Guo Xiao, Guo Liang, Lu Qing-Ze, Xie Hui, Chen Juan, Su Wen-Li, Tian Yuan, Li Xiao-Hua, Miao Hong-Lei, Zhang Yi, Yang Yan, Liao Cai, Deng Jun-Yuan, Yang Yun-Hao, Tang Cheng-Lin, Liu He-Jing
College of Traditional Chinese Medicine, Chongqing Medical University, Chongqing 400016, China.
Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, Chongqing Medical University, Chongqing 400016, China.
World J Gastroenterol. 2025 May 14;31(18):105495. doi: 10.3748/wjg.v31.i18.105495.
Knee osteoarthritis (KOA) is a chronic condition characterized by joint pain and dysfunction, driven by aging and obesity. Research indicates that the gut microbiota significantly influences KOA, potentially affecting inflammation and disease progression through the gut-joint axis. Traditional treatments like non-steroidal anti-inflammatory drugs offer symptom relief but have adverse effects. Emerging therapies like electroacupuncture (EA) and Tuina (TN) have shown promise in alleviating pain and improving joint function by targeting the gut microbiota.
To clarify the efficacy of EA with TN in treating KOA and its effect on gut microbiota regulation.
Sixty patients with KOA were allocated to EA or EA + TN (ET) group ( = 30 each). Seven acupoints were punctured. The ET group received TN after each EA session. Both groups completed 12 sessions. The visual analog scale (VAS) for assessing pain and the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) for measuring pain intensity, joint stiffness, and functional capacity were employed to assess clinical outcomes. Pre- and post-treatment fecal specimens underwent 16S ribosomal RNA sequencing to analyze the gut microbiota.
The ET group showed higher rates of "effective" and "markedly effective" outcomes. The VAS score of the ET group remained significantly lower than that of the EA group ( 0.001) immediately after treatment and 1 week post-treatment. The total WOMAC score ( 0.001), pain ( = 0.191), stiffness ( = 0.015), and function scores ( < 0.001) decreased significantly in the ET group post-treatment. The gut microbiota analysis revealed no significant changes in alpha diversity in either group. Beta-diversity analysis indicated distinct patterns in the ET group before and after treatment. Significant changes in microbial abundance were detected in both groups, highlighting variations in Firmicutes, Actinobacteria, Proteobacteria, and Bacteroidetes.
ET outperforms EA alone in improving KOA pain, stiffness, and function, potentially gut microbiota modulation, intestinal barrier protection, and inflammation reduction.
膝关节骨关节炎（KOA）是一种以关节疼痛和功能障碍为特征的慢性疾病，由衰老和肥胖引发。研究表明，肠道微生物群对KOA有显著影响，可能通过肠-关节轴影响炎症和疾病进展。非甾体抗炎药等传统治疗方法可缓解症状，但有不良反应。电针（EA）和推拿（TN）等新兴疗法已显示出通过靶向肠道微生物群缓解疼痛和改善关节功能的前景。
阐明电针联合推拿治疗KOA的疗效及其对肠道微生物群调节的作用。
将60例KOA患者分为电针组或电针+推拿组（ET组）（每组30例）。针刺7个穴位。ET组在每次电针治疗后接受推拿。两组均完成12次治疗。采用视觉模拟量表（VAS）评估疼痛程度，采用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）测量疼痛强度、关节僵硬程度和功能能力，以评估临床疗效。治疗前后采集粪便标本进行16S核糖体RNA测序，分析肠道微生物群。
ET组“有效”和“显效”的比例更高。ET组的VAS评分在治疗后即刻和治疗后1周仍显著低于电针组（<0.001）。ET组治疗后WOMAC总分（<0.001）、疼痛（=0.191）、僵硬（=0.015）和功能评分（<0.001）均显著降低。肠道微生物群分析显示，两组的α多样性均无显著变化。β多样性分析表明，ET组治疗前后存在明显差异。两组均检测到微生物丰度的显著变化，突出了厚壁菌门、放线菌门、变形菌门和拟杆菌门的变化。
在改善KOA疼痛、僵硬和功能方面，电针联合推拿优于单纯电针，可能与调节肠道微生物群、保护肠道屏障和减轻炎症有关。
