Wet Cupping—Traditional Hijamah Technique versus Asian Cupping Technique in Chronic Low Back Pain Patients: A Pilot Randomized Clinical Trial

To evaluate the feasibility of comparing the effect of the traditional Hijamah and the Asian wet cupping techniques in the management of patients with chronic low back pain (CLBP), a randomized clinical trial comparing traditional and Asian wet cupping techniques for CLBP was conducted in two secondary care hospitals in Saudi Arabia. Seventy eligible participants with CLBP were randomized to receive one session of wet cupping using either Asian technique (34 patients) or traditional Hijamah technique (36 patients). Cupping was performed at four sites of the bilateral bladder meridian (BL23, BL24, and BL25). The numeric rating scale, Present Pain Intensity, and Oswestry Disability Questionnaire scores were measured immediately after intervention, at seven days, and 14 days after intervention. In both groups, there was a significant decrease in the numeric rating scale, Present Pain Intensity, and Oswestry Disability Questionnaire scores, immediately after intervention, at seven days, and 14 days after intervention. However, there was no significant difference between the two groups across all the outcome measures up to 14 days after intervention. The study did not show a superiority of one technique compared with the other. Longer follow-up periods and more than one cupping session may be needed to evaluate the difference, if any, between both the techniques.Trial RegistrationNCT02012205.     

The value of postoperative prosthesis alignment and patellar height measurements on standard X-rays after Total Knee Arthroplasty: Does it relate to knee function after 5 years?

Background

The purpose of this retrospective cohort study was to investigate the influence of parameters of malalignment on knee function 5?years post TKA and, additionally, to explore alterations in patellar height after TKA.

A prospective,randomized, double-blind,multicenter comparative study on the safety and efficacy of Celecoxib and GCSB-5, dried extracts of six herbs,for the treatment of osteoarthritis of knee joint

Ethnopharmacological relevance

This prospective, randomized, double-blind, multicenter study compared the efficacy and safety of Celecoxib and GCSB-5, a new product from extracts of six herbs, for the treatment of knee osteoarthritis.

Materials and methods

A total of 198 eligible patients were randomly assigned to the Celecoxib group (n=99 patients) or the GCSB-5 group (n=99 patients) for the 12-week study. The amount of change and percentage of the change in Western Ontario and McMaster Universities (WOMAC) Arthritis Index from the baseline, the change in pain on walking by visual analogue scale (VAS), physician's global assessment on response to therapy (PGART) by five point Likert scale, and the amount of rescue medicine taken were used as parameters for efficacy. Adverse drug reactions (ADRs) were carefully investigated.

Results

The WOMAC score improved in both the Celecoxib group and GCSB-5 group by 20.5 and 21.3 (P=0.79). The percentage of the change in WOMAC score were −42.0% and −38.9% (P=0.54). The pain VAS score decreased by 29.9 and 27.9 (P=0.58). The responders by PGART were 95.3% and 93.8% (P= 0.66), and the median amount of rescue medicine taken were 2.0 and 6.5 tablets (P=0.06). The incidence of ADRs were 31.3% and 21.2% (P=0.11). The most common ADRs were gastrointestinal system related; 17.2% in GCSB-5 group and 22.2% in Celecoxib group. Any severe ADR was not observed in either group.

Conclusions

The result of this study supports that GCSB-5 is comparable to Celecoxib in terms of the efficacy and safety for the treatment of osteoarthritis of knee joint.     

Catquest 9SF-CN量表在白内障中的最小临床重要差异研究

目的：评估Catquest 9SF -CN量表应用于白内障手术人群的反应度,并结合校标法和分布法确定最小临床重要差异值（MCID）。方法：前瞻性队列研究。对纳入温州医科大学附属眼视光医院的213例白内障术前患者进行Catquest 9SF -CN量表调查。术后1～3个月对来院复查的患者再次进行量表调查和7个选项的校标条目调查。分析量表的天花板和地板效应,通过配对t检验分析手术前后量表得分和视力的差异,采用效应值、标准化反应均数和变化率三个指标联合评估量表的反应度。然后根据术前视力、术前并发症（有/无）和术眼数量（单眼/双眼）分组,计算手术带来的得分变化。通过单因素方差分析（根据术前视力分组）或独立样本t检验（根据并发症或者术眼数量分组）分析组间差异。分布法通过1个效应值、1个测量标准误和1/2个得分变化标准差估算MCID,校标法通过校标选项和得分变化的线性回归分析估算MCID,最后根据平均值法确定取值。结果：共144人完成Catquest 9SF -CN量表的随访调查。量表术前的天花板和地板效应为4.2%,术后提高至17.3%。手术带来的量表总得分变化为（10.4±7.7）分,logMAR视力变化为（0.3±0.3）,两者有相关性（r=0.30, P<0.001）,且各自手术前后的差异具有统计学意义（t视力=13.44,t得分=16.75,P<0.001）。量表的效应值、标准化反应均数和变化率分别是1.71,1.40和44.46%。有完整随访资料的患者根据术前视力分成3组,或者根据术眼数量分成2组后,组间的得分变化差异均无统计学意义。根据并发症分组后,差异有统计学意义（t=2.90,P=0.004）。分布法中1个效应值、1个测量标准误和1/2个得分变化标准差估算MCID分别为1.71分,2.12分和3.96分。校标法中量表得分变化和校标条目选项存在显著相关（r=-0.35,P<0.001）,回归公式中的β系数为3.74,用来估计MCID值。结合分布法和校标法取平均值得到最终MCID值2.88分。结论：Catquest 9SF-CN量表适用于白内障生活质量评估,在中国白内障手术前后的反应度良好,并建立了MCID值2.88分作为应用参考。