关键词: 穴位埋线, 浮针法, 不同分期, 膝关节骨关节炎, 临床疗效

Abstract: BACKGROUND: Acupoint embedding and floating needle therapy are two methods for the treatment of knee osteoarthritis, but there are few reports on the combined treatment of the two methods.
OBJECTIVE: To investigate the therapeutic effect of acupoint embedding combined with floating needle therapy on different stages of knee osteoarthritis using generalized estimating equations.
METHODS: A total of 436 patients with knee osteoarthritis admitted to Dongguan Hospital of Traditional Chinese Medicine from February 2019 to February 2023 were selected as the research subjects. All patients were randomly divided into a control group with floating needle therapy (n=218) and an observation group with acupoint embedding method combined with floating needle therapy (n=218). Staging was performed according to the K-L staging method. In the control group, there were 57 cases in stage I, 62 in stage II, 49 in phase III, and 50 in stage IV, while in the observation group, there were 48 cases in stage I, 66 in stage II, 63 in phase III, and 41 in stage IV. The levels of indexes and clinical efficacy were compared between groups before and after treatment. Generalized estimating equation model was used to analyze the influencing factors of clinical efficacy and the interaction effect of different time points, different methods and different stages on therapeutic efficacy. 
RESULTS AND CONCLUSION: There was no significant difference in baseline data between the observation group and the control group, as well as between the patients of different stages (P > 0.05). After treatment, the cure rate of stage I patients was the highest after treatment, and the total improvement rate in the observation group was significantly higher than that in the control group. There were significant differences in the cure rate among different stages in each group (P < 0.05). After treatment, all indicators in the two groups were significantly decreased. In the control group, there were significant differences in various indicators of patients at different stages after 4 weeks of treatment (P < 0.05). In the observation group, after 2 weeks of treatment, there were significant differences in various indicators of patients at different stages (P < 0.05), and all the indexes in the observation were lower than those in the control group after 4 weeks of treatment (P < 0.05) and the therapeutic effect in the observation group was better than that in the control group. Generalized estimating equation model analysis showed that trauma history, interleukin-6 level, treatment method, treatment time and K-L stage all significantly affected the clinical efficacy in patients. In the interaction effect analysis, after 2 weeks of treatment, there was a significant difference in the visual analogue scale score between the two groups in stages III and IV (P < 0.05). After 4 weeks of treatment, there was a significant difference in the visual analogue scale score between the two groups in stages II, III, and IV (P < 0.05). To conclude, acupoint embedding combined with floating needle therapy is superior to floating needle therapy alone in the treatment of different stages of knee osteoarthritis. Trauma history, interleukin-6 level, treatment method, treatment time and K-L stage significantly influence the therapeutic effect.

Key words: acupoint embedding, floating needle method, different stages, knee osteoarthritis, clinical effect