The efÏcacy of Turem in the treatment of knee osteoarthritis

Abstract

Background: The prevalence of knee osteoarthritis (OA) is estimated as 60-70% of the overall population older than 65 years of age; among those older than 75, the prevalence rises to as high as 85%, and its prevalence continues to increase as societies age2,3. Therefore, it increasingly impacts society as it reduces the ability to work and increases medical costs4. Furthermore, the current treatments such as medications lead to adverse gastrointestinal, cardiovascular, and renal events8. Therefore, many patients with knee OA are seeking complementary and alternative treatments including turem treatment. Aim: The study sought to determine the body constitution pattern in knee OA and the impacts of turem treatment in knee OA patients through standard pain scores and a quality-of-life questionnaire. Materials and Methods: It were a clinical trial covering 23 patients who were diagnosed with knee OA. The body constitution was evaluated through a survey developed by Dr Dagvatseren et al. in 2003. Then, The visual analogue scale (VAS) for pain and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) are utilized for monitoring symptom changes. Also, the relation between body constitution and treatment outcome was measured. The study included 23 patients who were eligible for inclusion criteria and received correctly prepared silver needles heated by three moxibustions. VAS and WOMAC scores were evaluated for clinical symptoms, while the quality of life was measured via EQ-5D-5L pre-trial and at seven days. Results: The Results of the body constitution survey showed 56.5% (n=13) of the participants were phlegm and phlegm - wind, and phlegm-bile type. Thus, there were statistically significantly higher body types of phlegm, phlegm-wind, and phlegm-bile types than wind-bile, wind, and bile types. Seven days later of the turem treatment, the EQ-5D-5L questionary was utilize to compare between pre and post-treatment scores, which illustrated improvement of mobility (p<0.001), self-care (p<0.001), usual activities (p<0.001), pain (p<0.001), depression (p<0.001). Measurements of health status increased from 65±14.930 to 70±9.750 after 7 days. Also, the pain was significantly relieved from 7.0±1.41 to 4±1.50. As for WOMAC score pain (p<0.001), stiffness (p<0.001), functional limitation (p<0.001) also improved. To conclude, Turem treatment relieved symptoms related to knee OA and support quality of life. Discussion: Turem treatment decreases pain mainly through thermal and chemical stimulation by affecting blood circulation, endocrine glands and the immune system then organ function, blood circulation improved20. When the needle temperature and its edge reach a temperature of 39-41°С24, moxibustion releases 1.5u ultraviolent, activating cell metabolism. Also, it influences the neural-humoral immune system by activating large hydrocarbons20. Conclusion: 1. We conclude that turem treatment causes a substantial improvement in the symptoms of osteoarthritis of the knee so that it could be punctured at all stages of the knee osteoarthritis. 2. Turem treatment significantly improved mobility, self-care, usual activities, and pain. Thus, it may positively impact social communication and maintain social status by improving their quality of life.