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Electro-Acupuncture is Beneficial for Knee Osteoarthritis: The Evidence from Meta-Analysis of Randomized Controlled Trials

Na Chen

School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing 210023, P. R. China

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Jing Wang

The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210023, P. R. China

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Attilio Mucelli

School of Economics “Giorgio Fuà”, Polytechnic University of Marche, Ancona 60121, Italy

E-mail Address: attilio.mucelli@gmail.com

Correspondence to: Attilio Mucelli, School of Economics “Giorgio Fuà”, Polytechnic University of Marche, Piazzale Martelli, Ancona 60121, Italy. Tel: (+39) 071-220-7183, Fax: (+39) 071-220-7183

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Xu Zhang

Jiangsu Collaborative Innovation Center of Traditional, Chinese Medicine Prevention and Treatment of Tumor, Nanjing 210023, P. R. China

E-mail Address: zhangxu@njucm.edu.cn

Correspondence to: Prof. Xu Zhang, Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine Prevention and Treatment of Tumor, Nanjing University of Chinese Medicine, 138 Xian Lin Road, Nanjing 210023, P. R. China. Tel: (+86) 25-8581-1058, Fax: (+86) 25-8581-1058

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Changqing Wang

School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing 210023, P. R. China

E-mail Address: cqwang1962@163.com

Correspondence to: Prof. Changqing Wang, School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xian Lin Road, Nanjing 210023, P. R. China. Tel: (+86) 25-858-1109, Fax: (+86) 25-858-1109

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https://doi.org/10.1142/S0192415X17500513Cited by:88 (Source: Crossref)

Abstract

Knee osteoarthritis (KOA) is a common chronic degenerative disease of the elderly. Electro-acupuncture (EA) is considered as a beneficial treatment for KOA, but the conclusion is controversial. This systematic review compiled the evidence from 11 randomized controlled trials to objectively assess the effectiveness and safety of EA for KOA. Eight databases including PubMed, Cochrane Library, Clinic trials, Foreign Medical Literature Retrial Service (FMRS), Science Direct, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang Data were extensively searched up to 5 July 2016. The outcomes included the evaluation of effectiveness, pain and physical function. Risk of bias was evaluated according to the Cochrane risk of bias tool. Eleven RCTs with 695 participants were included. Meta-analysis indicated that EA was more effective than pharmacological treatment (RR $=$ $=$ 1.14; 95% CI $=$ $=$ 1.01,1.28; $P = 0.03$ $P = 0.03$ ) and manual acupuncture (RR $=$ $=$ 1.12; 95% CI $=$ $=$ 1.02,1.22; $P = 0.02$ $P = 0.02$ ). Also, EA had a more significant effect in reducing the pain intensity (SMD $= - 1.11$ $= - 1.11$ ; 95% CI $= - 1.33, - 0.88$ $= - 1.33, - 0.88$ ; $P < 0.00001$ $P < 0.00001$ ) and improving the physical function in the perspective of WOMAC (MD $= - 9.81$ $= - 9.81$ ; 95% CI $= - 14.05$ $= - 14.05$ , 5.56; $P < 0.00001$ $P < 0.00001$ ) and LKSS (pharmacological treatment: MD $= 5.08$ $= 5.08$ ; 95% CI $= 3.52$ $= 3.52$ , 6.64; $P < 0.00001$ $P < 0.00001$ ). Furthermore, these studies implied that EA should be performed for at least 4 weeks. Conclusively, the results indicate that EA is a great opportunity to remarkably alleviate the pain and improve the physical function of KOA patients with a low risk of adverse reaction. Therefore, more high quality RCTs with rigorous methods of design, measurement and evaluation are needed to confirm the long-term effects of EA for KOA.

Keywords:

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