Clinical promotion of acupuncture and moxibustion therapy for the prevention and treatment of KOA, and mechanism research on regulating the spinal MAPK-Glu-Gln pathway to improve KOA pain

INTERVENTION: Medicine Group:Diclofenac Sodium;Moxibustion group:Moxibustion ;Tong tiao group:Moxibustion +acupotomy; CONDITION: knee osteoarthritis PRIMARY OUTCOME: WOMAC; SECONDARY OUTCOME: visual analogue scale;Suprapatellar bursa effusion;Brain Region Glutamate Concentration Levels;FAAH‐mRNA;Serum inflammatory markers;Cartilage matri Xmetabolic markers;MAPK (Mitogen‐Activated Protein Kinase) signaling pathway and Glu‐Gln shuttle pathway expression; INCLUSION CRITERIA: (1) Diagnostic criteria: Western medicine diagnostic criteria: The diagnostic criteria for knee osteoarthritis (KOA) in Western medicine are based on the "Guidelines for the Diagnosis and Treatment of Osteoarthritis (2018 Edition)" published in 2018: 1) recurrent knee joint pain in the past month; 2) X‐ray findings of decreased joint space, subchondral bone sclerosis, cystic degeneration, or osteophyte formation around the joint; 3) morning stiffness =30 minutes; 4) crepitation during movement. Patients meeting 1) and any one of 2) to 4) can be diagnosed with KOA. Kellgren‐Lawrence (K‐L) grading criteria: Grade 0: normal joint space appearance, no osteophytes; Grade I: joint space narrowing, possible osteophytes; Grade II: suspected joint space narrowing, obvious osteophytes; Grade III: obvious joint space narrowing, sclerotic changes, moderate amount of osteophytes; Grade IV: obvious joint space narrowing, severe sclerotic changes and obvious deformities, large amo