[Effects of acupotomy on partial movement gait and serum tumor necrosis factor-α, interleukin-1ß in patients with knee osteoarthritis].

OBJECTIVE: To explore effects of acupotomy on pain, function, gait and serum inflammatory factors in patients with knee osteoarthritis(KOA). METHODS: From December 2017 to June 2019, 110 patients with KOA were collected and divided into acupotomy group(56 cases) and western medicine group(54 cases) by using random number table method. In acupotomy group, there were 16 males and 40 females, aged from 46 to 74 years old with an average of (62.98±6.68) years old, the course of disease ranged from 1 to 240 months with an average of 24.5(15.25, 33.00) months;were treated with acupotomy on the pain points around knee joint once a week for 3 weeks. In western medicine group, there were 18 males and 36 females, aged from 47 to 73 years old with an average of (64.19±5.98 ) years old;the course of disease ranged from 1 to 220 months with an average of 25.00(13.75, 33.00) months;were took celecoxib capsule orally, 200 mg once a day for 3 weeks. Oxford Knee Score(OKS) was performed before treatment, 3 weeks and 3 months after treatment. Gait kinematics analysis and serum levels of tumor necrosis factor-α(TNF-α) and interleukin-1ß (IL-1ß) were measured before and after treatment for 3 weeks. RESULTS: All patients were followed up from 6 to 24 months with an average of(15.03±4.55) months. OKS between two groups decreased significantly at 3 weeks and 3 months after treatment(P<0.001). Functional scores and overall scores in acupotomology group were significantly decreased at 3 months compared with 3 weeks after treatment(P<0.001). OKS of acupotomy group were significantly lower than those of western medicine group at 3 weeks and 3 months after treatment(P<0.05). Gait speed, frequency and length between two groups were significantly improved at 3 weeks after treatment(P<0.05). At 3 weeks after treatment, gait freguency of acupotomy group was significantly improved compared with western medicine group(P<0.05). TNF-α and IL-1ß were significantly lower in both groups at 3 weeks after treatment than before treatment(P<0.05). At 3 weeks after treatment, level of IL-1 ß was lower in western medicine group than in acupotomy group(P<0.05), and difference in TNF-α level was not statistically significant(P>0.05). CONCLUSION: Acupotomology of pain points could significantly improve pain, function, gait, and decreased serum inflammatory factors at early to mid stage of KOA patients, in particular, it is superior to non-steroidal anti-inflammatory drugs in terms of knee function recovery and cadence improvement.

[Experimental study on improvement of blood supply timeliness of rabbits with vertebral artery type of cervical spondylosis by massage].

OBJECTIVE: Establishing a rabbit model of vertebral artery type of cervical spondylosis(CSA) and to observe the characteristics of timeliness in improving the blood flow of vertebral artery by massage, and discusse the material basis of this timeliness based on NPY and ET-1. METHODS: Fifty New Zealand healthy and white rabbits, 6-month-old, the body mass of (2.0±0.5) kg, with half males and half females, were randomly divided into blank group, model group, three massage groups(including massage for 10 min, 20 min, and 30 min group by random number table), 10 rabbits in each group. In addition to the blank group, CSA rabbit model was made by injection of sclerosing agent in other groups. The rabbits of massage for 10 min, 20 min, and 30 min groups received the massage therapy of corresponding duration, one times a day, continuous 10 days. The blood flow of vertebral artery in each group was detected by PeriFlux5000 laser doppler, and the contents of NPY and ET-1 in serum were detected by ELISA before and after treatment. RESULTS: Changes in blood flow of vertebral artery before and after treatment:there was no significant difference between model group and massage for 10 min group;there was significant difference between model group and massage for 20, 30 min groups(P<0.01); there was significant difference between massage for 10 min group and massage for 20, 30 min groups(P<0.01); there was no significant difference between massage for 20 min group and massage for 30 min group. Changes of NPY content before and after treatment: there was significant difference between model group and massage for 10 min group(P<0.05); there was significant difference between model group and massage for 20, 30 min groups(P<0.01); there was significant difference between massage for 10 min group and massage for 20, 30 min groups(P<0.01); there was no significant difference between massage for 20 min group and massage for 30 min group. Changes of ET-1 content before and after treatment:there was no significant difference between model group and massage for 10 min group;there was significant difference between model group and massage for 20, 30 min groups(P<0.01); there was significant difference between massage for 10 min group and massage for 20 min, 30 groups (P<0.01); there was no significant difference between massage for 20 min group and massage for 30 min group. CONCLUSIONS: Massage needed 20 min for rabbits with CSA can only significantly improve the blood flow of vertebral artery. However, prolonging the time of massage has no obvious effect. The material basis of this timeliness characteristic of massage is closely related to the change of NPY and ET-1 levels in serum.