Tukmachi Emad, Jubb Ronald, Dempsey Emma, Jones Peter
Selly Oak Hospital, Birmingham, UK.
Acupunct Med. 2004 Mar;22(1):14-22. doi: 10.1136/aim.22.1.14.
Using an open randomised controlled study, we examined the effectiveness of manual and electroacupuncture on symptom relief for patients with osteoarthritis of the knee.
Patients with symptomatic osteoarthritis of the knee were randomised to one of three treatment groups. Group A had acupuncture alone, group B had acupuncture but continued on their symptomatic medication, and group C used their symptomatic medication for the first five weeks and then had a course of acupuncture added. Patients receiving acupuncture were treated twice weekly over five weeks. Needles were inserted (with manual and electrical stimulation) in acupuncture points for pain and stiffness, selected according to traditional acupuncture theory for treating Bi syndrome. Patients were assessed by a blinded observer before treatment, after five weeks' treatment and at one month follow up, using a visual analogue pain scale (VAS) and the Western Ontario McMaster (WOMAC) questionnaire for osteoarthritis of the knee.
The 30 patients in our study were well matched for age, body mass index, disease duration, baseline VAS pain score and baseline WOMAC scores. Repeated measure analyses gave a highly significant improvement in pain (VAS) after the courses of acupuncture in groups A (P = 0.012) and B (P=0.001); there was no change in group C until after the course of acupuncture, when the improvement was significant (P = 0.001). Similarly significant changes were seen with the WOMAC pain and stiffness scores. These benefits were maintained during the one month after the course of acupuncture. Patients' rating of global assessment was higher than that of the acupuncturist.
We conclude that manual and electroacupuncture causes a significant improvement in the symptoms of osteoarthritis of the knee, either on its own or as an adjunct therapy, with no loss of benefit after one month.
我们采用开放随机对照研究，检验了手法针刺和电针治疗对膝关节骨关节炎患者症状缓解的有效性。
有症状的膝关节骨关节炎患者被随机分为三个治疗组之一。A组仅接受针刺治疗，B组接受针刺治疗但继续服用对症药物，C组在前五周使用对症药物，然后增加一个疗程的针刺治疗。接受针刺治疗的患者在五周内每周接受两次治疗。根据传统针灸理论治疗痹证，选取疼痛和僵硬的穴位进行针刺（采用手法和电刺激）。在治疗前、治疗五周后和随访一个月时，由一名盲法观察者使用视觉模拟疼痛量表（VAS）和西 Ontario McMaster（WOMAC）膝关节骨关节炎问卷对患者进行评估。
我们研究中的30名患者在年龄、体重指数、病程、基线VAS疼痛评分和基线WOMAC评分方面匹配良好。重复测量分析显示，A组（P = 0.012）和B组（P = 0.001）在针刺疗程后疼痛（VAS）有高度显著改善；C组在针刺疗程前没有变化，针刺疗程后改善显著（P = 0.001）。WOMAC疼痛和僵硬评分也有类似的显著变化。这些益处在针刺疗程后的一个月内得以维持。患者对整体评估的评分高于针灸师。
我们得出结论，手法针刺和电针治疗无论是单独使用还是作为辅助治疗，都能显著改善膝关节骨关节炎的症状，且一个月后仍无益处丧失。
