[Combined application of physiotherapy and acupuncture in patients with knee osteoarthrosis].

RATIONALE: Osteoarthrosis (OA) is one of the most common heterogeneous diseases. OA treatment is stopping the pain syndrome with the help of medical methods. Currently, there are no comprehensive programs, including a combination of physiotherapy and acupuncture, in the treatment of OA.

AIM: The scientific justification and development of a comprehensive treatment for patients with OA of the knee joints (OAKJ) using transdermal electropharmstimulation (TEFS) and acupuncture in microacupuncture zones of the hand and foot.

MATERIAL AND METHODS: We examined 210 patients with OAKJ who underwent outpatient treatment at LLC 'Sanatorium 'Zelenaya Roscha'', Republic of Bashkortostan (Ufa) in 2014-2017. Patients were divided into 3 groups at random. The groups were comparable by medical and demographic characteristics (gender, age), average duration and stage of the disease, and body mass index. The 1st group (comparison group) included 70 patients who were prescribed TEFS with a non-steroidal anti-inflammatory drug, combined with traditional drug treatment. In the 2nd group (main group) - 70 patients who underwent TEFS with a non-steroidal anti-inflammatory drug in combination with acupuncture in the microacupuncture zones of the hand and foot, as well as traditional drug therapy. In the 3rd group (control group) - 70 patients who received only drug therapy with a non-steroidal anti-inflammatory drug of 15 mg/day. Therapeutic efficacy was evaluated on the 4th, 7th, 11th, 11th and 12-15th days of treatment based on the timing of the relief of the pain syndrome, the dynamics of the clinical presentation of the disease, the visual analogue scale (VAS) for pain, the McGill pain questionnaire, tensoalgometry, electromyography of the thigh muscles, as well as changes in blood microcirculation in the knee joints on the 1st - 5th day of treatment.

RESULTS: It was found that the combined use of TEFS and acupuncture in the microacupuncture zones of the hand and foot in patients with OAKJ relieves pain earlier than in the patients of the control group and the comparison group, and also leads to an increase in tensoalgometry, a decrease in VAS pain, and a decrease in the number of words-descriptors and sums of ranks, normalization of the amplitude of electric potentials and the frequency of muscle contractions of the thigh muscles, improvement of microcirculation of blood of the knee joints faster.

CONCLUSION: The obtained results indicate the high efficiency of the combined use of TEFS and acupuncture in the microacupuncture zones of the hand and foot in the treatment of patients with OAKJ.