[Warm-needling moxibustion for knee osteoarthritis:a randomized controlled trial].

OBJECTIVE: To evaluate the clinical efficacy of warm-needling moxibustion for knee osteoarthritis (KOA), and to explore its effects on isokinetic strength of lower limb muscle.

METHODS: Fifty cases of KOA were randomly divided into an observation group (25 cases) and a control group (21 cases), but 4 cases lost contact. The observation group was treated with warm-needling moxibustion at Dubi (ST 35), Neixiyan (EX-LE 4), Xuehai (SP 10), Liangqiu (ST 34), Yinlingquan (SP 9), Yanglingquan (GB 34), Weizhong (BL 40), Heyang (BL 55) and Fengshi (GB 31) for 40 min per treatment. The first 6 treatments were given once a day, and the last 6 treatments were given once every other day. 12 treatments were taken as one course, and totally 3-week treatment was given. No treatment was given in the control group for 3 weeks. The isokinetic strength of extensor muscle and flexor muscle, including the total work, absolute peak torque (aPT) and relative peak torque (rPT), and Western Ontario and McMaster Universities Arthritis Index (WOMAC), and comprehensive efficacy were observed and compared in the two groups.

RESULTS: Compared before treatment, the total work, aPT and rPT of the extensor and flexor muscle increased significantly after treatment in the observation group ( P <0.01, P <0.05), but the flextion/extention ratio was lowered ( P <0.05). In the control group, aPT and rPT of flexor muscle were reduced after treatment ( P <0.05, P <0.01). The total work, aPT and rPT of the extensor muscle in the observation group were higher than those in the control group after treatment ( P <0.05, P <0.01), but the flextion/extention ratio was lowered ( P <0.05). The item score and total score of WOMAC were reduced in the observation group after treatment (all P <0.01), but no significant change was observed in the control group (all P >0.05). The pain score, stiffness scores and total score of WOMAC in the observation group were lower than those in the control group ( P <0.01, P <0.05); the score of daily function activities was declined in the observation group, but not significantly different from that in the control group ( P >0.05). The total effective rate was 88.0% (22/25) in the observation group.

CONCLUSIONS: Warm-needling moxibustion could relieve pain, improve function and muscle balance, strengthen extensor and flexor muscle power, especially extensor, which has superior clinical efficacy.