DOI:10.13703/j.0255-2930.2011.12.003 2011 12 31 12 Chinese Acupuncture & MoxibustionDec.2011Vol.31No.12 1057 :0255-2930(2011)12-1057-05 :R246.2 : A 檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪 : 12 2 23 2 2 2 2 (1. 226001;2. 201203;3. ) [ ] : :59 (31 ) (28 ) 3 1 3 6 3 6 6 (WOMAC) 46m UT-325 : 3 6 WOMAC (P<0.05P<0.01P<0.001); (P<0.05); 6 (P<0.01P<0.05) 6 46m (P<0.01) (P> 0.05) (P>0.05) (49.81±3.10) (40.98±1.67) (P<0.001P<0.01) (P<0.001) : [ ] ; ; Kneeosteoarthritistreatedwithmoxibustion:arandomizedcontroledtrial REN Xiu-mei 12 CAO Jin-jin 2 SHEN Xue-yong 23 WANG Li-zhen 2 ZHAO Ling 2 WU Fan 2 ZHANG Hai-meng 2 (1.Acupuncture-Moxibustion Department Afiliated Hospital of Nantong UniversityNantong 226001Jiangsu ProvinceChina;2.Acupuncture-Moxibustionand Massage ColegeShanghai University of TCMShanghai201203;3.ShanghaiResearchCenterofAcupuncture-Moxibustionand Meridian) ABSTRACT Objective Toobservetheeficacyofmoxibustionontheimprovementinpainstifnessandmotordistur- banceforthepatientswithkneeosteoarthritis (OA)andevaluatetheefectivenessandsafetyofmoxibustiontherapy. Methods Fifty-ninecasesofkneeOA wererandomlydividedintoamoxibustiongroup(31cases)andaplacebomoxibus- tiongroup(28cases)inwhichmoxaconeandplacebomoxastickerwereappliedtoneixiyan(ex-le4)dubi(st35) andashipointsseparately3conesoneachpointineachtreatment.thetreatmentwasgivenonceeverytwodays 3timesperweekcontinuouslyfor6weeks.Thefolow-upvisitwasperformedin6weeksaftertheendoftreatment. The WesternOntarioand McmasterUniversitiesOsteoarthritisIndex(WOMAC)andthetimeof46-meterwalkingatthe fastestspeedwereadoptedtoevaluatetherecoveryofjointfunction.ut-325digitalthermaldetectorwasusedtorecord thetemperaturechangeatthemostapparentpainpointsofkneejointbeforeandaftermoxibustiontreatment.results In moxibustiongroupthescoresin WOMAC werereducedapparentlyin3and6weekstreatmentandduringfolow-upvi- sitseparately(p<0.05p<0.01p<0.001).inplacebomoxibustiongroupduringfolow-upvisitthescoreofstif- nesswaslowerascomparedwiththatbeforetreatment(p<0.05).in6weeksoftreatmentandduringfolow-upvisit thescoresofpainstifnessandmotordisturbanceinmoxibustiongroupwerereducedmuchmoreremarkablyascompared withplacebomoxibustiongroup(p<0.01p<0.05).inmoxibustiongroupaftertreatmentfor6weeksthetimeof46-me- terwalkingatthefastestspeedwasshorterapparentlyascomparedwiththatbeforetreatment(p<0.01)buttherewasno apparentimprovementaftertreatmentinplacebomoxibustiongroup(p>0.05).thediferencewasnotsignificantstatistical- lyingroupcomparison(p>0.05).aftermoxibustionthetemperatureattreatmentpointwas(49.81±3.10) inmoxi- bustiongroupandwas(40.98±1.67) inplacebomoxibustiongroup.thelocalskintemperatureincreasedapparentlyas 973 :2009 CB522901; :S30304; :08 DZ197280108 DZ1973000 : (1957-) : E-mail:snowysh@hotmail.com
1058 2011 12 31 12 Chinese Acupuncture & MoxibustionDec.2011Vol.31No.12 comparedwiththatbeforetreatmentineithergroup (P<0.001P<0.01)butthetemperatureincreasinginmoxibustion groupwasmuchmoreremarkable(p<0.001).conclusion Moxibustioncanobviouslyimproveintheclinicalsymptomsfor thepatientswithkneeosteoarthritissuchaspainstifnessandmotordisturbance.itisasafeandefectivetherapy. KEY WORDS OsteoarthritisKnee;Moxibustion;RandomizedControledTrial(RCT) [6] [1] 1 1.1 ( :ChiECRCT - 20110022) Meta 2009 9 2010 12 [2-5] 65 (33 ) (32 ) 2 3 ; 2 2 59 6 ( P>0.05) 1 1 ( ) ( ) ( x±s) 珚 ( ) ( ) ( x±s ) 珚 ( x±s) 珚 31 11 20 55 78 64.03±7.24 6 30 6.82±6.60 24.36±2.90 28 8 20 47 77 62.57±8.12 3 30 7.15±7.72 25.03±3.35 1.2 ;3 3 (ACR) ( ) (1995) [7] :11 ;2X ;4 ;3 1.5 ;4 40 ;5 30min;6 12 1356 145 1 : 6 2 : 1.3 1 45~78 ;2 3 : 1 ;3 3 ( ) ;4X : (Kelgren-Lawrencegrade 2);5 1.4 1.6 1 Excel2003 ( ) ;2 ; ( 5 ) ;
