Effects of intensity of electroacupuncture on chronic pain in patients with knee osteoarthritis: a randomized controlled trial

Arthritis Research & Therapy

Si-yi Yu¹  Lin-lin Shen²  Guo-fu Huang²  Xiao-cui Yuan³  Man Li³  Ling-ling Yu⁴  Zheng-tao Lv⁵  Jing Li⁶  Bing Zhu⁷  Xiang-hong Jing⁷  Wei He⁷  Jing Yin⁸  Zhao-qing Zhang⁸  Chao-yang Ma⁹  Ming-qiao Ding^1,10 

[1] 0000 0001 0376 205X, grid.411304.3, School of Acupuncture and Moxibustion, Chengdu University of Traditional Chinese Medicine, 610075, Chengdu, China;0000 0004 0368 7223, grid.33199.31, Combined Traditional Chinese and Western Medicine Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, 430030, Wuhan, China;0000 0004 0368 7223, grid.33199.31, Department of Neurobiology, School of Basic Medicine, Tongji Medical College of Huazhong University of Science and Technology, 430030, Wuhan, China;0000 0004 0368 7223, grid.33199.31, Department of Neurobiology, School of Basic Medicine, Tongji Medical College of Huazhong University of Science and Technology, 430030, Wuhan, China;0000 0004 0368 7223, grid.33199.31, Combined Traditional Chinese and Western Medicine Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, 430030, Wuhan, China;0000 0004 0368 7223, grid.33199.31, Department of Neurobiology, School of Basic Medicine, Tongji Medical College of Huazhong University of Science and Technology, 430030, Wuhan, China;0000 0004 1799 5032, grid.412793.a, Department of Orthopedics, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, 430030, Wuhan, China;0000 0004 0368 7223, grid.33199.31, Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, 430022, Wuhan, China;0000 0004 0632 3409, grid.410318.f, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, 100700, Beijing, China;The Third Hospital of Wuhan, 430060, Wuhan, China;grid.440160.7, Central Hospital of Wuhan, 430014, Wuhan, China;grid.452862.f, The Fifth Hospital of Wuhan, 430050, Wuhan, China;

关键词: Electroacupuncture;    Knee osteoarthritis;    Diffuse noxious inhibitory control;    Randomized controlled trial;    Pain;   

DOI  :  10.1186/s13075-019-1899-6

来源: publisher

【 摘 要 】

BackgroundConditioned pain modulation (CPM) is impaired in people with chronic pain such as knee osteoarthritis (KOA). The purpose of this randomized, controlled clinical trial was to investigate whether strong electroacupuncture (EA) was more effective on chronic pain by strengthening the CPM function than weak EA or sham EA in patients with KOA.MethodsIn this multicenter, three-arm parallel, single-blind randomized controlled trial, 301 patients with KOA were randomly assigned. Patients were randomized into three groups based on EA current intensity: strong EA (> 2 mA), weak EA (< 0.5 mA), and sham EA (non-acupoint). Treatments consisted of five sessions per week, for 2 weeks. Primary outcome measures were visual analog scale (VAS), CPM function, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).ResultsThree hundred one patients with KOA were randomly assigned, among which 271 (90.0%) completed the study (mean age 63.93 years old). One week of EA had a clinically important improvement in VAS and WOMAC but not in CPM function. After 2 weeks treatment, EA improved VAS, CPM, and WOMAC compared with baseline. Compared with sham EA, weak EA (3.8; 95% CI 3.45, 4.15; P < .01) and strong EA (13.54; 95% CI 13.23, 13.85; P < .01) were better in improving CPM function. Compared with weak EA, strong EA was better in enhancing CPM function (9.73; 95% CI 9.44, 10.02; P < .01), as well as in reducing VAS and total WOMAC score.ConclusionEA should be administered for at least 2 weeks to exert a clinically important effect on improving CPM function of KOA patients. Strong EA is better than weak or sham EA in alleviating pain intensity and inhibiting chronic pain.Trial registrationThis study was registered with the Chinese Clinical Trial Registry (ChiCTR-ICR-14005411), registered on 31 October 2014.

【 授权许可】

CC BY