Adjuvant auricular electroacupuncture and autogenic training in rheumatoid arthritis: a randomized controlled trial. Auricular acupuncture and autogenic training in rheumatoid arthritis.
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.
Bernateck
Michael
M
Department of Anesthesiology, Pain Clinic, Hannover, Germany. bernateck.michael@mh-hannover.de
Becker
Mareike
M
Schwake
Christine
C
Hoy
Ludwig
L
Passie
Torsten
T
Parlesak
Alexandr
A
Fischer
Michael J
MJ
Fink
Matthias
M
Karst
Matthias
M
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