Comparison Of Clinical Efficacy Of Electroacupuncture/manual Acupuncture In The Treatment Of Knee Osteoarthriti

Objective:Knee osteoarthritis(KOA)is a kind of cartilage degenerative osteoarthritis.The common clinical symptoms are pain,stiffness and dysfunction and there is no curative treatment.At present,the guidelines emphasize the importance of non-drug therapy for KOA.Acupuncture is favored by many patients because of its simple operation and high safety.Electro-acupuncture(EA)and manual acupuncture(MA)are two acupuncture treatments commonly used in clinic.Previous clinical studies showed that the results of EA for KOA were mostly positive,while the curative effect of MA was controversial.For patients with KOA,there is still a lack of clinical study on the curative effect of both of them.Objective:The purpose of our study is to compare the effectiveness of EA or MA for knee pain,stiffness and function of people who have been diagnosed with KOA.Methods:This study is a randomized controlled,double-blind clinical trial.Sixty patients with KOA meeting the inclusion criteria were recruited by WeChat platform,posters and outpatient from September 2017 to January 2018.They were randomly allocated by a 1:1 ratio to either EA group(n=30)or MA group(n=30).Patients in the EA group were treated by use of 6-7 local acupoints and 2-3 distal acupoints.In addition,an electrical apparatus was connected to stimulate two pairs acupoints.Patients in MA group had the same schedule as the EA group except that the electrical apparatus had working power indicator and sound without actual current output.Both groups received treatment for 24 sessions over 8 weeks.The primary outcome was success rate,which was calculated according to a change of 50%from baseline in Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)total scores to 8 weeks.Secondary outcomes included pain,stiffness,function,quality of life,blind assessment,number of emergency analgesics(paracetamol)used and acupuncture-related adverse events were assessed at 4 and 8 weeks.Results:After 8 weeks of treatment,there were 25 patients in EA group and and 28 patients in MA group and the expulsion rates were 10%and 6.67%respectively.The success rate was 43%in the EA group and 30%in the MA group.There was no significant difference in the success rate between the two groups(P=0.309).Compared with baseline,there was a significant difference in total scores of WOMAC index,pain sub-scale,stiffness sub-scale,functional sub-scale and VAS scores in the EA group and the MA group(P<0.05),but no significant difference between groups(P>0.05).There was no significant difference in the SF-12 scale compared with baseline(P>0.05).The overall effect of acupuncture evaluation of EA group was better than that of MA group(P=0.009).No serious adverse events occurred in both groups during the trial.Conclusion:EA and MA could improve the clinical symptoms of knee osteoarthritis and the general effect of EA was no better than MA.This finding requires confirmation in further trials with large sample.