Chen Meiren, Hu Rong, Lin Jian, Huang Yuhui, Mao Wanping, Wen Yuanying, Dai Gaole
Hunan TCM College, Zhuzhou 412012, China.
Department of Acupuncture and Moxibustion, the Second Hospital of Zhuzhou City.
Zhongguo Zhen Jiu. 2018 Jan 12;38(1):45-9. doi: 10.13703/j.0255-2930.2018.01.011.
To observe the effects among aconite cake-separated moxibustion, moxibustion and acupuncture for knee osteoarthritis (KOA) with kidney-marrow deficiency and to explore the feasibility of cake-separated moxibustion as a home remedy solution.
Ninety patients were randomized into an aconite cake-separated moxibustion group, a moxibustion group and an acupuncture group, 30 cases in each one. The acupoints in the three groups were Neixiyan (EX-LE 4), Dubi (ST 35) in the affected side, and bilateral Xuehai (SP 10), Liangqiu (ST 34), Heding (EX-LE 2), Shenshu (BL 23) and Zusanli (ST 36). All the treatment was given for 3 sessions, 10 days as a session with 2 to 3 days between 2 sessions, and once a day. The first 2 courses of aconite cake-separated moxibustion was applied in the hospital and the other 1 session was used at home guided by officer physician. Symptoms and physical signs classification score and life quality scores were recorded before and after treatment and 6 months after treatment, including walking pain, knee pain in stoop and squat, knee discomfort in stair activity and daily discomfort. The effects were evaluated.
The symptoms and physical signs classification scores in the three groups after treatment and at follow-up were lower than those before treatment (<0.01, <0.05), and the scores in the aconite cake-separated moxibustion group were better than those in the moxibustion group and acupuncture group (all <0.01). The scores of walking pain, knee pain in stoop and squat, knee discomfort in stair activity and daily discomfort were lower in the three groups after treatment and 6 months after treatment (<0.01, <0.05), and the scores of walking pain and daily discomfort in the aconite cake-separated moxibustion group were lower than those in the moxibustion group and acupuncture group (<0.01, <0.05). After treatments, the cured and markedly effective rate in the aconite cake-separated moxibustion group was 63.3% (19/30); that in the moxibustion group was 50.0% (15/30) and one in the acupuncture group was 43.3% (13/30). The cured and markedly effective rate of aconite cake-separated moxibustion group was more promising than those in the other two groups (both <0.05). At follow-up, the cured and markedly effective rate in the aconite cake-separated moxibustion group was 56.7% (17/30), which was better than 36.7% (11/30) in the moxibustion group and 40.0% (12/30) in the acupuncture group (both <0.05).
Aconite cake-separated moxibustion can be used for KOA patients with kidney-marrow deficiency, which can improve patients' life quality and is better than moxibustion and acupuncture. The method is feasible as a home remedy solution.
观察隔附子饼灸、艾灸与针刺治疗肾精亏虚型膝骨关节炎（KOA）的疗效，探讨隔附子饼灸作为家庭疗法的可行性。
将90例患者随机分为隔附子饼灸组、艾灸组和针刺组，每组30例。三组取穴均为患侧内膝眼（EX-LE 4）、犊鼻（ST 35），双侧血海（SP 10）、梁丘（ST 34）、鹤顶（EX-LE 2）、肾俞（BL 23）、足三里（ST 36）。所有治疗均进行3个疗程，10天为1个疗程，疗程间间隔2至3天，每天治疗1次。隔附子饼灸的前2个疗程在医院进行，另1个疗程在医师指导下在家中进行。记录治疗前、治疗后及治疗后6个月的症状体征分级评分和生活质量评分，包括行走疼痛、蹲起时膝关节疼痛、上下楼梯时膝关节不适及日常不适情况，并对疗效进行评价。
三组治疗后及随访时的症状体征分级评分均低于治疗前（<0.01，<0.05），且隔附子饼灸组评分优于艾灸组和针刺组（均<0.01）。三组治疗后及治疗后6个月的行走疼痛、蹲起时膝关节疼痛、上下楼梯时膝关节不适及日常不适评分均降低（<0.01，<0.05），隔附子饼灸组的行走疼痛及日常不适评分低于艾灸组和针刺组（<0.01，<0.05）。治疗后，隔附子饼灸组的痊愈显效率为63.3%（19/30）；艾灸组为50.0%（15/30），针刺组为43.3%（13/30）。隔附子饼灸组的痊愈显效率优于其他两组（均<0.05）。随访时，隔附子饼灸组的痊愈显效率为56.7%（17/30），优于艾灸组的36.7%（11/30）和针刺组的 40.0%（12/30）（均<0.05）。
隔附子饼灸可用于肾精亏虚型KOA患者，能改善患者生活质量，且疗效优于艾灸和针刺。该方法作为家庭疗法可行。
