Acupuncture is effective for treating degenerative osteoarthritis of the knee joint. Researchers from the Nanchong Hospital of Traditional Chinese Medicine and Chuanbei University of Medicine conducted a clinical trial comparing the efficacy of routine pharmaceutical care with that of warm needle acupuncture. The study concludes that in addition to conventional pharmaceutical treatment, acupuncture at specific acupoints with warm needling can improve the efficacy of treating degenerative osteoarthritis of the knee joint, alleviate pain, restore knee joint function, and improve inflammatory responses and bone metabolism. [1]

The total effective rate in the warm needle acupuncture group was 92.3%, whereas the total effective rate in the control group was 80.0%. After treatment, both groups showed lower WOMAC scores, VAS scores, IL-1β, TNF-α, and IL-6 levels compared with before treatment; Lysholm scores, OPG, and BGP levels were higher than before treatment. The warm needle acupuncture observation group had lower WOMAC scores, VAS scores, IL-1β, TNF-α, and IL-6 levels compared with the control group after treatment; Lysholm scores, OPG, and BGP levels were higher than those of the control group. Observation indicators in the study included the following parameters:

· Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, used to assess the severity of osteoarthritis symptoms in the knee joint

· Visual Analog Scale (VAS) score, used to measure pain intensity experienced by patients

· Lysholm score, utilized to evaluate knee joint function and stability

· Serum inflammatory factors, including Interleukin-1β (IL-1β), Tumor Necrosis Factor-α (TNF-α), and Interleukin-6 (IL-6), markers for assessing inflammatory responses in the body

· Bone metabolism indicators, including osteoprotegerin (OPG) and bone Gla Protein (BGP), indicate the status of bone health

The study included 130 patients who were randomly divided into a warm needle acupuncture observation group and a pharmaceutical control group, with 65 cases in each group. In the warm needle acupuncture group, there were 29 male patients and 36 female patients, with 24 cases graded as Kellgren-Lawrence (K-L) grade I and 41 cases as grade II. The patients’ ages ranged from 42–73 years, with an average age of 59 ±6 years. There were 37 cases of unilateral involvement and 28 cases of bilateral involvement, with disease duration ranging from 1–7 years and an average duration of 3.82 ±0.81 years.

In the control group, there were 26 male patients and 39 female patients, with 28 cases graded as K-L grade I and 37 cases as grade II. The patients’ ages ranged from 40–74 years, with an average age of 57 ±6 years. There were 33 cases of unilateral involvement and 32 cases of bilateral involvement, with disease duration ranging from 0.5–9 years and an average duration of 4.01 ±0.93 years.

In the control group, patients received conventional pharmaceutical treatment. This included oral administration of glucosamine hydrochloride tablets, twice daily at a dosage of 75 g per dose and celecoxib capsules, once daily at a dosage of 0.2 g per dose. The treatment regimen spanned a total of 4 weeks.

In addition to the above treatment, the warm needle acupuncture group also received warm moxibustion therapy. The main acupoints selected were:

· EX-LE04 (Neixiyan)

· ST35 (Dubi)

Supplementary acupoints included the following:

· GB39 (Xuanzhong)

· KD10 (Yingu)

· SP9 (Yinlingquan)

· GB34 (Yanglingquan)

· ST40 (Fenglong)

· ST34 (Liangqiu)​

· SP10 (Xuehai)

Patients were seated with their knees naturally separated, aligned with their shoulders. After ensuring stable breathing, disposable filiform needles (0.30 mm × 40 mm) were inserted into Neixiyan and Dubi using the oblique needling method, angled at 45 degrees to the sagittal plane and parallel to the tibial plateau, to a depth of approximately 2.0 cun.

The needles were gently lifted, thrust, and rotated until the patient felt a strong soreness or numbness sensation around the entire knee. Fenglong (ST40) was needled to a depth of 1.5 cun using the same technique to stimulate a deqi sensation in the popliteal fossa and joint cavity. Standard needling techniques were applied to the remaining acupoints until deqi was obtained. The needles were retained for 30 minutes. After completing the treatment at Neixiyan and Dubi, a 2 cm moxa piece was placed at the needle ends and ignited. Treatment was administered three times per week for a total of 4 weeks.

 

Reference:
[1] Ming Haijun, Pang Dan, Liu Le, Zhou Nanling, Wang Yongquan, Fan Xiaochun, Efficacy Observation of Turtle-probing Needling Combined with Warming Needle on Knee Degenerative Osteoarthropathy，Shanghai Journal of Acupuncture, Volume 42, Issue 11, November 2023.