Effect of electroacupuncture on knee osteoarthritis and relevant inflammatory factors:A randomized clinical trial

Objective:To explore the treatment effects of electroacupuncture(EA),acupuncture with filiform needle,and western medication for knee osteoarthritis(KOA).Methods:It was a randomized,controlled trial with the blinding of outcome assessors and statistician.90 outpatients were diagnosed as KOA in Department of Acupuncture and Moxibustion,the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine.Using the random number table,they were divided into a medication group,an acupuncture group and an EA group,30 cases in each one.In the medication group,routine medication was provided with oral administration of celebrex for 21 days.Regular acupuncture was applied in the remaining groups,at Liángqiū(梁丘ST34),Xuèhǎi(血海SP10),Dúbí(犊鼻ST35),Nèixīyǎn(内膝眼EX-LE4),Yánglíngquán(阳陵泉GB34),Hèdǐng(鹤顶EX-LE2)and Sānyīnjiāo(三阴交SP6)and the needles were retained for 30 min.In the EA group,electric stimulation with low-frequency pulse current and dense wave was applied for 30 min on the basis of the treatment of the acupuncture group.The treatment was applied once daily at 1-day intervals after each 6-day treatment for a total of 21 days.Western Ontario and McMaster University Osteoarthritis Index(WOMAC)and visual analogy scale(VAS)scores and levels of serum inflammatory factors(interleukin-1β[IL-1β]and tumor necrosis factor[TNF-α])were used to assess the clinical therapeutic effect.Results:Following treatment,there were significant differences in the WOMAC score in the medication,acupuncture,and EA groups after treatment(all P<0.01).In the comparison among groups,after treatment,the WOMAC score in the EA group was lower than that in either the acupuncture or medication group(both P<0.01).Compared to before treatment,VAS scores were significantly different in the medication group(3.95±0.55 vs 5.75±1.40),the acupuncture group(2.78±0.38 vs 5.78±1.44)and EA group(1.72±0.38 vs 5.78±1.39)separately after treatment(all P<0.01).In the comparison among groups,after treatment,the VAS score in the EA group was lower than that in either the acupuncture or medication group(both P<0.01).Compared to before treatment,IL-1βlevels were significantly different in the medication group(31.53±6.84 vs 63.33±10.25),acupuncture group(31.70±7.54 vs63.90±9.96)and the EA groups(23.43±3.94 vs 63.10±10.66)separately after treatment(all P<0.01).IL-1βlevels were significantly lower in the EA group than in the acupuncture and medication groups(both P<0.01).Compared to before treatment,TNF-αlevels were significantly different in the medication group(40.20±6.09 vs 68.77±11.13),the acupuncture group(39.60±7.55 vs 68.33±11.51)and the EA groups(22.17±5.72 vs 68.97±10.52)separately after treatment(all P<0.01).TNF-αlevels were significantly lower in the EA group than in the acupuncture and medication groups(both P<0.01).After treatment,there were no significant differences in TNF-αand IL-1βlevels between the acupuncture and medication groups(both P>0.05).The total effective rates were 86.67%(26/30),73.33%(22/30)and70.00%(21/30)in the EA,acupuncture,and medication groups,respectively.The total effective rate was higher in the EA group than in either the acupuncture or medication group(both P<0.05).In the whole process of trial,the adverse events occurred in three groups.In consideration of the potential association between these adverse events and acupuncture treatment,the acupuncture physiotherapists and experts classified the adverse events into the treatment relevance or non-treatment relevance within 24 h of occurrence.Conclusion:All three therapeutic methods alleviated clinical symptoms of KOA and reduced levels of relevant inflammatory factors in serum.EA with dense wave is more advantageous than the traditional acupuncture technique and routine medication and is therefore worthy of clinical application.