Comparative Study on the Clinical Therapeutic Effect of Moxibustion from Different Origins in the Treatment of Moderate to Severe Knee Osteoarthritis
Shimin Liu Yin Shi Chunyan Wang Shiyong Xue Tao Li
(1 Shanghai University of Traditional Chinese Medicine, Shanghai, 201203; 2 Shanghai Institute
of Acupuncture-Moxibustion and Meridian, Shanghai, 200030)
Abstract Objectives: Based on the clinical randomized controlled trial, treating moderate to severe knee osteoarthritis by using mugwort stick from different place of origin (Qichun county, Hubei province VS Nanyang city, Henan province). Evaluating the clinical efficacy by WOMAC OA, VAS and SF-36 to reveal the therapeutic effect and short-term effects of different origin mugwort used.Methods: 60 patients with moderate to severe KOA were randomly assigned to 2 groups, which are consisted of Qichun moxibustion group (here in after referred to as Qichun group) and Nanyang moxibustion group (hereinafter referred to as the Nanyang group), with each group 30 cases. All patients informed consent before treatment, and according to the criteria, the treatment starts three days after the discontinuation of all kind of medication related to KOA. Qichun group uses the 3-year-old mugwort from Qi-Chun County, Hubei Province group as the Nanyang group also uses the 3-year-old mugwort from Nanyang city, Henan Province. The 10:1 mugwort processed into a diameter of 1.75cm, 20cm long Moxa. Du Bi (ST -35), Nei Xi Yan (EXLE4), He Ding (EX-LE2) were selected, moxibustion applied to each acupoints for 20 minutes, three times a week, two weeks in a total of six treatments. Observation of the effect was taken at the time of recruitment (0 weeks, W0), by the end of treatment (2 weeks, W2) and a follow-up for two weeks (4 weeks, W4). This study uses WOMAC OA scales, visual analog scale (VAS) scale and the SF-36 quality-of-life scale to evaluate the effect of the two group differences and the recent efficacy. A database was created after the trial ended, statistical analysis by the SPSS v.23.0. Assessment: Cure: WOMAC OA score lowered than 80% before treatment. Significantly effective: score lowered between 50% and 80%. Slightly effective: score lowered between 25% and 50%. Ineffective: score lowered <25%. Results: 1. Baseline studies: Gender, age, lesion site, duration, WOMAC pain subjects, VAS scale, the physiological functions (PF) and body pain (BP) score of SP-36 showed no significant difference (P >0.05) in both groups. 2. Qichun pain subjects comparison: At the end of the treatment, WOMAC pain subjects, VAS scale, SF-36 PF and BP scores have significant difference compared to the baseline (P <0.01). In two weeks of follow-up, WOMAC pain subjects, VAS scale have significant difference compared to the baseline (P<0.01), SF-36 PF and BP scores have significant difference compared to the baseline (P <0.05). 3. Nanyang group pain subjects comparison: At the end of treatment, WOMAC pain subjects, VAS scale, SF-36 PF and BP scores have significant difference compared to the baseline (P <0.01). In two weeks of follow-up, WOMAC pain subjects, VAS scale has significant difference compared to the baseline (P <0.01), SF-36 PF and BP scores has significant difference compared with baseline(P <0.05). 4. Trial interventions: vertical comparison: the decreasing of scores in WOMAC pain subjects, VAS scale, SF-36 PF of both groups showed no significant differences (P >0.05). The increasing scores in SF-36 BP showed significant difference (P <0.05). In two weeks of follow-up, the decreasing of scores in WOMAC pain subjects, VAS scale of both groupsshowed no significant differences (P >0.05). Conclusion: 1. Moxibustion treatment for moderate to severe osteoarthritis of the knee cansignificantly relieve patients’ pain, stiffness and improve knee functions and quality of life. 2. There is no significant difference of treating effect between using mugwort from two different origins in the treatment. The difference of the short-term treatment needs further studies.
Key words: Different origins; Moxibustion; Moderate to severe osteoarthritis of the knee; Therapeutic effect