2011 12 31 12 Chinese Acupuncture & MoxibustionDec.2011Vol.31No.12 1059 ; 2 2.1 8mm ( 1) [8] 1 2.2 100mm( ) 3 6 14 ; (2) UT-325 ( 3 1 3 618 1 ) 3 2 ; >2 (3)50 (46 m) : 2.3 46 ( ) =[ 46m - 46m ) 46m ] 100% 3.2 3 3.1 (1) (Western Ontarioand Mc- Master Universities OsteoarthritisIndexWOMAC): SPSS16.0 ± ( x±s) 珔 WOMAC 46m t P<0.05 24 5 2 3.3 17 (1) WOMAC 0( )~ ( 2) 2 WOMAC ( x±s) 珚 3 6 6 32.42±16.97 22.92±14.60 1) 12.67±7.51 3)4) 13.57±10.95 3)5) 31 32.07±16.70 20.26±13.56 2) 15.39±12.56 3)5) 14.66±13.36 3)5) 37.15±22.73 24.87±20.39 2) 15.39±11.74 3)5) 14.97±16.21 3)5) 28 26.94±13.13 27.34±15.50 22.47±15.41 23.29±18.81 28.35±15.06 27.86±16.43 23.73±18.07 23.79±18.45 34.95±20.48 26.63±18.02 26.18±22.60 24.18±17.85 1) : 1) P<0.05 2) P<0.01 3) P<0.001; 4) P<0.01 5) P<0.05
1060 2011 12 31 12 Chinese Acupuncture & MoxibustionDec.2011Vol.31No.12 2 WOMAC (NSAID) [12] ( P>0.05) [13-14] ; 3 6 6 WOMAC (P< 0.05P<0.01P<0.001); (P<0.05); 6 (P<0.01P<0.05) (2) ; ( 3) 22 28.52±1.34 40.98±1.67 2) t 1.614 11.876 P >0.05 <0.001 : 1) P<0.001 2) P<0.01; 3) P<0.001 46m ( s) (%) 31 34.73±5.65 32.10±4.87 1) 6.68±13.28 28 33.69±6.11 32.31±5.44 2.75±14.82 t 0.680 0.157 1.074 P >0.05 >0.05 >0.05 : 1) P<0.01 4 46m WOMAC (P>0.05) ; 46m (t= 3.444P<0.01) (P>0.05) :1 (P>0.05) 2 4 ; 3 ( x±s ) 珚 24 29.11±1.16 49.81±3.10 1)3) 3 6 6 WOMAC ; 3 ; 3 (P<0.01P<0.001); 6 (P<0.001) (3) 46 m ( 4) 6 4 46m ( x±s) 珚 (OA) 3 [9-10] 53% [11] 4
檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪檪 2011 12 31 12 Chinese Acupuncture & MoxibustionDec.2011Vol.31No.12 1061 [5] BermanB MLaoLLangenbergPetal.Efectiveness ofacupunctureasadjunctivetherapyinosteoarthritis oftheknee:arandomizedcontroledtrial[j].annin- tern Med2004141(12):901-910. 5 [6]. [J]. 200121(7):388. [7] AmericanColegeofRheumatologySubcommiteeonOs- 46 m teoarthritisguidelines.recommendationsforthe medical 46 m managementofosteoarthritisofthehipandknee[j]. (P>0.05) ArthritisRheum200043(9):1905-1915. [8] ZhaoBWangXLinZetal.Anovelsham moxibus- 10 tiondevice:arandomizedplacebo-controledtrial[j]. 3 1 ComplementTherMed200614(1):53-60. [9] DawsonJLinselLZondervanKetal.Impactofper- sistenthiporkneepainonoveralhealthstatusinel- derlypeople:alongitudinalpopulationstudy[j].ar- thritisrheum200553(3):368-374. [10] PalmerK TReadingICalnan Metal.Doeskneepainin thecommunitybehavelikearegionalpainsyndrome Pro- spectivecohortstudyofincidenceandpersistence[j].ann Rheum Dis200766(9):1190-1194. [11]. (2007 )[J]. 200727(10):793-796. [12] Watson MBrookesS TFaulkner Aetal.WITH- [1]. [M]. : DRAWN:Non-aspirinnon-steroidalanti-inflammato- rydrugsfortreatingosteoarthritisoftheknee[j]. 2004:37. [2] CochraneDatabaseSystRev2007(1):CD000142. SangdeeCTeekachunhateanSSananpanich Ketal. [13] TramèrM RMooreR AReynoldsDJetal.Quan- Electroacupunctureversus diclofenacin symptomatic titativeestimationofrareadverseeventswhichfolow treatmentofosteoarthritisoftheknee:arandomized abiologicalprogression:anew modelappliedtochro- controledtrial[j].bmc Complement Altern Med nicnsaiduse[j].pain200085(1-2):169-182. 20022:3. [14] [3] SilversteinFEFaichGGoldsteinJLetal.Gastroin- TukmachiEJubbRDempseyEetal.Theefectof testinaltoxicitywithcelecoxibvsnonsteroidalanti-in- acupunctureonthesymptomsofkneeosteoarthritis: flammatorydrugsforosteoarthritisandrheumatoid an open randomised controled study[j].acupunct arthritis:theclassstudy:arandomizedcontroled Med200422(1):14-22. [4]. trial.celecoxiblong-term ArthritisSafetyStudy[J]. : [J]. 201030(8): JAMA2000284(10):1247-1255. 617-622. 2010 ( :2011-05-31 ) 2010 75 140 30 3 : 16 :100700 :010-84046331 :