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therapeutic use Knee osteoArthritis (OA) is one of the main cause knee pain, and seriously endanger the health of the elderly. I since March 2006 ~ June 2008 a small needle-knife treatment using traditional Chinese medicine plus 40 cases of curative effect satisfaction, report as follows.
A clinical data 40 cases, 17 were males and 23 females; aged 39 to 76 years, mean 56.5 years old; course of 20 d ~ 16 years, an average of 2.7 years. 7 cases of left knee, right knee in 14 cases, both knees in 19 cases. Clinical manifestations of knee pain, stiffness, limited mobility, or snapping, upstairs and downstairs difficulties and can not squat and non-durable line. CR films showed sharp edges or knee osteophyte formation, joint space narrowing and so on.
Two treatment
2.1 The Chinese medical treatment using self-prepared Gubi soup. Medicinal: Rehmannia 15 g, psoralen 12 g, mistletoe 15 g, deer grass title 15 g, Radix Paeoniae Alba 12 g, pangolin 6 g, safflower 12 g, soap thorn 15 g, Arisaema 12 g, Prunella vulgaris 18 g, honeysuckle 18 g, Cyathula 9 g. Modified: If Tongshen TGP dosage increased to 30 g, gav dhumnades 9 g, centipede 3; case of cold Tongshen plus Homalomena 12 g, the system Chuanwu 9 g; and damp evil, accompanied by swelling in knee effusion, floating patella experiment (), the soil Poria 30 g, Coix Seed 30 g. 1 day, simmered them in water 2 times juice 500 mL, 2 times, oral, and even served two weeks, and then the medicine is to fine, made Shuiwan, each serving 9 g, 2 times a day orally after a meal.
2.2 needle-knife therapy
2.2.1 supine position, knees buckling with pillow 20 ° ~ 30 ° , feet flat on the treatment table.
2.2.2 fixed within the lateral collateral ligament in the knee, lower quadriceps tendon, patellar ligament top, infrapatellar fat pad-side tender point fixed.
2.2.3 routine skin disinfection disinfection, wearing gloves, shop towels sterile hole, line needle-knife technique.
2.2.4 Needle-knife operations
(1) within the lateral collateral ligament in the knee motivated needle-knife, knife-edge line and the body longitudinal axis parallel to the vertical piercing needle-knife body and leather up to bone surface, vertical lines and horizontal lines to clear the strip. Then, adjust the knife-edge line of 90 ° , cut peel 1 ~ 2 knives.
(2) under the quadriceps tendon ends into the needle-knife, knife-edge line and the quadriceps muscle fibers in parallel, needle-knife body and leather surfaces perpendicular to penetrate up to bones, line longitudinal dredge, rampant peeling, there are bone spurs in the Spur Cross axis line of cut strip to peel around the shovel.
(3) in the patellar tendon at the top into the needle-knife, knife-edge line and patellar ligament fibers parallel to the vertical leather body piercing needle-knife over bone surface, line longitudinal and transverse spin-off to clear, there are bone spurs, the adjustment of knife-edge line of 90 ° , OK cut peel.
(4) DepArtment of infrapatellar fat pad into the needle-knife, fat pad transparent peel, and then straightened needle-knife, the needle-knife to the bottom of body tilt, with 45 ° angle beneath the skin appear before, in-depth needle-knife over lower pole of patella, turned around knife-edge line of 90 ° , line cut strip, the lower pole of patella fat pad and complete lysis of adhesions. Surgery complete, needle-knife mouth covered with Band-Aid. 3 d within the cut-off bath.
2.2.5 means operations
(1) flip the patella, doctor with the whole palm of the hand grip buckle up in the patella around flip up and down, so that increased patellar activity.
(2) knee flexion and hyperextension, the doctor stood side limb bedside, patient-foot hand side of the lower limbs to stretch in the forearm cephalic nest below the limb with both hands raised, and buckling knees to keep pace with the Ministry of forearms as a fulcrum, as knee flexion, and then press the knee near cephalic hand in front of the knee hyperextension, to loosen the knee, joint capsule and the ligament contracture purposes.
2.2.6 Other treatment of joint effusion more persons, first puncture and aspiration, and then do needle-knife therapy. And the pressure bandage 3 ~ 5 d untied. And given antibiotics, 3 ~ 5 d, to prevent infection. After 1 week, as the conditions change again the 2nd or 3rd needle-knife therapy. Observed and recorded 1 week, 6 weeks after the assessment of efficacy.
3 Clinical Standards and the results of
3.1 excellent efficacy criteria: knee pain disappeared, no activity limitation, resume its normal work and life; good: knee pain significantly reduced, sports pArt of the limited, basic resume its normal work and life; in: knee pain are reduced, yet to resume their daily work and life; poor: no improvement in knee joint pain and movement or increased.
3.2 The treatment results in 40 cases, excellent in 15 cases (37.5%), good in 18 cases (45%), in 6 cases (15%) and poor in 1 case (2.5%). Excellent and good rate was 82.5%, total effective rate was 97.5%.
4 Discussion
OA is Articular cartilage degeneration, osteophyte formation and joint edges of different degrees of synovitis as the main pathological features of disease, common symptoms are involved joint pain, limited mobility, rest after mitigation, early morning with stiff flu, post - joint deformity, severe pain, loss of walking function and disability, morbidity, and gradually increasing [1].
Is a traditional Chinese medicine 'Arthralgia''Gubi' areas, the incidence of this disease to kidney-oriented, rheumatism, phlegm, blood stasis as a standard. Expelling kidney Tongluo mainly with phlegm blood circulation, the Gubi Qufengchushi soup. Fang Shu Di-huang, psoralen benefit kidney essence, nourishing and calm the nerves King and medicine;
supplemented with mistletoe, deer grass fill the title of liver and kidney, strong bones and muscles, rheumatism Tameomi medicine; pangolins, soap thorn, safflower, Arisaema , Prunella vulgaris Speranskia tuberculata search network, Phlegm and stasis, Ruanjian Sanjie total of adjuvant; Cyathula promoting blood circulation, removing blood stasis Tongluo, their sexual accessibility, walking channeling, direct patients to make the drug. Combination of various drugs were played supplement liver and kidney, the flow of qi, live blood effect.
Kidney in order to cure, so that the degeneration of bone to be precise necessary and sufficient to support the restoration of blood; flow of qi and blood in order to live a temporary solution, so that General not painful but effective. All parties make up but not too sweet, warm but not dry, made into pills for long-term application, have a good effect on osteoarthritis.
Acupotomology that, OA mostly cumulative fatigue caused by forces within the knee joint imbalance Erzhi [2].
As the muscles around the knee a long time in a state of tension, excessive weight-bearing or pulling on the knee decreased ability to control, joint instability, joint surface of the pressure imbalance in the body in order to strengthen these muscles, strength, hardness, so that a large number of calcium accumulation in here.
Due to excessive calcium extrusion where the micro-circulation channel, so that muscle degeneration, adhesion, scarring, so that the final ossification. Small needle-knife to peel dredge adhesion between the muscles and ligaments, scarring, so that micro circulation to restore blood nutrients in the water continued to infiltrate the muscle has been denatured to go, calcium also easy to be gradually absorbed by the muscles to restore the original flexibility, disease healthy.
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