Objective: To observe the clinical effect of internal heat acupuncture therapy for knee osteoarthritis of early to middle stages, and explore its influence on cartilage thickness.
Methods: A total of 44 patients with knee osteoarthritis of early to middle stages were treated with internal heat acupuncture therapy at ashi points (most of them are located at the subpatellar fat pad, both sides of the patellar ligament, the tendon of the quadriceps and the attachment of the medial and lateral collateral ligaments), once a week, a total of 4 weeks of treatment. Before and after treatment, after 3 months of treatment completion (in the follow-up), the visual analogue scale (VAS) score, Western Ontario and McMaster Universities osteoarthritis index (WOMAC) score, frequency of 30-second chair stand test (30sCST), cartilage thickness of femoral intercondylar and knee joint ultrasound score were compared, and the clinical effect was evaluated.
Results: After treatment, the VAS、WOMAC and knee joint ultrasound scores were reduced (P<0.05), frequency of 30sCST was increased (P<0.05) compared with those before treatment; in the follow-up, the VAS、WOMAC scores were reduced (P<0.05), frequency of 30sCST and cartilage thickness of femoral intercondylar were increased (P<0.05) compared with those before treatment. After treatment, the total effective rate was 93.2% (41/44), in the follow-up, the total effective rate was 95.5% (42/44).
Conclusion: Internal heat acupuncture therapy is effective in the treatment of knee osteoarthritis of early to middle stages, could relieve the pain, improve the joint function, and delay cartilage degeneration and disease progression.
目的：观察内热针疗法治疗早中期膝关节骨关节炎（KOA）的临床疗效，并探究其对软骨厚度的影响。方法：招募44例早中期KOA患者采用内热针疗法治疗，穴取阿是穴（多位于髌下脂肪垫、髌韧带两侧、股四头肌肌腱处、内外侧副韧带附着处），每周1次，共治疗4周。比较患者治疗前后及治疗结束后3个月（随访）疼痛视觉模拟量表（VAS）评分、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分、30 s椅立测试（30sCST）次数、股骨髁间软骨厚度及膝关节超声评分，并评定临床疗效。结果：与治疗前比较，患者治疗后VAS、WOMAC、膝关节超声评分降低（P<0.05），30sCST次数增加（P<0.05）；随访时VAS、WOMAC评分降低（P<0.05），30sCST次数和股骨髁间软骨厚度增加（P<0.05）。治疗后总有效率为93.2%（41/44），随访时总有效率为95.5%（42/44）。结论：内热针治疗早中期KOA患者疗效较好，可减轻疼痛、改善关节功能，并有助于延缓软骨退变和疾病进展。.
Keywords: acupuncture; cartilage degeneration; internal heat acupuncture therapy; knee osteoarthritis, early to middle stages; musculoskeletal ultrasound.