral celecoxib were applied after the operation. In the observation group, electroacupunture was used at Liangqiu (ST 34), Xuehai (SP 10), Yinlingquan (SP 9), Zusanli (ST 36), Fenglong (ST 40) and Qiuxu (GB 40) on the operation side from the 1st to 7th day after the operation to support analgesia, 30 min for each time, once a day. The visual analogue scale (VAS) was used to record postoperative pain of resting state and active state. The levels of serum prostaglandin E2 and ß-endorphin were measured on the 1st and 7th day after surgery in the two groups. RESULTS: In the observation group, the VAS scores of resting state and active state were superior to the control group on the 3rd, 5th and 7th day after the operaton (all P<0.05); after the treatment, the level of serum ß-endorphin was increased and the level of serum prostaglandin E2 was reduced in the two groups (all P<0.05), and the change of the observation group was larger than that of the control group (both P<0.05). CONCLUSION: Electroacupunture has the effect of supplementary analgesia for patients after TKA, the mechanism may be related to promote the synthesis of ß-endorphin and inhibit the synthesis of prostaglandin E2.

[Electroacupuncture Intervention Reduces Post-surgical Pain of Patients Undergoing Total Knee Arthroplasty].

OBJECTIVE: To observe the analgesic effect and safety of electroacupuncture (EA) intervention for patients undergoing total knee arthroplasty (TKA). METHODS: A total of 40 patients undergoing TKA were randomly assigned to control group (simple multi-mode analgesia, n＝20) and EA group (EA combined with multi-mode analgesia, n＝20). Both groups were treated with epidural anesthesia during surgical operation, and conventional epidural automatic analgesia and oral Celecoxib after surgery. Following surgery, EA was applied to Liangqiu (ST 34)-Xuehai (SP 10), Yinlingquan (SP 9)-Zusanli (ST 36), Fenglong (ST 40)-Qiuxu(GB 40) on the operation side for 30 min, once daily for 7 consecutive days. The patients' pain state during rest and motion was assessed by using visual analogue scale (VAS). The active and passive knee flexion range of motion (ROM), use of painkillers including the number of patient's controlled epidural analgesia (PCEA) during 48 h after surgery, and other complications were recorded. RESULTS: After the treatment, the VAS scores under rest and motion state were both significantly lower in the EA group than in the control group on day 3, 5 and 7 after surgery (P<0.05). During 48 h after surgery, the number of PECA was significantly lower in the EA group than in the control group (P<0.05). Of the two 20 cases in the control and EA groups, 3 and 1 asked to receive muscular injection of Tramadol Hydrochloride for pain relief, 3 and 2 experienced nausea-vomiting, 2 and 1 had dizziness and headache, and 2 and 1 had a chest distress feeling, respectively, which had no significant differences between the two groups (P>0.05). The white blood cell (WBC) count in both groups were decreased gradually from day 1 to 7 after surgery, and plasma C-reactive protein content on day 5 and 7 were also lowered in both groups, without statistical differences between the two groups in the post-operative complications, dosages of additional postoperative analgesic drugs, and levels of plasma WBC and C-reactive protein (P>0.05). CONCLUSION: EA can effectively improve the early postoperative pain of TKA, reduce the incidence of postoperative complications and the use of analgesic drugs in TKA patients.