Clinical Observation of Local Tissue Characteristics and Clinical Effects Associated with"De Qi"During Acupuncture at the Outer Knee Eye Point in Patients with Acute Knee Osteoarthritis
Objective:To dynamically observe the process of"de qi"during acupuncture at the outer knee eye point in patients with acute knee osteoarthritis(KOA)using high-frequency musculoskeletal ultrasound,and to study the local tissue characteristics and surrounding tissues when"de qi"occurs,providing objective evidence for the phenomenon of"de qi"in clinical practice and teaching.Additionally,to observe the effectiveness and safety of acupuncture at the outer knee eye point in treating patients with acute KOA.Methods:60 patients with acute KOA were randomly divided into an acupuncture group and a control group,with 30 patients in each group.The acupuncture group received acupuncture at the outer knee eye point,while the control group received celecoxib and glucosamine sulfate treatment.Observations were conducted over 4 weeks.During acupuncture,the needle was inserted until the"de qi"state was achieved,and the distance between the needle tip and the skin surface,as well as the tibia,and the anatomical layer distribution characteristics were recorded under real-time,dynamic musculo-skeletal ultrasound.The clinical observation indicators included Visual Analog Scale(VAS)scores,Lysholm scores,and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores.Results:In the acupuncture group,30 patients received acupuncture at the outer knee eye point,totaling 30 acupoints.The muscu-loskeletal ultrasound images showed that the vertical distance between the needle tip and the skin surface when"de qi"occurred was(13.12±3.51)mm,and when the strongest"de qi"sensation was felt,it was(16.67±4.08)mm.The distance from the needle tip to the tibia was(7.23±1.34)mm,and to the femur was(22.49±5.66)mm.The main anatomical layers where the needle tip was located were:deep infrapatellar fat pad near the superficial synovium in 13 cases,within the synovium in 12 cases,totaling 25 acupoints(25/30,83.33％).The strongest"de qi"sensation was felt when the needle tip was located at the junction of the infrapatellar fat pad and the synovi-um.After treatment,the Lysholm scores of both the acupuncture group and the control group increased(P＜0.05),with the acupuncture group showing a higher increase than the control group(P＜0.05).The VAS scores and WOMAC scores decreased in both groups(P＜0.05),with the acupuncture group showing a greater decrease than the control group(P＜0.05).The overall effective rate in the acupuncture group was significantly higher than in the control group(P＜0.05).Conclusion:The strongest"de qi"sensation is felt when the needle tip is located at the junction of the infrapatellar fat pad and the synovium,suggesting that the main tissue structure involved in"de qi"during acupuncture at the outer knee eye point is the synovium.Acupuncture at the outer knee eye point can effectively alleviate patient pain,enhance knee joint function,and improve quality of life,with high safety.
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