Effect of Acupuncture on Cytokine Levels in Persons with Multiple Sclerosis: A Randomized Controlled Trial

Effect of warm needle therapy guided by ultrasound on pain relief and improvement of physical function in patients with knee osteoarthritis

BACKGROUND

Conventional treatments for knee osteoarthritis (KOA) often fall short in providing optimal outcomes.

OBJECTIVE

To evaluate the effect of warm needle therapy guided by ultrasound on pain relief and physical function in patients with KOA.

METHODS

In this retrospective study, the clinical records of patients with KOA undergoing either meloxicam alone or meloxicam combined with warm needle therapy were reviewed. Various parameters, including pain evaluations, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, range of motion for knee flexion, knee society scores, quality of life scores, inflammatory factor levels, and patient satisfaction were comparatively analyzed.

RESULTS

A total of 140 patients were included, including 68 patients treated by Meloxicam and 72 patients treated by Meloxicam and warm needle therapy. Following treatment, the meloxicam combined with warm needle therapy group exhibited lower pain scores (3.62±1.98 vs. 4.38±1.95, P=0.023), improved WOMAC scores (27.82±8.75 vs. 31.25±8.82, P=0.022), increased range of motion (136.82°±8.58° vs. 133.43°±8.86°, P=0.023), higher knee society scores (93.32±7.21 vs. 90.21±7.78, P=0.016), and superior Short Form-36 Health Survey (SF-36) scores (81.24±6.33 vs. 78.43±6.85, P=0.013). Furthermore, a significant reduction in inflammatory factors including interleukin-8 (IL-8), matrix metalloproteinase-3 (MMP-3), Interleukin-1 beta (IL-1β), Tumor Necrosis Factor-alpha (TNF-α), and cyclooxygenase-2 (COX-2) levels was observed in the meloxicam combined with warm needle therapy group compared to the meloxicam alone group (all P<0.05). Patient satisfaction was likewise notably higher in the meloxicam combined with warm needle therapy group (8.43±2.15 vs. 7.58±2.24, P=0.024), with a greater proportion of patients willing to recommend the treatment (81.94% vs. 64.71%, P=0.034).

CONCLUSION

Warm needle therapy guided by ultrasound, in combination with meloxicam, significantly improves pain relief, physical function, inflammatory modulation, and patient satisfaction in KOA patients.

The blinding status and characteristics in acupuncture clinical trials: a systematic reviews and meta-analysis

BACKGROUND

Sham acupuncture is a widely accepted control in acupuncture clinical trials. Given the nature of acupuncture, it is warranted to assess the blinding of sham-controlled trials. Despite the sham acupuncture design having been widely used, the overall blinding of sham acupuncture and the characteristics of blinding assessment in acupuncture trials are unclear. This research aims to assess the blinding status of acupuncture clinical trials and explore the blinding assessment characteristics in acupuncture trials.

METHODS

This meta-analysis included all the acupuncture clinical trials published in English that performed blinding assessments and reported the results. We searched PubMed, Embase, and Web of Science for randomized controlled trials (RCTs) from inception to April 2024. The primary outcome is Bang's Blinding Index (Bang's BI) and 95% credibility interval (CrI) was pooled using a Bayesian hierarchical model. The study adheres to the PRISMA guidelines.

RESULTS

Sixty-four eligible studies published from 1999 to 2024 were included. The mean of Bang's BI was - 0.24 (95% CrI - 0.34 to - 0.14, tau2 = 0.13) for the sham acupuncture group and 0.41 (95% CrI 0.32 to 0.49, tau2 = 0.10) for the verum acupuncture group. The characteristics of blinding showed that 62.50% of the trials had a Bang's BI greater than 0 in the verum group and less than 0 in the sham group; in 28.15% of the trials, the Bang's BI was greater than 0 in the verum group and greater than 0 in the sham group. Subgroup analysis revealed that area, number of research centers, treatment sessions, acupoints number, and evaluation timepoint can influence blinding results.

CONCLUSION

Overall blinding status in current acupuncture clinical trials shows a majority correctly guessing for the verum group and opposite guessing for the sham group. However, in some acupuncture trials, the blinding of sham acupuncture might be compromised. Factors such as the Asian population, penetrating sham needling, and querying participants about their group assignment during the study increase the risk of unblinding and warrant careful consideration in sham acupuncture control design. Furthermore, researchers should closely monitor the blinding status of sham acupuncture and transparently report details of blinding assessments.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42023403595.

[Restorative capability of traditional Chinese medicine in autoimmune diseases of nervous system: a literature review]

Autoimmune diseases of the nervous system are characterized by the formation of pronounced neurological deficiency and often lead to disability. Complementary medicine as an adjuvant or preventive therapy of various diseases, including autoimmune ones, is increasingly attracting the attention of doctors and researchers. Traditional Chinese medicine (TCM) has a complex of treatment methods, including acupuncture, phytotherapy, nutrition, physical exercises and other methods that are often used in common with the recognized approaches of the official medical science. The article describes the TCM methods application in autoimmune diseases of nervous system, presents the practical experience of using acupuncture, phytotherapy, diet, physical exercises. It was concluded that TCM is important and frequently underestimated health care resource, especially in prevention and treatment of autoimmune diseases of nervous system.