针刺痛敏穴治疗膝骨关节炎的自身对照研究OA

Objective:To evaluate the clinical efficacy of needling pain-sensitive acupoints in treatment of knee osteoarthritis(KOA),and to explore both therapeutic outcomes and assessment methods by observing changes in pressure pain threshold and skin temperature before and after needling.Methods:After screening,30 patients with KOA treated between May 2022 and February 2023 in the Joint Disease and Rehabilitation Medicine wards of the Affiliated Hospital of Shaanxi University of Chinese Medicine were included.19 acupoints on the affected knee and lower back-namely(ST35),Yanglingquan(GB34),Neixiyan(EX-LE4),Yinlingquan(SP9),Xuehai(SP10),Heding(EX-LE2),Liangqiu(ST34),Zusanli(ST36),Xiguan(EX-LE5),Weizhong(BL40),Weiyang(BL39),Ququan(LR8),Yingu(KI10),Yaoyangguan(DU3),Xuanzhong(GB39),Shenshu(BL23),Dazhu(BL11),Qiuxu(GB40),and Mingmen(DU4),were tested for pressure pain threshold.The five acupoints with the lowest thresholds were selected as intervention points for acupuncture,while the contralateral side received no treatment.Acupuncture was performed once daily for 10 consecutive days.A self-controlled pre-post design was used to compare outcomes before and after the treatment,including the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores,visual analogue scale(VAS)scores,and the pressure pain thresholds and skin temperatures at each acupoint.Results:After acupuncture,patients' WOMAC scores decreased significantly(P＜0.01),and VAS scores also showed a significant reduction(P＜0.01).The pressure pain thresholds of SP9,GB34,LR7,KI10,BL40,BL39,EX-LE4,ST35,SP10,ST34,GB40,GB39,DU4,DU3,BL11 and BL23 were increased(P＜0.05).The skin temperatures of BL40,SP10,SP9,and EX-LE4 were decreased(P＜0.05),whereas the skin temperature of GB34 was increased(P＜0.05).Conclusion:Needling pain-sensitive acupoints can significantly relieve pain and improve knee function in patients with KO A.Additionally,it increases the pressure pain thresholds at most related acupoints around the knee and lower back and decreases skin temperature at certain acupoints,which may serve as a reference method for evaluating acupuncture efficacy.