title: Evaluation of the effect of acupuncture on hand pain, functional deficits and health-related quality of life in patients with rheumatoid arthritis--A study protocol for a multicenter, double-blind, randomized clinical trial.
abstract: BACKGROUND
  Rheumatoid arthritis (RA) is a systemic inflammatory disease characterized by functional disability and pain. Although acupuncture is widely used, until now Western acupuncture studies on RA have not shown conclusive positive results. Acupuncture is regarded as a reflex therapy that has effects on the human autonomic nervous system. By establishing a traditional Chinese medicine (TCM) diagnosis first, the practitioner is able to choose acupoints according to the state of each individual patient.
  
  
  METHODS
  We are interested if acupuncture, using a classical diagnostic procedure to allocate acupoints to the patient according to the Shang Han Lun theory, can be effective in relieving pain, improving hand function and increasing health-related quality of life in RA.The authors intend to harmonize TCM diagnosis according to clinical and genetic profiles. Patients with the TCM diagnosis of a so-called Turning Point syndrome will be followed up in a randomized, prospective, double-blind, placebo-controlled, multicenter and three-armed parallel-group study with a standardized treatment in order to optimize potential therapeutic effects of acupuncture on pain, strength and muscle function of patients with RA as well as the influence on inflammation and quality of life.
  
  
  CONCLUSIONS
  The findings of this study will provide important clinical information about the feasibility and efficacy of acupuncture treatment for RA patients. In addition, it will explore the feasibility of further acupuncture research.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier NCT02553005.
authors.affiliation: Faculty of Medicine, University of Coimbra, 3045-137 Coimbra, Portugal.|Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal.|Heidelberg School of Chinese Medicine, 69126 Heidelberg, Germany.
authors.forename: Susana
authors.initials: S
authors.lastname: Seca
authors.affiliation: Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal.|Heidelberg School of Chinese Medicine, 69126 Heidelberg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kirch
authors.affiliation: Faculty of Medicine, University of Coimbra, 3045-137 Coimbra, Portugal.
authors.forename: António S
authors.initials: AS
authors.lastname: Cabrita
authors.affiliation: Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal.|Heidelberg School of Chinese Medicine, 69126 Heidelberg, Germany.
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Greten
mesh_terms: D015670:Acupuncture Therapy; D001172:Arthritis, Rheumatoid / Q000523:psychology / Q000628:therapy*; D002985:Clinical Protocols; D004311:Double-Blind Method; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008516:Medicine, Chinese Traditional; D010865:Pilot Projects; D011788:Quality of Life