title: Adjuvant auricular electroacupuncture and autogenic training in rheumatoid arthritis: a randomized controlled trial. Auricular acupuncture and autogenic training in rheumatoid arthritis.
abstract: BACKGROUND
  In contrast to psychological interventions the usefulness of acupuncture as an adjuvant therapy in rheumatoid arthritis (RA) has not yet been demonstrated.
  
  
  OBJECTIVE
  The efficacy of auricular electroacupuncture (EA) was directly compared with autogenic training (AT).
  
  
  METHODS
  Patients with RA (n = 44) were randomized into EA or AT groups. EA and lessons in AT were performed once weekly for 6 weeks. Primary outcome measures were the mean weekly pain intensity and the disease activity score 28 (DAS 28); secondary outcome measures were the use of pain medication, the pain disability index (PDI), the clinical global impression (CGI) and pro-inflammatory cytokine levels, which were assessed during the study period and 3 months after the end of treatment.
  
  
  RESULTS
  At the end of the treatment and at 3-month follow-up a clinically meaningful and statistically significant improvement (p < 0.05) could be observed in all outcome parameters and both groups. In contrast to the AT group, the onset of these effects in the EA group could already be observed after the 2nd treatment week. In the 4th treatment week the EA group reported significantly less pain than the AT group (p = 0.040). After the end of treatment (7th week) the EA group assessed their outcome as significantly more improved than the AT group (p = 0.035). The erythrocyte sedimentation rate in the EA group was significantly reduced (p = 0.010), and the serum concentration of tumor necrosis factor-alpha was significantly increased compared to the AT group (p = 0.020).
  
  
  CONCLUSIONS
  The adjuvant use of both EA and AT in the treatment of RA resulted in significant short- and long-term treatment effects. The treatment effects of auricular EA were more pronounced.
authors.affiliation: Department of Anesthesiology, Pain Clinic, Hannover, Germany. bernateck.michael@mh-hannover.de
authors.forename: Michael
authors.initials: M
authors.lastname: Bernateck
authors.forename: Mareike
authors.initials: M
authors.lastname: Becker
authors.forename: Christine
authors.initials: C
authors.lastname: Schwake
authors.forename: Ludwig
authors.initials: L
authors.lastname: Hoy
authors.forename: Torsten
authors.initials: T
authors.lastname: Passie
authors.forename: Alexandr
authors.initials: A
authors.lastname: Parlesak
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fischer
authors.forename: Matthias
authors.initials: M
authors.lastname: Fink
authors.forename: Matthias
authors.initials: M
authors.lastname: Karst
mesh_terms: D020831:Acupuncture, Ear / Q000009:adverse effects / Q000379:methods*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000628:therapy*; D001326:Autogenic Training; D001774:Blood Chemical Analysis; D015671:Electroacupuncture / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000145:classification / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult