[Treatment of knee osteoarthritis with acupuncture and moxibustion: a randomized controlled trial]

To compare the difference of the efficacy on knee osteoarthritis (KOA) between the combined therapy of acupuncture and moxibustion and western medication, and explore the better therapeutic method for KOA.

One hundred and sixty patients were divided into a combined therapy group and a western medication group, 80 cases in each one according to the visit sequence, with the random number table adopted. In the combined therapy group, the main points were selected from the local painful sites, combined with the acupoints based on the syndrome differentiation and distal acupoints on the affected meridians. The lifting, thrusting or rotating technique was used and the reinforcing or reducing manipulation was applied according to the syndrome differentiation. "Duanci" or "Shuci" needling technique was used specially at the extra points and Ashi points. The needling sensation relied on the patients' tolerance. After acupuncture, the heat-sensitive moxibustion with pure moxa stick was applied over the local painful sites around knee joint and Shenshu (BL 23) to detect the heat-sensitized points. Acupuncture and moxibustion were given once every day. The treatment of 5 days made 1 session. There were 2 days at the interval between two sessions. In the western medication group, glucosamine sulfate capsules were prescribed for oral administration, 2 capsules each time, three times a day. Additionally, the joint cavity injection was combined. On the first day, sodium hyaluronate 25 mg and triamcinolone acetonide acetate 50 mg were injected. Afterwards, on the 8th, 15th, 22nd and 29th days, sodium hyaluronate injection 25 mg was used only. The treatment was for 5 weeks totally in the two groups. The efficacy was analyzed statistically in 5 weeks. The follow-up visit was conducted in 3 months and 6 months after 5 weeks treatment, respectively. The Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC) and visual analogue scale (VAS) were adopted to assess the recovery of joint function.

The efficacy in 5 weeks of treatment was different significantly between the two groups (P < 0.05). The efficacy in the western medication group was better than that in the combined therapy group. The difference in the safety assessment was remarkable (P < 0.01). The result in the combined therapy group was superior remarkably to the western medication group. In 3-month follow-up visit after treatment, the knee joint function was not different obviously between the two groups (P > 0.05). In 6-month followup visit after treatment, the knee joint function was different obviously between the two groups (P < 0.01). The result in the combined therapy group was better remarkably than that in the western medication group.

The combined therapy of acupuncture and moxibustion achieves the safe and effective therapeutic effect with less adverse reactions in the treatment of KOA. The immediate effect in the combined therapy group is not so obvious as compared with the western medication, but the long-term efficacy is remarkably superior to western medication.