Non-drug therapies are now being increasingly evaluated for its role in acute and chronic gout with less side effects and better therapeutic effects. This review summarized the possible mechanisms of non-drug therapies for the acute gouty arthritis and provided the available evidence on the effectiveness of these modalities in acute gouty arthritis.
Non-drug treatments include traditional therapies, such as acupuncture, puncture cupping, and modern therapies, such as laser therapy, electrotherapy, magnetic therapy and ultrasonic therapy. The non-drug therapies, especially the increasing varieties of modern physical therapies, have achieved good effects in the treatment of acute gouty arthritis with the characteristics of less toxicity and side effects, which is worthy of wide use. However, at present, these effects are from the clinical observation, and further researches on the specific mechanisms should be encouraged.
The incidence and prevalence of acute gouty arthritis are increasing with the total prevalence of gout in China. Non-drug therapies are now being increasingly evaluated for its role in acute and chronic gout with less toxic and side effects and better therapeutic effects. This review summarized that activated coarse fiber, inhibited fine fiber, the influence on 5-hydroxytryptamine (5-HT), increased K+ and the anti-inflammation factors were the possible mechanisms of non-drug therapies for the acute gouty arthritis; This review also introduced the traditional non-drug therapies and modern non-drug therapies; The traditional non-drug therapies, including acupuncture, puncture cupping can significantly alleviate acute inflammation of gout joints and prevent joint dysfunction without obvious toxic and side effects; Modern non-drug therapies, such as laser therapy, electrotherapy, magnetic therapy and ultrasonic therapy, also could effectively improve swelling and pain symptoms and joint function of patients with acute gouty arthritis, and reduce the levels of C-reactive protein, serum uric acid and erythrocyte sedimentation rate. To sum up, the non-drug therapies, especially the increasing varieties of modern physical therapies, have achieved good effects in the treatment of acute gouty arthritis with the characteristics of less toxicity and side effects, which are worthy of wide use.
Psoriatic arthritis is a kind of arthritis associated with psoriasis. The clinical manifestations of psoriatic arthritis with arthritis as the first symptom are often similar to ankylosing spondylitis and rheumatoid arthritis. Thus differential diagnosis should be made in clinical practice so as to improve the therapeutic effect. Psoriatic arthritis skin lesions are usually papules or plaques, with scales on the surface and punctate hemorrhage on the basement. About 10% of patients with psoriatic arthritis have skin rash after the onset of arthritis. In order to provide a reference for clinicians, our study the analyzed the clinical diagnosis of psoriatic arthritis in combination with a case of psoriatic arthritis with concealed skin rash and related literatures.
disease (OD), including rheumatoid arthritis, knee osteoarthritis, lumbar disc bulge, and so
on, is a category chronic and progressive disease with the primary character of
pain and joint dysfunction. Serious patients are more prone to suffer from
disability. The application of analgesic, NSAIDs, and surgical operation in Western medicine is always accompanied with the occurrence
of side effects and high cost. Non-drug therapy
of traditional Chinese medicine, including Yoga, acupuncture, massage, etc, is the main stream treatment of OD. The current special
issue focuses on the field of non-drug therapy of OD.
The effectiveness of massage is superior to that of joint cavity injection while the integrated therapeutic method containing massage is superior to that of single massage.
Massage plays a key role in the non-drug therapy of knee osteoarthritis.
Knee osteoarthritis (KOA) is a disease due to the degenerative pathological change of knee joint, which commonly occurs in the elderly. The main clinical characters of KOA are the pain, stiffness, and dysfunction of knee joint. Western medicine regarding to the treatment of KOA aims to relieve the pain and delay the progress of disease such as intra-articular injection and functional exercise. Traditional Chinese medicine (TCM) therapy includes massage, herb, acupuncture, microwave, etc. Among them, the massage technique has the advantages of simpleness, effectiveness and non-invasive manipulation. The present study compared the curative effects of different therapies on KOA including Western medicine therapeutic method, single massage, complementary TCM therapeutic method containing massage and integrated TCM and western medicine therapeutic method containing massage. We found that the effectiveness of single massage method is better than that of joint cavity injection. The effectiveness of massage in combination with herb and acupuncture is better than that of massage alone. The effectiveness of joint cavity injection or functional exercise combined with massage and acupuncture is better than that of the single articular cavity injection or functional exercise. However, more research and clinical trials are still needed to determine the exact mechanism of massage.
The comprehensive therapy containing prone- positioned upside-done arch exercise showed beneficial effects in patients with lumbar disc bulge in the terms of visual analogue score, bulge size and straight leg raise test.
As a nonoperative treatment for lumbar disc herniation, lumbodorsal muscle training has the potentials to provide better prevention measures for lumbar disc bulge.
