[Clinical effect and mechanism of heat sensitive moxibustion for knee joint synovitis].

OBJECTIVE: To observe the effect of heat sensitive moxibustion based on the articular injection for knee joint synovitis.

METHODS: Sixty-seven patients with knee joint synovitis were randomly assigned into an observation group (34 cases) and a control group (33 cases). Articular injection of triamcinolone was used in the control group for 2 courses, 2 times as a course, once 5 days. Based on the treatment in the control group, heat sensitive moxibustion was used in the observation group for 2 courses, 2 weeks as a course, 5 times a week. The acupoints were Yanglingquan (GB 34), Yinlingquan (SP 9), Liangqiu (ST 34), Xuehai (SP 10), Heding (EX-LE 2) or the pain point, subcutaneous nodules around the patella. American Knee Society (AKS) score was measured before and after treatment and one month after treatment. At the same time, the knee joint synovium thickness was measured by MRI; the knee joint effusion was observed by ultrasound; the serum interleukin-1 (IL-1) and matrix metalloproteinase-3 (MMP-3) were measured.

RESULTS: After treatment, the AKS scores increased in the two groups (both P <0.05); after treatment and at follow-up, the AKS scores in the observation group were higher than those in the control group (both P <0.05); at follow-up, the AKS score in the control group was lower than that after treatment ( P <0.05). After treatment, the synovium thickness, effusion, IL-1 and MMP-3 were lower than those before treatment in the two groups (all P <0.05); after treatment and at follow-up, the four indexes in the observation group were lower than those in the control group (all P <0.05); at follow-up, the four indexes in the control group increased than those after treatment (all P <0.05).

CONCLUSION: Heat sensitive moxibustion combined with medicine articular injection can improve synovium inflammatory reaction and the absorption of effusion in the articular cavity,with long-time effect, which are better than simple medicine articular injection.