Acupuncture For Knee Osteoarthritis:Controling Acute Phase Proteind Of Serum Amyloid A&Hyper Sensitive C-reactive Protein

Introduction:Knee osteoarthritis (OA) is considered a major public health issue causing chronic disability worldwide. It is the most prevalent form of arthritis and a major cause of disability in elderlies. OA is characterized by a series of pathological changes in the whole joint, including cartilage loss, bone remolding, excess synovial fluid secretion, capsular swelling, synovitis, muscle weakness and atrophy and eventually bone spurs that interfere with joint movement. According to NIH, biomarker can be defined as a characteristic that is objectively measured and evaluated as an indicator of normal biologic processes, pathogenic processes, orresponses to a therapeutic intervention. Recent studies of the acute-phase response in OA suggest that the concentrations of CRP and SAA are elevated in OA, so they could be used as a biomarker to follow up the treatment. Currently there is no cure for OA and all the interventions are to control pain, inflammation, motility of the joint and to improve life quality of patients. Acupuncture has found to have satisfactory treatment result, though there is still controversial reports that claiming there is no superiority in acupuncture's effect comparing to placebo.Subjective:The purpose of this study was to investigate the efficacy of acupuncture for knee OA also anti-inflammatory effect of it, by measuring the two sensitive acute phase proteins of serum Amyloid A&hypersensitive C-reactive protein.Methods:50subjects, clinically, diagnosed as knee OA were randomly allocated into two groups of control and intervention group. No treatment was given to control group except educations about their life style, for intervention group,10sessions of acupuncture therapy was given during4weeks. At the beginning and the end of the4week, WOMAC standard OA questionnaire was filled by patients also blood samples were take at both starting point and the end of4weeks and serum levels of SAA&Hs-CRP were checked in both groups.Results: According to the results of T-test, WOMAC scores percentage change in control group was0.7947%and in intervention group was60.89%, difference in WOMAC score change between groups was significant.(p<o.oo5).That's to say WOMAC scores were significantly raised in intervention group but not in control group. hs-CRP change in control group was-0.51%and in intervention group was-29.13%. hs-CRP was notably decreased in intervention group and the difference between groups were significant(p=0.003). SAA change in control group was0.50%and in intervention group was-11.86%, SAA was significantly decreased in intervention group but not in control group, the difference between groups was significant.(p=0.002)Conclusion:Acupuncture was efficiently lowered SAA&hs-CRP serum levels. These findings suggest that one of the underlying mechanisms of acupuncture treatment in OA is controlling inflammation. WOMAC test, demonstrating the pain degree and functional abilities of patients was shown to have a notable improvement. Further studies are seem to be necessary to investigate the long term effect of acupuncture on inflammatory markers.