Objective: To study the effects of prone-positioned upside-done arch exercise, a kind of lumbodorsal muscles training originated from Yoga, on curbing the progression of lumbar disc bulge. Methods: A total of 120 out-patients, diagnosed with lumbar disc bulge by CT and/or MRI, were randomly divided into the observation group and the control group, with 60 patients in each group. Patients in the observation group received the prone-positioned upside-done arch exercise combined with traction and acupuncture for two months and followed with a two-year treatment with prone-positioned upside-done arch exercise while the patients in the control group only received traction and acupuncture for two months. After two years, patients in both groups were investigated for the visual analogue score, MR image and straight leg raise tests. Results: Compared to the control group, prone-positioned upside-done arch exercise combined with traction and acupuncture showed significant decrease in patients’ visual analogue score, bulge size and the positive ratio of straight leg raise test (P = 0.001, P = 0.001 and P = 0.02 respectively), suggesting the inhibitory effect on the progression of lumber disc bulge. Conclusion: Prone-positioned upside-done arch has the potentials to protect patients with lumbar disc bulge from nerve root compression syndrome.
Patients with rheumatoid arthritis have higher incidence rate of cardiovascular diseases than those with osteoarthritis.
This study focuses on the effects of non-traditional risk factors on the incidence rate of cardiovascular diseases in patient with rheumatoid arthritis, including inflammation indexes, echocardiography and carotid ultrasound related indexes etc.
Objective: To compare the difference of cardiovascular risk factors in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Methods: A retrospective analysis was performed to compare the difference of cardiovascular factors between 44 patients with RA and 36 patients with OA in terms of their gender, age, body mass index, course of disease, carotid ultrasound related indicators, homocysteine, blood lipid levels, inflammation index, echocardiographic index, etc. Results: (1) General situation: there was no significant difference between two groups in terms of gender and age (P > 0.05). However, body mass index of OA group was significantly higher than that of RA group and the course of disease of RA group was significantly longer than that of OA group (P = 0.024). (2) Laboratory index: the level of homocysteine of RA group was significantly higher than that of OA group (P = 0.002). Though there was no significant difference between these two groups in terms of total cholesterol, triglyceride, low density lipoprotein, apolipoprotein B and high density lipoprotein (P > 0.05), the level of apolipoprotein A1 of RA group was significantly lower than that of OA group (P < 0.001) and the level of lipoprotein A of RA group was significantly higher than that of OA group (P < 0.001). The levels of erythrocyte sedimentation rate and C reactive protein of group RA were significantly higher than those of OA group (P < 0.001). (3) Stroke volume and ejection fraction of echocardiography of RA patients were significantly lower than those of OA patients (P = 0.022, P = 0.009). However, there was no significant difference between two groups in terms of aortic diameter, left atrial diameter, left ventricular end diastolic diameter, left ventricular end systolic diameter, left ventricular posterior wall thickness, left ventricular fractional shortening, right ventricular diameter, right atrial diameter, and interventricular septum thickness (P > 0.05). Though significant difference in carotid artery plaque incidence between the two groups was not observed (P > 0.05), the incidence of carotid artery thickening and carotid artery middle thickness were significantly different between the two groups (P < 0.001). Conclusion: The rate for the occurrence of cardiovascular events in patients with RA was higher than those with OA. Additionally, effective control of RA patients’ conditions has the potential to reduce the risk of cardiovascular events.
Warming acupuncture combined with joint mobilization had a significant effect on the treatment of scapulohumeral periarthritis.
This review provides a new combination of non-drug therapy in the treatment of scapulohumeral periarthritis.
Objective: To evaluate the clinical efficacy of warming acupuncture combined with joint mobilization for the treatment of scapulohumeral periarthritis. Methods: A search for published randomized controlled trials (RCT) investigating warming acupuncture combined with joint mobilization for the treatment of scapulohumeral periarthritis was performed using the Cochrane Library, PubMed, Embase, and Web of Science databases. According to requirements of the Cochrane systematic review, all evaluations of RCT investigating warming acupuncture with joint mobilization in the treatment of scapulohumeral periarthritis were performed via method quality assessment, data extraction, and data analysis. Revman 5.3 and Stata 12.0 statistical software were used for the meta-analysis, and the trial sequential analysis (TSA) software estimated the required information size for each outcome. Results: A total of 14 articles were retrieved for meta-analysis, which included 551 cases in the treatment group and 539 cases in the control group. Meta-analysis showed that: (1) warming acupuncture combined with joint mobilization improved total efficiency [OR = 6.16, 95% CI (3.79, 10.00), Z = 7.34; P < 0.001), TSA results confirmed the results of the meta-analysis; (2) warming acupuncture combined with joint mobilization improved the cure rate [OR = 2.84, 95% CI (2.19, 3.70), P < 0.001], TSA results revealed that no further tests were needed to verify; (3) warming acupuncture combined with joint mobilization reduced the number of treatments required for healing [MD = -7.49, 95% CI (-9.75, -5.23), P < 0.001], TSA results confirmed the results of the meta-analysis; (4) in comparing visual analog scale scores before and after treatment, meta-analysis result showed that: SMD = -2.01, 95%CI (-2.37, -1.65), P < 0.001, the difference was statistically significant, TSA results confirmed the results of the meta-analysis. Conclusion: Warming acupuncture combined with joint mobilization had a significant effect on the treatment of scapulohumeral periarthritis.
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