Knee osteoarthritis treated with TCM
【Key Words】 knee osteoarthritis; Arthralgia / TCM therapy; acupuncture therapy; Massage Therapy
Knee osteoarthritis (knee osteoarthritis, KOA) is common in the elderly, multiple bone and joint diseases, the pathological features of articular cartilage degeneration and destruction and osteophyte formation, eventually leading to joint dysfunction, pain and swelling in knee , stiffness, dysfunction as the main clinical manifestations. Domestic survey ,35-64-year-old group the prevalence of knee pain and KOA were
13.6% and 10.9% [1], with the socio-demographic aging, KOA incidence gradually
increased. Chinese medicine believe that osteoarthritis of the knee are "Gubi" "Tong Bi" "Crane knee Wind" and other areas in recent years, Chinese medicine KOA
continuous deepening of the study, treatment has also been enriched satisfactory outcome is almost 10 years KOA medical treatment literature are summarized below.
A traditional Chinese medicine
1.1 within the governance of ancient Chinese medicine Doctors believe that the incidence of KOA with the old liver and kidney deficiency, and exogenous factors such as wind cold dampness evil, eventually leading to partial knee joint blood, phlegm
stasis, meridian barrier disease. "Doctor Chang Tong" On the expression: "the knee for the tendons of the House ... ... there is no knee pain due to liver and kidney are not imaginary person." QI Shuqing [2] emphasized that its incidence in order to empty the
main root of the problem-based therapy to complement liver and kidney in order to
cultivate the strengths, Sheng Jin Rong Gu legislation, treatment with Fu Yuan-Rong
soup KOA 64 cases were cured, 48 cases improved in 11 cases, ineffective in 5 cases, the
total effective rate 92.18%, the recurrence rate of 18.75%, and the long-term better
effect. Zhen-Hua Li [3] so as to replenishing liver and kidney, Qi Blood Circulation for the rule is used to repair a bone in the treatment side and the Western Fenbid KOA 60
cases, the results of bone-treated group significantly alleviate clinical symptoms of knee joint, joint function improved significantly, Fenbid and more effective than the control group. Xie Xin-jun [4] to the main Chinese herbs, use the "Puji competent party" Si
Xian Fang Modified treatment of Dipsacus KOA 44 cases of clinical control in 17 cases, 19 cases were markedly effective in 7 cases, ineffective in 1 case. "Su asked numb On the chapter," reads: "wind cold dampness to the three gas-hybrid, combined into
paralyzed people." Tang Rong Chuan "blood card" formula, "Bi by stasis disease," said, so there are many scholars treat from the real start by expelling wind, cold-
dispelling, dehumidification, Huoxue Tongluo symptoms serve as a model. Leibo [5] so
as to stimulate blood circulation, phlegm dampness arguments, since the parties intended to treat blood stasis and phlegm KOA 48 cases, the total effective rate 91.7%. "Treatment of the criterion" Cloud: "(knee) has the wind, there is cold, there is sprain,
there is bleeding, there is phlegm accumulation, all they really should, kidney its the people." Majority of scholars believe that the actual situation of the disease inclusions, blood, liver and kidney of virtual-based, blood stasis, phlegm as the standard,
emphasizing specimens wen, actual situation and stressed that more effective than pure tonic or cured real France. Li Zhimin, etc. [6] in order to stimulate blood circulation, expectorant dehumidification, temperature through the liver and kidney meridians and
qi and blood to fill method was used to Guiyuan Powder Treatment KOA 50 cases, 9 cases recovered, 26 cases markedly effective in 15 cases, ineffective 0 cases . Lin Yan Germany [7] Kidney strong bones, and cold-dispelling Qufeng other drugs with the use,
eliminate redundant self-made Huoxue Decoction KOA 42 cases, the total effective rate 95.24%. Italy Rong Zeng et al [8] stressed the kidney is the incidence of knee osteoarthritis of the fundamental, congestion closed resistance is the key to the
pathogenesis of two interrelated and influence each other can cause kidney deficiency and blood stasis, blood stasis increased kidney, The virtual standard is a false certificate, with the kidney Zhuanggu, promoting blood circulation and pain of Bu Shen Huo Xue Fang immortal tablets in the treatment of KOA 42 cases of patients with symptoms and signs of significant improvement, efficacy was significantly better than the control group.
1.2 Chinese medicine for external use outside the governance of Chinese medicine
therapies, including KOA Fumigation method, external application of law, medicine iontophoresis and so on, have a good curative effect, non-toxic side effects, cheap, etc.,
and the drug through the heat, more conducive to drug penetration, improve local
blood cycle. Liujin Wen et al [9] with Kim Washing Treated KOA 40 cases, the party has Qufengchushi, pass through the rolling, in addition to stasis pain of power, can quickly reduce symptoms lasting. Wang Li [10] with expelling wind, promoting blood
circulation, meridians of Chinese medicine treatment of home-made tri-color deposited
fomentation 60 cases of the disease, the total efficiency of 95%, indicating that its KOA has Shujin vibrant, and swelling analgesic effect. Tai-Ping Peng et al [11] with
replenishing kidney-qi, promoting blood circulation Qufengchushi, the kidney
Tongbizhitong Juanbi liquid Iontophoresis treatment of senile KOA 50 cases, symptom improvement rate of 90%, significantly better than Fenbid the control group.
