Objective To verify the clinical efficacy of beryllium acupuncture in the treatment of osteoarthritis pain. Methods Retrospectively analyzed 98 patients with osteoarthritis of the knee and divided into 58 cases in the treatment group (beryllium acupuncture group) and 40 cases in the control group (physiotherapy group) for clinical comparison and observation. Results The CR+PR rates were 87.9% and 42.5% in group A and group B, respectively P<0.05 The difference between the two groups was statistically significant. Conclusion Beryllium acupuncture is an effective treatment for relieving osteoarthritis pain of the knee.
Osteoarthritis of the knee is a joint lesion caused by degenerative degeneration of joint cartilage and is a common disease in middle-aged and elderly people. The incidence of osteoarthritis in the knee is increasing year by year with the increase of human life expectancy and the aging of society. Currently, there is no definitive and effective treatment for osteoarthritis of the knee in either Chinese or Western medicine. Although there are many non-surgical and surgical treatments available, none of them are completely satisfactory. A significant number of patients end up having to have artificial joints replaced due to severe degeneration, destruction, and deficiency of joint cartilage, joint deformity, pain, and loss of function. Due to the high cost of artificial joint replacement, it will cause a heavy economic burden to individuals and the country; and its sequelae, moreover, become a major problem for society, so more and more people turn their attention to minimally invasive [1] beryllium needle is a treatment method for knee joint disorders, which has the characteristics of small trauma, short course and good effect, the author used] beryllium needle for the treatment of knee osteoarthritis from June 2011 to June 2012 osteoarthritis of the knee joint from June 2011 to June 2012, and observed 98 cases to achieve better results, which are reported as follows.
Information and methods
1. Clinical data
1.1, general information
Among the patients with knee osteoarthritis pain from June 2011 to June 2012, 98 cases of early and mid-stage knee osteoarthritis patients were selected (according to the Kellgren-Lawrance X-ray 5-grade grading method, those with grade 3 or higher were selected, without joint interlocking and instability) and divided into experimental and control groups using a randomized control method, and randomly divided into treatment group (beryllium needle group) 58 cases, control group (physiotherapy group) 40 cases
1.2. Diagnostic criteria
The diagnostic criteria of the American College of Rheumatology (ACR) for osteoarthritis of the knee [2]: knee pain without joint interlocking and instability. x-ray staging: initial osteosclerosis and osteophytes, no joint space narrowing. Intermediate stage: joint space narrowing or loss
1.3. Inclusion criteria Anyone who meets the above diagnostic criteria and is 45-65 years old and signs an informed consent form can be enrolled.
1.4. Exclusion criteria (1) local soft tissue with tendency to infection; (2) those with bleeding tendency; (3) those with serious cardiovascular disease or organ failure who cannot tolerate stimulation; (4) diabetic patients with limb ischemia; (5) those with other neurological diseases; (6) those who are unconscious and cannot cooperate with treatment.
2.Treatment method
2.1 Specifications of beryllium needle Diameter 0.5-0.75 mm, overall length 5-8 cm, needle head length 1 cm, needle body length 4-7 cm, flattened end with blade, beveled mouth, blade line 0.5-0.75 mm, needle handle is a common needle handle wrapped with steel wire, about 3-5 cm long, the treatment should make the blade line and the plane mark of the handle on the same plane, in order to identify the direction of the blade line in the body. direction.
2.2. Operation method (1) Positioning: The patient is in prone position, firstly, find the pressure point in the patient’s knee as the entry point. (2) Disinfection: Local disinfection with 2% iodine and 75% alcohol is routine. (3) Needle entry: the doctor’s left thumb is pressed next to the needle entry point, the right hand holds the needle handle with wrist force to stab the beryllium needle directly into the pressure point vertically, so that the needle tip through the skin, subcutaneous tissue to reach the deep fascia, in the process of needle entry can have a sense of breakthrough, looking for a sunken tight astringent needle feeling, and in the needle feeling layer to loosen and unblock, that is, loosen the soft tissue where the pressure is stuck, when there is no sunken tight astringent feeling under the needle, the needle is discharged. Do not twist, do not leave the needle, fast stabbing and quick pulling. (4) Dressing: After the needle is released, press the needle hole with sterile cotton ball to stop bleeding, cover the needle hole with sterile dressing and dressing.
