温通针法结合涌泉灸治疗膝骨性关节炎的预后因素分析OA

Objective:To evaluate the clinical efficacy of Wentong(warming and unblocking)acupuncture combined with Yongquan(KI1)moxibustion in treatment of knee osteoarthritis(KOA)and to analyze the factors affecting the prognosis of the patients.Methods:A total of 119 patients with KOA were randomly assigned by drawing lots to the control group(n=61)and the combination group(n=58).The control group was treated with Yongquan moxibustion;on which basis,the combination group was also treated with Wentong acupuncture.One treatment course lasted 1 week,and both groups completed three consecutive courses.TCM symptom scores and bone metabolism indices were evaluated before the treatment and after completion of the three treatment courses in the two groups.Clinical efficacy was compared between the two groups.All patients were followed up for 4 months.According to the Lysholm Knee Scoring Scale,patients were classified into a poor prognosis group(n=33)and a good prognosis group(n=86).Univariate analysis and logistic regression analysis were performed to identify the risk factors associated with poor prognosis in patients with KOA.Results:After the treatment,compared with the control group,the combination group showed significantly lower scores in terms of joint swelling and pain,impaired mobility,soreness and weakness of the lower back and knees,and dizziness with tinnitus;the combination group also exhibited significantly lower serum levels of COMP and RANKL,and significantly higher level of OC(P＜0.05).Multivariate logistic regression analysis identified BMI,ankle injury,osteoporosis,and lack of regular physical exercise as independent risk factors for poor prognosis in patients with KOA(P＜0.05).The total effective rate was 91.38％(53/58)in the combination group,which was significantly higher than 70.49％(43/61)in the control group(P＜0.05).Conclusion:Wentong acupuncture combined with Yongquan moxibustion effectively alleviates clinical symptoms and significantly improves bone metabolism in patients with KOA.It is found that BMI,ankle injury,osteoporosis,and lack of regular physical exercise were identified as independent risk factors for poor prognosis.