穴位埋线治疗早中期膝关节骨关节炎的疗效与成本-效果评价OA

Objective To compare the clinical efficacy of acupoint thread-embedding and electroacupuncture for knee osteoarthritis(KOA)of early to middle stage,and to evaluate their economic benefits based on cost-effectiveness analysis.Methods A total of 66 patients with KOA of early to middle stage were randomized into an acupoint thread-embedding group(33 cases,1 case dropped out)and an electroacupuncture group(33 cases,2 cases dropped out).In the acupoint thread-embedding group,acupoint thread-embedding was applied at Xuehai(SP10),Liangqiu(ST34),Weizhong(BL40),etc.on the affected side,once a week.In the electroacupuncture group,electroacupuncture was applied at Xuehai(SP10),Liangqiu(ST34),Zusanli(SP36),etc.on the affected side,with disperse-dense wave,in frequency of 2 Hz/100 Hz,once every other day,3 times a week.Both groups were treated for 4 weeks.The Western Ontario and McMaster Universities arthritis index(WOMAC)score was observed before and after treatment,as well as at the follow-up of 4 weeks after treatment completion,the visual analogue scale(VAS)score of pain and the Lysholm score were observed before and after treatment in the two groups.The clinical efficacy was evaluated between the two groups,and the cost-effectiveness analysis was conducted based on WOMAC score.Results After treatment,the WOMAC and pain VAS scores were decreased compared with those before treatment(P<0.001),and the Lysholm scores were increased compared with those before treatment(P<0.001)in both groups.At follow-up,the WOMAC score in the acupoint thread-embedding group was decreased compared with that before treatment(P<0.001),and was lower than that in the electroacupuncture group(P<0.05).The total effective rates were 93.8％(30/32)in the acupoint thread-embedding group and 87.1％(27/31)in the electroacupuncture group,with no statistically significant difference between the two groups(P>0.05).The cost-effectiveness ratio(CER)and the total cost of the acupoint thread-embedding group were lower than those in the electroacupuncture group.Conclusion Both acupoint thread-embedding and electroacupuncture can improve knee joint function,pain and stability in patients with KOA of early to middle stage,with comparable efficacy,and the acupoint thread-embedding group shows better long-term efficacy,lower cost and higher economic benefit.