[Clinical observation of warm needling therapy for treating knee osteoarthritis of different Chinese medical syndrome types].

OBJECTIVE: To observe the difference in the therapeutic efficacy of warm needling therapy on knee osteoarthritis (KOA) patients of different Chinese medical syndrome types. METHODS: Totally 197 KOA outpatients [including wind-cold-damp retention syndrome (50 cases, 61 knees), yang deficiency cold coagulation syndrome (48 cases, 58 knees), stagnation of blood stasis syndrome (49 cases, 63 knees), and insufficiency of Shen-essence syndrome (50 cases, 66 knees)] were treated with warm needling therapy, 10 days as one therapeutic course, 3 courses in total. The symptom score and changes of clinical efficacy were assessed. The contents of interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) in the synovial fluid were determined before and after treatment. RESULTS: The symptom scores and the clinical efficacy were improved in all syndrome groups after treatment (P < 0.05), with the best effects shown in the yang deficiency cold coagulation syndrome (P < 0.05) and the worst effects shown in the stagnation of blood stasis syndrome (P < 0.05). The contents of IL-1, IL-6, and TNF-alpha in the synovial fluid decreased after treatment in all syndrome groups (P < 0.05), with the best effects shown in the yang deficiency cold coagulation syndrome (P < 0.05). CONCLUSION: Warm needling therapy had favorable therapeutic effects on KOA patients of wind-cold-damp retention syndrome, yang deficiency cold coagulation syndrome, and insufficiency of Shen-essence syndrome, with the best effects shown on KOA patients of yang deficiency cold coagulation syndrome.

Clinical study on the treatment of knee osteoarthritis of Shen-Sui insufficiency syndrome type by electroacupuncture.

OBJECTIVE: To study the clinical effificacy of electroacupuncture (EA) on treating knee osteoarthritis (KOA) of Shen ()-Sui () insuffificiency (SSI) syndrome type. METHODS: A total of 245 patients (279 knees) of KOA-SSI were randomly assigned to two groups by lottery: 141 knees in the treatment group and 138 knees in the control group. The treatment group was managed with EA at the dominant points of Neixiyan (Ex-LE4) and Waixiyan (Ex-LE5) as well as the conjugate points of Xuanzhong (GB39) and Taixi (KI3) for 30 min, once a day, with 15 days as one course; 2 courses were applied with a 5-day interval in between. The control group was treated with intra-articular injection of 2 mL hyaluronic acid into the affected joint every 7 days for 5 times in total. The clinical effects on the patients in different stages were observed, and their symptom scores of knee and contents of cytokines, including interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), prostaglandin E(2alpha) (PGE(2alpha)) and matrix metalloproteinases-3 (MMP-3), in the knee joint fluid were measured before and after treatment. RESULTS: The study was completed in 235 patients (263 knees); four patients (7 knees) in the treatment group and six patients (9 knees) in the control group dropped out. Comparison of therapeutic effects (excellent and effective rates) between the two groups showed insignificant differences (P>0.05). Symptom scores of knee and contents of cytokines in the knee flfluid after treatment were lowered signifificantly in the patients of stage I-III in both groups (P<0.05 or P<0.01). However, the lowering of the total symptom score of knee in the patients of stage III in the treatment group was more signifificant (P<0.05). CONCLUSIONS: EA could effectively alleviate the clinical symptoms in KOA patients of stage III, showing an effect superior to that of hyaluronic acid. EA also shows action in suppressing the secretion of IL-1, IL-6, TNF-alpha, PGE(2alpha) and MMP-3 in the knee flfluid.