3, efficacy observation: general treatment 1 to 3 times, once a week. The changes of the main clinical symptoms of the patients before and after treatment were observed and followed up at 3 months-6 months after treatment.
3.1, efficacy criteria: VAS [4] pain relief efficacy assessment criteria were used: ① complete relief (CR) means pain disappears; ② partial relief (PR) pain is significantly reduced, does not affect sleep and does not require painkillers; ③ mild relief (MR) pain is reduced, but still obviously requires painkiller treatment; ④ ineffective (NR) pain is not reduced or aggravated after treatment, total healing rate = CR + PR. The total effective rate of pain relief in the two groups was compared by chi-square test, and the number of effective days of pain relief was expressed as mean + standard deviation (X+S).
Discussion
Osteoarthritis is a joint disease caused by a variety of factors that lead to fibrosis, cracking, ulceration, and loss of articular cartilage. The etiology is unclear, and its occurrence is associated with age, obesity, inflammation, trauma, and genetic factors. The pathology is characterized by degeneration and destruction of articular cartilage, subchondral bone sclerosis or cystic changes, osteophytes at the joint edges, synovial hyperplasia, joint capsule contracture, ligament relaxation or contracture, and muscle atrophy and weakness. The prevalence of osteoarthritis is more common in middle-aged and elderly patients, more women than men, and can reach 50% in people over 60 years of age and 80% in those aged 75 years. Current treatment of osteoarthritis is limited to attempts to reduce symptoms and preserve function. The goals of treatment for osteoarthritis are to reduce or eliminate pain, correct deformities, improve or restore joint function, prevent disability, and improve quality of life. Drug treatment can eliminate the original lesion stimulation, block the occurrence and development of pathological reflexes, eliminate inflammatory exudative hyperplastic swelling, relieve muscle tension and spasm, improve local blood circulation, and stop pain.
In the past, physical therapy, manual therapy, drug therapy, closure therapy and other treatment methods have the disadvantages of slow onset, high toxic side effects of drugs and easy recurrence, and then because the dermal nerve compression often occurs in the fascial connective tissue layer, simple conservative treatment cannot achieve effective depth to obtain good results. The adhesions, scars and spasms cannot be completely lifted. With the continuous development of surgical science, many scholars have been exploring the clinical, anatomical and pathological aspects of heel pain, which has led to a consistent and better academic argument in terms of etiology, anatomical basis, clinical manifestations, diagnosis and treatment. The pathological mechanism of osteoarthritis of the knee is aseptic inflammation, exudation, edema, spasm, local high pressure, nerve entrapment, and fibrous changes and adhesions if the lesion persists over time. Increased tension and compression of the nerve is an important factor in knee pain. Whatever the cause (e.g. edema, tissue hyperplasia, etc.) the increased tension can affect the nerve directly or indirectly causing pain. [2] Painful points in the knee are mostly located at points of stress concentration and are essentially caused by a state of hypertonicity of the nerve endings.
The histological manifestation of the pathology is in three major forms: adhesion, scarring and spasm. [3] Beryllium acupuncture originates from the ancient nine needles, which has the effect of opening paralysis and opening ligaments, reducing tension and pressure, eliminating the high tension state of the nerve endings and thus achieving paralysis and pain relief. With the strong promotion of minimally invasive techniques at home and abroad, beryllium needle is widely used in clinical practice for its small trauma and significant therapeutic effect. According to the concept of “tension pain” proposed by Professor Dong Fuhui, [4] [5] we applied beryllium needle to “decompress” the heel hypertension area, thus releasing the tension compression on the nerve and relieving the pain, which achieved immediate clinical The clinical effect is immediate. The clinical efficacy of beryllium acupuncture is immediate. It has obvious advantages over the control group in terms of pain relief and onset time, and there is no adverse reaction, which indicates that beryllium acupuncture not only has good therapeutic effect on the treatment of pain caused by osteoarthritis but also is safe to use. However, the indications should be strictly controlled, and joint surgery should be performed if necessary for patients with severe deformation and loss of function of the joint.
This method of treatment has the advantages of safe and easy operation, short treatment time, no anesthesia, no hospitalization, no pain to the patient, and little damage to the organism, which is conducive to clinical promotion.