[Acupotomy at trigger points combined with meridian sinew manipulation in treatment of knee osteoarthritis: a randomized controlled trial].

Objectives: To observe the clinical efficacy of acupotomy at trigger points combined with meridian sinew manipulation in treatment of early and mid-term knee osteoarthritis (KOA), and investigate whether its therapeutic mechanism is related to the regulation of inflammatory response.

Methods: Seventy-four patients with early and mid-term KOA were randomly divided into the control group (37 cases, with 2 cases dropouts) and the observation group (37 cases, with 1 case dropout). The control group was treated with meridian sinew manipulation for 30 min each time, 5 times a week, for 4 consecutive weeks. The observation group was given acupotomy at trigger points on the basis of the treatment of control group, once a week, for 4 consecutive weeks. Western Ontario and McMaster University osteoarthritis index (WOMAC) scores, short-form McGill pain questionnaire (SF-MPQ) scores, the medical outcome 36-item short form health survey (SF-36) scores, serum inflammatory factors content before and after treatment were compared between the two groups. The clinical efficacy were assessed after the treatment.

Results: Compared with those before treatment, the total scores and the scores of pain, stiffness and activity impairment of WOMAC, the pain rating index (PRI), visual analog scale (VAS) and present pain intensity (PPI) scores of SF-MPQ, and the contents of serum tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10 in both groups were significantly decreased after treatment (P<0.05), while the scores of the physical component summary (PCS) and the mental component summary (MCS) of SF-36 were significantly increased (P<0.05). Compared with the control group, the total scores, scores of pain, stiffness and activity impairment of WOMAC, the PRI, VAS and PPI scores of SF-MPQ, and the contents of serum TNF-α, IL-6 and IL-10 in the observation group were significantly decreased after treatment (P<0.05), while the scores of PCS and MCS of SF-36 were significantly increased (P<0.05). The total effective rate of the observation group was 94.4% (34/36) after treatment, which was significantly higher than that of the control group (74.3%, 26/35, P<0.05).

Conclusions: Acupotomy at trigger points combined with meridian sinew manipulation can significantly improve the clinical symptoms such as joint pain, stiffness and limited activity in patients with KOA, improve the quality of life, and its mechanism may be related to reducing the inflammatory response.