Electroacupuncture combined with thunder-fire moxibustion for knee osteoarthritis of cold-damp type:A randomized controlled trial

Objective:To observe the clinical effect differences of knee osteoarthritis(KOA)with cold-damp type between electroacupuncture(EA)combined with thunder-fire moxibustion and medication.Methods:A total of 72 cases of KOA patients with cold-damp type were randomly divided into a combined treatment group of EA and thunder-fire moxibustion(combined treatment group)and a medication group,36 cases in each group.In the combined treatment group,the acupoints for EA were Dubi(犊鼻ST35),Neixiyan(内膝眼EX-LE4),Zusanli(足三里ST36),Yanglingquan(阳陵泉GB34),Yinlingquan(阴陵泉SP9),Xuehai(血海SP10),Liangqiu(梁丘ST34)and Heding(鹤顶EX-LE2).During the period of EA,the suspending thunder-fire moxibustion was applied to Shenque CV8)and Guanyuan(关元CV4).In the medication group,diclofenac sodium double release intestine-sol capsule and Fugui gutong capsules were prescribed for oral administration.The treatment for 14 days was taken as one course and the consecutive 2 courses of treatment were required in each group.Before and after treatment,as well as in the follow-up visit,the pain score(visual analogue scale,VAS),the knee function score(Western Ontario and McMaster University,WOMAC,the expressions of interleukin 6(IL-6)and transforming growth factorβ1(TGF-β1)in the joint fluid as well as the difference in the clinical therapeutic effect were observed in the two groups separately.Results:(1)The pain score:compared with those before treatment,the VAS scores were all reduced after treatment and in the follow-up in the two groups(all P<0.05).After treatment and in the follow-up,VAS scores in the combined treatment group were lower than those in the medication group(both P<0.05).(2)The knee function score:WOMAC score of each item,i.e.pain,stiffness and function,as well as the total score after treatment and the follow-up were all lower than those before treatment in the patients of the two groups(all P<0.05).The score of each item,i.e.pain and function,as well as the total score in the combined treatment group were all lower than those in the medication group after treatment and the follow-up respectively(all P<0.05).(3)The expressions of IL-6 and TGF-β1:the level of IL-6 in the joint fluid was reduced after treatment as compared with that before treatment in either group and the level of TGF-β1 was increased,indicating the statistical differences(all P<0.05).After treatment,the level of IL-6 in the combined treatment group was lower than that in the medication group and the level of TGF-β1 was higher than that of the medicating group,indicating the statistical significance(both P<0.05).(4)The total effective rate in the combined treatment group was 97.1%,higher than 78.8%in the medication group,indicating the statistical significance(P<0.05).Conclusion:The clinical effect of the combined treatment of electroacupuncture and the thunder-fire moxibustion is remarkable on knee osteoarthritis of cold-damp type.The combined treatment presents a more advantageous at the sustainability of the therapeutic effect as compared with medication.

Meta-analysis and trial sequential analysis on blood uric acid and joint function in gouty arthritis treated with fire needling therapy in comparison with western medication

Objective:To conduct the meta-analysis and trial sequential analysis(TSA) on clinical trials of fire needling therapy in treatment of gouty arthritis and review systematically the clinical therapeutic effect of fire needling therapy on gouty arthritis so as to provide the medical evidences of the extensive application of this therapy in treatment of gouty arthritis.Methods:The relevant clinical trials of fire needling therapy for treatment of gouty arthritis were searched from China National knowledge Infrastructure,Wanfang Data Knowledge Service Platform,Chinese Science and Technology Journal Database,American Medical Online,Dutch Medical Literature Database and International Evidence-Based Medical library.Using Review Manager 5.3 software,the quality of the included trials was assessed and meta-analysis was performed.With TSA v0.9 software,the trial sequential analysis was conduced on the appropriate outcomes.Results:A total of 10 trials were included with 775 patients involved.The analysis results showed that compared with the western medication,the total effective rate(RR=1.14’95%CI [1.09,1.20]),the curative rate(RR=1.59’95%CI [1.33,1.89]),the reduced VAS score(MD=-1.44’ 95%CI [-1.93,-0.951]) and the reduced incidence of adverse reaction(RR=0.27’ 95% CI [0.09,0.76]) of the fire needling therapy were different significantly(all P <0.05).Regarding the reduction of blood uric acid(MD=-40.47’ 95%CI [-80.21,-0.72]) and the score of symptoms and physical signs(MD=-1.38’95% CI [-3.71,0.95]),the effect of fire needling therapy was similar to that of western medication group(both P≥0.05).The trial sequential analysis suggested that the result was reliable,in which,the total effective rate of fire needling therapy was much higher than the western medication.But,it was potentially a false-positive finding,in which,fire needling therapy was much more advantageous at reducing blood uric acid as compared with the western medication.Conclusion:Based on the analytic results,it can be determined that fire needling therapy,as an effective approach to the treatment of gouty arthritis,has a certain advantage as compared with western medication.Given the low overall quality of trials,it still needs high-quality clinical trial to verify the findings of this study results.

Influence of stuck-needle technique on joint function and related inflammatory markers in patients with knee osteoarthritis:A randomized controlled trial

Objective:To observe the differences of clinical effect and influence on joint function and inflammatory markers in joint fluid between stuck-needle technique and regular acupuncture in patients with knee osteoarthritis.Methods:Seventy-two patients with knee osteoarthritis were randomly divided into a stuck-needle technique group and a regular acupuncture group,with 36 cases in each one.The selection of acupoints,retaining time of needles,and treatment course were all the same in both groups.The visual analog scale(VAS)score,Lequesne index score,and the content of related inflammatory indexes in joint fluid before and after treatment were observed,and the therapeutic effect were evaluated.Results:After treatment,the VAS scores,Lequesne index scores,interleukin-1 beta(IL-1β),and the tumor necrosis factor a(TNF-α)of the two groups were all lower than those before treatment(all P<0.05).After treatment,the VAS scores,Lequesne index scores,IL-1β,and TNF-αof the stuck-needle technique group were all lower than those of the regular acupuncture group(all P<0.05).The total effective rate of the stuck-needle technique group was 96.97%(32/33),higher than 93.75%(30/32)of the regular acupuncture group(P<0.05).Conclusion:Stuck-needle technique can effectively relieve the pain and improve the joint functions,being more effective than regular acupuncture for the treatment of knee osteoarthritis.