Clinical Efficacy of Acupuncture on Rheumatoid Arthritis and Associated Mechanisms: A Systemic Review

Abstract

Objective The objective of this review is to investigate the detailed existing scientific information about the clinical efficacy of acupuncture on rheumatoid arthritis (RA) conditions and to reveal the proposed mechanisms. Methods We searched the PubMed, EMBASE, Cochrane, AMED (Allied and Complementary Medicine), NCCAM (The National Center for Complementary and Alternative Medicine), and CNKI (China National Knowledge Infrastructure) databases to identify relevant monographs and related references from 1974 to 2018. Chinese journals and theses/dissertations were hand searched. Results 43 studies were recruited. Each research was analyzed for study design, subject characteristics, intervention, selected acupoints, assessment parameters, proposed mechanisms, and results/conclusions. Conclusions In our review, we concluded that acupuncture alone or combined with other treatment modalities is beneficial to the clinical conditions of RA without adverse effects reported and can improve function and quality of life and is worth trying. Several important possible mechanisms were summarized including anti-inflammatory effect, antioxidative effect, and regulation of immune system function. However, there is still inconsistency regarding the clinical efficacy and lack of well-designed human/animal double-blinded RCTs. Future discussion for further agreement on taking traditional Chinese medicine (TCM) theory into consideration as much as possible is a top priority.

Chinese Herbal Medicines for Rheumatoid Arthritis: Text‐Mining the Classical Literature for Potentially Effective Natural Products

“…Traditional treatment methods are widely used in China often in combination with DMARDs and/or biologics [10]. is is likely due to a combination of concerns about the side effects of DMARD combination therapy, the high cost of biological agents in China, the ready availability of traditional treatments in the hospital system [11], and public awareness of the increasing literature on the evidence base for traditional treatments such as herbal formulations and acupuncture [12][13][14][15][16].…”

The RIGHT Extension Statement for Traditional Chinese Medicine: Development, Recommendations, and Explanation

“…Acupuncture is an important component of TCM interventions. Acupuncture has been increasingly used as an integrative or complementary therapy and it is well-tolerated with little risk of serious adverse effects [ [31] , [32] , [33] , [34] ]. For item 10-1 (S5-1in the checklist of the RIGHT-TCM), it is recommended to describe the acupuncture points, major points, matching points, and their addition and subtraction information.…”

New perspectives on dry needling following a medical model: are we screening our patients sufficiently?

“…While inflammatory autoimmune disorders should not preclude dry needling, proper screening of the stability of the disease and medication status is merited to avoid overly aggressive dry-needling dosage and technique in unstable or active flares to prevent exacerbating symptoms. Despite support for needle-based therapies such as acupuncture in rheumatoid arthritis [42], clinicians should consider avoiding the application of dry needling during the active phase of chronic autoimmune inflammatory diseases, however may consider application during the stationary or remittent phase.…”