Yu Dan, Xie Hong-wu, Zhang Bo, Wen Hai-ju, Chen Ri-xin
Clinical College of Jiangxni College of Chinese Medicine, Nanchang 330004, China.
Department of Acu-moxibustion and Rehabilitation, The Affiliated Hospital of Jiangxi College of Chinese Medicine, Nanchang 330006.
Zhen Ci Yan Jiu. 2013 Dec;38(6):497-501.
To observe the clinical effect of moxibustion of different acupoints undergoing heat-sensitive state and resting state in the treatment of knee osteoarthritis (KOA) patients.
A total of 60 cases of KOA patients were enrolled in the present trial. They were divided into heat-sensitive moxibustion (heat-sensitive) group and non-sensitive moxibustion group (resting group). Moxibustion was applied to Neixiyan (EX-LE 4), Waixiyan (i.e. Dubi, ST 35) and Heding (EX-LE 2) for about 45 min, once daily for 20 days. The heat-sensitive state was evaluated according to the patient's feeling. After moxibustion stimulation at the acupoint area, if the patient feels the heat penetrating from the skin surface to the deep tissue, or/and extending peripherally around the moxibustion site, or/and transmitting toward a certain direction, it is considered to be heat sensitization state. The therapeutic effect was evaluated by using visual analogue scale (VAS) for pain severity changes and by Guiding Principles for Clinical Trials of New Drugs of Chinese Materia Medica for evaluating functional activity of the knee-joint.
After 20 sessions of treatment and after a half year's follow-up, the total integrated scores of VAS in the heat-sensitive group were all lower than those of the resting group (P < 0.01). Following 20 sessions of treatment, of the two 30 KOA patients in the heat-sensitive group and resting group, 14 (46.67% )and 5 (16.67%) experienced a marked improvement, 10 (33.33%) and 9 (30.00%) were effective, 6 (20.00%) and 16 (53.33%) were invalid, with the effective rates being 80.00% and 46.67 , respectively. Half-year's follow-up showed that the effective rates of the heat-sensitive group and resting group were 79.17% (19/24) and 42.86% (6/14), respectively, suggesting a better therapeutic effect of heat-sensitive moxibustion.
The clinicaln effect of heat-sensitive moxibustion is significantly superior to that of non-sensitive moxibustion in the treatment of KOA patients, being worthy of clinical application.
观察对处于热敏态和静息态的不同穴位进行艾灸治疗膝骨关节炎（KOA）患者的临床疗效。
本试验共纳入60例KOA患者。将其分为热敏灸（热敏）组和非热敏灸组（静息组）。艾灸内膝眼（EX-LE 4）、外膝眼（即犊鼻，ST 35）和鹤顶（EX-LE 2）约45分钟，每日1次，共20天。根据患者的感觉评估热敏态。在穴位区域进行艾灸刺激后，若患者感觉热从皮肤表面渗透至深部组织，或/和在艾灸部位周围向周边扩散，或/和向某一方向传导，则认为处于热敏化状态。采用视觉模拟评分法（VAS）评估疼痛严重程度变化，并参照《中药新药临床试验指导原则》评估膝关节功能活动情况来评价治疗效果。
治疗20次后及半年随访后，热敏组VAS总积分均低于静息组（P<0.01）。治疗20次后，热敏组和静息组的30例KOA患者中，显效分别为14例（46.67%）和5例（16.67%），有效分别为10例（33.33%）和9例（30.00%），无效分别为6例（20.00%）和16例（53.33%），有效率分别为80.00%和46.67%。半年随访显示，热敏组和静息组有效率分别为79.17%（19/24）和42.86%（6/14），提示热敏灸治疗效果更佳。
热敏灸治疗KOA患者的临床疗效明显优于非热敏灸，值得临床应用。
