Acupuncture as an adjunctive therapy to pharmacological treatment in patients with chronic pain due to osteoarthritis of the knee: A 3-armed, randomized, placebo-controlled trial

Abstract

The efficacy of acupuncture as an adjunctive therapy to pharmacological treatment of chronic pain due to knee osteoarthritis was studied with a 3-armed, single-blind, randomized, sham-controlled trial; it compared acupuncture combined with pharmacological treatment, sham acupuncture including pharmacological treatment, and pharmacological treatment alone. A total of 120 patients with knee osteoarthritis were randomly allocated to 3 groups: group I was treated with acupuncture and etoricoxib, group II with sham acupuncture and etoricoxib, and group III with etoricoxib. The primary efficacy variable was the Western Ontario and McMaster Universities (WOMAC) index and its subscales at the end of treatment at week 8. Secondary efficacy variables included the WOMAC index at the end of weeks 4 and 12, a visual analogue scale (VAS) at the end of weeks 4, 8, and 12, and the Short Form 36 version 2 (SF-36v2) health survey at the end of week 8. An algometer was used to determine changes in a predetermined unique fixed trigger point for every patient at the end of weeks 4, 8, and 12. Group I exhibited statistically significant improvements in primary and secondary outcome measures, except for Short Form mental component, compared with the other treatment groups. We conclude that acupuncture with etoricoxib is more effective than sham acupuncture with etoricoxib, or etoricoxib alone for the treatment of knee osteoarthritis.

Updated Systematic Review and Meta-Analysis of Acupuncture for Chronic Knee Pain

“…These 19 studies were published between 1992 and 2014. [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] The number of participants in the studies varied from 20 to 712. Two studies were conducted in the USA, [43][44][45] three in Germany, 46 58 59 four in China, 47-49 61 three in the UK, 52 56 57 and one each in Australia, 50 Japan, 51 Greece, 53 Iran, 54 Thailand 55 and Denmark.…”

“…[43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] The number of participants in the studies varied from 20 to 712. Two studies were conducted in the USA, [43][44][45] three in Germany, 46 58 59 four in China, 47-49 61 three in the UK, 52 56 57 and one each in Australia, 50 Japan, 51 Greece, 53 Iran, 54 Thailand 55 and Denmark. 60 Thirteen studies compared acupuncture as a primary treatment against different types of control intervention, 43-45 47 48 50-52 56-60 of which two consisted of no treatment, 50 56 three used allocation to a waiting list, [58][59][60] two used pharmaceutical interventions (namely sodium hyaluronate 47 and glucosamine hydrochloride capsules 48 ), and one each used standard care (oral therapy), 43 usual care (medications and interventions), 52 education, 44 45 topical poultices, 51 isometric exercises 54 and home exercises.…”

“…46 Two studies evaluated acupuncture as an adjunctive treatment compared with usual care 52 and etoricoxib. 53 Overall, between 4 and 23 sessions of acupuncture were administered over a period of 2-26 weeks.…”

“…56 Regarding other potential sources of bias (including lack of intention-to-treat analysis, information about cointerventions, compliance, acceptability and baseline comparisons), 16 studies were found to demonstrate an unclear risk of bias due to the lack of intention-to-treat analysis, insufficient information about cointerventions, compliance and acceptability. [45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] Additionally, one of these trials failed to report baseline WOMAC and VAS information. 56 The completeness of the STRICTA checklist for each study is detailed in table 2.…”

Literature Review and Network Analysis on the Pain Disease Approach of Saam Acupuncture Method

“…최근 다양한 임상 연구를 통해서 침 치료가 관절염 5) , 두통 6) , 요통 7,8) 등의 통증 질환에 우수한 진통효과가 있음이 증명되 고 있으며, 침의 진통기전을 규명하기 위한 기초 연구 또한 중추신경 계를 중심으로 활발하게 이루어지고 있다 [9][10][11][12] .…”