Clinical study on the treatment of knee osteoarthritis of Shen-Sui insufficiency syndrome type by electroacupuncture.
OBJECTIVE
To study the clinical effificacy of electroacupuncture (EA) on treating knee osteoarthritis (KOA) of Shen ()-Sui () insuffificiency (SSI) syndrome type.


METHODS
A total of 245 patients (279 knees) of KOA-SSI were randomly assigned to two groups by lottery: 141 knees in the treatment group and 138 knees in the control group. The treatment group was managed with EA at the dominant points of Neixiyan (Ex-LE4) and Waixiyan (Ex-LE5) as well as the conjugate points of Xuanzhong (GB39) and Taixi (KI3) for 30 min, once a day, with 15 days as one course; 2 courses were applied with a 5-day interval in between. The control group was treated with intra-articular injection of 2 mL hyaluronic acid into the affected joint every 7 days for 5 times in total. The clinical effects on the patients in different stages were observed, and their symptom scores of knee and contents of cytokines, including interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), prostaglandin E(2alpha) (PGE(2alpha)) and matrix metalloproteinases-3 (MMP-3), in the knee joint fluid were measured before and after treatment.


RESULTS
The study was completed in 235 patients (263 knees); four patients (7 knees) in the treatment group and six patients (9 knees) in the control group dropped out. Comparison of therapeutic effects (excellent and effective rates) between the two groups showed insignificant differences (P>0.05). Symptom scores of knee and contents of cytokines in the knee flfluid after treatment were lowered signifificantly in the patients of stage I-III in both groups (P<0.05 or P<0.01). However, the lowering of the total symptom score of knee in the patients of stage III in the treatment group was more signifificant (P<0.05).


CONCLUSIONS
EA could effectively alleviate the clinical symptoms in KOA patients of stage III, showing an effect superior to that of hyaluronic acid. EA also shows action in suppressing the secretion of IL-1, IL-6, TNF-alpha, PGE(2alpha) and MMP-3 in the knee flfluid.
Wu
Ming-xia
MX
The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou 350003, China.
Li
Xi-hai
XH
Lin
Mu-nan
MN
Jia
Xi-rui
XR
Mu
Rong
R
Wan
Wen-rong
WR
Chen
Rui-hua
RH
Chen
Li-hua
LH
Lin
Wan-qing
WQ
Huang
Cong-yang
CY
Zhang
Xue-ru
XR
Hong
Kun-da
KD
Li
Li
L
Liu
Xian-xiang
XX
D000368:Aged; D016207:Cytokines / Q000378:metabolism; D015671:Electroacupuncture / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D019278:Matrix Metalloproteinase 3 / Q000378:metabolism; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000201:enzymology / Q000628:therapy*; D011859:Radiography; D013577:Syndrome; D013582:Synovial Fluid / Q000201:enzymology; D016896:Treatment Outcome
D016207:Cytokines; D019278:Matrix Metalloproteinase 3