1.
Effect and safety of acupotomy in treatment of knee osteoarthritis: a systematic review and Meta-analysis.
Fang, T, Li, Q, Zhou, F, Liu, F, Liu, Z, Zhao, M, Chen, M, You, J, Jin, Y, Xie, J
Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan. 2020;(3):355-364
Abstract
OBJECTIVE To evaluate the clinical efficacy and safety of acupotomy in treatment of knee osteoarthritis (OA). METHODS Extensive literature searches were carried out in PubMed, EMBASE, Cochrane Library (Issue 5, 2017), Chinese Biomedical Literature Database, China National Knowledge Infrastructure Database, China Science and Technology Journal Database and Wanfang Database. All databases were retrieved from their inception until May 31, 2017. Randomized controlled trials incorporating acupotomy versus intra-articular sodium hyaluronate for knee osteoarthritis were included. According to Cochrane Reviews' Handbook (5.2), two reviewers screened each article and extracted data independently and were blinded to the findings of each reviewer. Meta-analysis was performed by the Cochrane Collaboration's RevMan 5.3 software. RESULTS We identified 12 studies involving 1150 patients aged between 40 and 78 years old. The pooled analysis indicated that acupotomy showed a significant improvement for short-term effect [cure rate: odds ratio (OR) = 2.04, 95% confidence interval (CI) (1.46, 2.85), P < 0.01; total effective rate: OR = 2.25, 95% CI (1.55, 3.28), P < 0.01; pain score: standard mean difference (SMD) = -1.02; 95% CI (-1.72, -0.31); P = 0.005; Western Ontario and McMaster Universities Questionnaire (WOMAC) score: SMD = -0.74; 95% CI (-1.11, -0.37); P < 0.01]; and also for long-term effect [total effective rate: OR = 2.99, 95%CI (1.88, 4.76), Z = 4.64, P < 0.01; pain score: SMD = -1.68; 95% CI (-2.14, -1.22); P < 0.001; WOMAC score: SMD = -0.91; 95% CI (-1.40, -0.41); P < 0.001]. In addition, there was no obvious difference between acupotomy group and control group in adverse events [OR = 2.13, 95%CI (0.14, 32.28), P = 0.58]. CONCLUSION Acupotomy is a safe and effective treatment for KOA. However, due to the methodological deficiency of the included studies, well-designed randomized controlled trials are required to further confirm the findings.
2.
Heat-sensitive moxibustion in patients with osteoarthritis of the knee: a three-armed multicentre randomised active control trial.
Chen, R, Chen, M, Su, T, Zhou, M, Sun, J, Xiong, J, Chi, Z, Xie, D, Zhang, B
Acupuncture in medicine : journal of the British Medical Acupuncture Society. 2015;(4):262-9
Abstract
BACKGROUND In China, heat-sensitive moxibustion (HSM) is used for knee osteoarthritis (KOA) to reduce pain and improve physical activity. However, there is little high-quality evidence of its effectiveness. OBJECTIVE To evaluate the effectiveness of HSM in the treatment of KOA compared with usual care. METHODS We performed a multicentre, randomised controlled trial. In total, 432 patients with KOA were randomly assigned to one of three groups (HSM, conventional moxibustion, or conventional injection with sodium hyaluronate). The primary end point was the guiding principle of clinical research on new drugs in the treatment of KOA (GPCRND-KOA). Measurements were obtained at baseline and after 1 and 6 months (month 7) of study. RESULT For GPCRND-KOA, there were significant differences among the three groups after treatment at months 1 and 7. Pairwise comparisons showed that HSM was more effective than the conventional drug. There was no difference in any measures between conventional moxibustion and the conventional drug. Compared with conventional moxibustion, HSM resulted in greater improvement in all outcomes. CONCLUSIONS This trial provided some evidence of the superiority of HSM in patients with KOA, suggesting that the observed differences might be due to superiority effects of a heat-sensitive point, although the effect of expectation cannot be ruled out. TRIAL REGISTRATION NUMBER The trial was registered at Controlled Clinical Trials: ChiCTR-TRC-09000600.