2 Acupuncture
Acupuncture by stimulating the systemic and local points can effectively clear the systemic and local meridians, played Qufeng cold-dispelling, promoting blood
circulation pain and so on. ZHANG Yi [12] using acupuncture therapy (knee eyes,
Yanglingquan, Yin Ling Quan, Zusanli liangqiu) in treatment of KOA 34 cases, the total effective rate was 97%. ZHANG Bi-meng et al [13] reported that acupuncture can
enhance penetration through the exterior and adjacent meridians of communication,
enhance the amount of stimulation, so that a sense of easy-to-needle conductive to
effective partial knee to clear the meridians, to reconcile qi and blood, bones and muscles Ruyang the purpose of using long - needle in treating 32 cases of KOA, the
total effective rate 78.5%, obviously superior to western medicine control group. Tao Kwan et al [14] The treatment of abdominal acupuncture with acupoint selection of local KOA, abdomen, knees to take the same side of the Zhongwan, Guan yuan, foreign Ling, Tai Wang, abdominal odd hole, with the partial knee points, the total effective rate 96.7% , acupuncture points can be adjusted abdominal organs function of meridians and related parts of blood, abdominal Acupoints also has Qufengchushi, reduces swelling, pain, Huayu Tongluo the role of various points combined, played a
rousing effect. Huang Jing [15] with the scar moxibustion therapy (taking the full three years and the clock hanging points) in treatment of KOA 50 cases, the total effective rate 92.0%, direct moxibustion can take advantage of moxibustion Qufengchushi, Wen Tong meridians, qi and blood Warming the role of acupuncture after the partial formation of moxibustion moxibustion sore on the points to create a continuous stimulation, can continue to play a regulatory role Meridian, effectively dispel wind
cold dampness weakness, so deep into the inside of the Evils product efflux. CAO Yin-
Xiang et al [16] using warm acupuncture treatment KOA, mainly the partial selecting points (Yin Ling Quan, Yang Ling-chuen, knee, eye, A is the Point), acupuncture was
gas, then ignited moxa needle handle end, burn After the needle injection, a total of 42 patients, with a total effective rate was 96.7%, this method can effectively promote the partial blood circulation, speed up the metabolism of the organization is conducive to intra-articular inflammation of the absorption to eliminate swelling, pain only, the purpose of improving joint function .
3 Massage
Local application of massage techniques with Shujin vibrant, and lifting the role
of local muscle spasm. JIANG Sheng-Yun [17] To observe the KOA will cause changes
in ipsilateral lower extremity muscle strength, so that increase joint instability, which in turn increase the degree of osteoarthritis of the disease, massage can help to restore
muscle function, enhance joint stability, simple to use manipulation therapy for KOA 50 cases, the results of 31 cases recovered, accounting for 62%, improved in 15 cases, accounting for 30%, 4 cases, accounting for 8%. YANG [18] reported that massage has
to adjust imbalances in the meridian system, improve local blood circulation, strengthen muscles, tendons, ligaments flexible, eliminating muscle cramps and joints such as the role of adhesion, using manipulation therapy for 156 patients, results were
excellent in 115 cases , good in 31 cases, in 8 cases and poor in 2 cases, results were satisfactory. Reposted elsewhere in the paper for free download http://
4 other therapies and comprehensive treatment
Treatment also includes the needle-knife, scraping, cupping and so on. Liu Tie
[19] stressed the knee ligaments and tendons around the ending point of the edema, exudation, adhesions, and scars in the pathogenesis of osteoarthritis play an important
role in needle-knife treatment can change the ligament and tendon activity, flexibility and mechanical direction, the promotion of local metabolism, so that the organizational functions and activities of recovery, using needle-knife lysis treatment of KOA 84 cases
were cured in 52 cases, effective in 29 cases, improvement in 3 cases, efficiency 100%. Wang Xue-Pu [20] using temperature-acupuncture and Gua Sha Treatment KOA 48
cases, the total effective rate 97.9%, partial scraping can play to clear the meridians, Qi
pain, dispels dampness muddy the role of needle used in conjunction with the temperature, efficacy enhanced. Many scholars will be an organic combination of a variety of treatment methods to use, such as Acupuncture and Chinese Herbs, massage combined with drugs and so on, Chenyue An [21] The combination of traditional Chinese medicine massage therapy fumigation KOA 38 cases of apparent effect.
5 Summary and Outlook
Looking at literature, Chinese medicine treatment of knee osteoarthritis way more
significant effect, no significant toxicity in patients with different syndromes according to a flexible set of square sub-type, choose the best treatment options, more in line with the principle of individual treatment of KOA. But also there are some problems: (1)
Chinese medicine treatment KOA is still lack of uniform diagnostic criteria, clinical classification and efficacy standards, research design also is not stringent enough, and the observation of clinical cases a short time, the lack of appropriate long-term
randomized double-blind controlled study. (2) to control symptoms while Chinese medicine treatment can change the KOA progression of the disease, but its underlying mechanism is not fully clear, still combined with modern experimental methods, to
further enhance the depth and breadth of experimental studies to give evidence. (3) Chinese medicine, acupuncture, massage and other treatment methods each with its own strengths and weaknesses, how to be an organic combination of each other to
provide a reasonable clinical observation of combined treatment should also be confirmed. (4) for the extraction of active ingredients of Chinese medicine, developed the application of convenience, high efficacy and affordable pills, tablets, injection and
external plaster, etc. are consistent with osteoarthritis of the knee mechanism of TCM Syndrome patients have identified experimental basis of modern medicine in medicine preparation, give full play to traditional Chinese medicine "Jane, then, inspection, and
honesty," the characteristics and advantages, is still the focus of future research directions.
【References】
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46. Reposted elsewhere in the paper for free download http://www.hi138. com