Introduction
Gonitis is a kind of retrograde disease, usually seen among middle-aged and old people. The clinical manifestations are pain and swelling of the knee joint, aggravation in walking, relief after rest, appearance of frictional sound in movement, stiffness of the joint after long-term sleeping or sitting or standing (which can be relieved gradually after relaxation), mild exudates from the joint cavity in severe cases or even evident swelling due to hemorrhage from the joint cavity. The symptoms in the late stage are restricted movement of the knee joint, disuse atrophy, or even inversion or eversion of the knee. Gonarthritis pertains to the conception of obstructive syndrome in TCM due to insufficiency of liver and kidney, malnutrition of tendons and bones and obstruction of the meridians by pathogenic wind, cold, dampness and heat in the aged; or due to production of phlegm resulting from spleen asthenia and migration of phlegm and dampness in the meridians; or due to long-term stagnation of blood vessels and retention of blood stasis in the joints.
Syndrome differentiation
Pain, swelling, aching weakness, unsmoothness of the knees that become aggravated with cold and relieved with warmth; stiffness of the knees after long-term duratiom muscular atrophy; or accompanied by aching or pain of the waist, vertigo, tinnitus and fatigue.
Treatment
1. Body Acupuncture
Prescription:
Xiyan (EX-LE 5), Heding (EX-LE 2), Xiyangguan (GB 33), Yanglingquan (GB 34) and Ashi acupoints.
Modification:
For evident swelling and pain, Liangqiu (ST 34), Xuehai (SP 10) and Yinlingquan (SP 9) are added; for aching and weakness of the waist as well as dizziness and tinnitus, Ganshu (BL 18), Shenshu (BL 23), Zusanli (ST 36) and Sanyinjiao (SP 6) are added.
Performance: The proximal acupoints is needled with reducing needling technique. Ganshu (BL 18), Shenshu (BL 23) and Zusanli (ST 36) are needled with reinforcing needling technique. Moxibustion can be used and cupping is applied for reinforcement of the curative effect.
2. Ear Acupuncture
Prescription:
Knee (AH4), Kidney (CO10) and Ear Shenmen (TF4).
Performance:
Medium and strong stimulation, retention of the needles for 20 - 30 minutes. Or Wangbuliuxingzi (Semen Vaccariae) is used for ear acupressure.