DOI QR코드

DOI QR Code

Efficacy and Safety of Miniscalpel Acupuncture on Knee Osteoarthritis - A randomized controlled pilot trial -

  • Jun, Seungah (Department of Acupuncture & Moxibustion medicine, College of Korean medicine, Daegu Haany University) ;
  • Lee, Jung Hee (Department of Acupuncture & Moxibustion medicine, College of Korean medicine, Daegu Haany University) ;
  • Gong, Han Mi (Department of Acupuncture & Moxibustion medicine, College of Korean medicine, Daegu Haany University) ;
  • Choi, Seong Hun (Department of Anatomy and Histology, College of Korean medicine, Daegu Haany University) ;
  • Bo, Min Hwang (Department of Oriental Ophthalmology and Otolaryngology and Dermatology, College of Korean medicine, Daegu Haany University) ;
  • Kang, Mi Suk (Department of Acupuncture & Moxibustion, College of Korean medicine, Gachon University) ;
  • Lee, Geon-Mok (Department of Acupotomy, LeeGeonmok Wonli Korean Medicine Hospital) ;
  • Lee, Hyun-Jong (Department of Acupuncture & Moxibustion medicine, College of Korean medicine, Daegu Haany University) ;
  • Kim, Jae Soo (Department of Acupuncture & Moxibustion medicine, College of Korean medicine, Daegu Haany University)
  • 투고 : 2018.02.09
  • 심사 : 2018.08.07
  • 발행 : 2018.09.30

초록

Objectives: We investigated the efficacy and safety of miniscalpel acupuncture (MA) for knee osteoarthritis (KOA) in an assessor-blinded randomized controlled pilot trial; this would provide information for a large-scale randomized controlled trial. Methods: Participants (n = 24) were recruited and randomly allocated to the MA group (experimental) or acupuncture group (control). The MA group received treatment once a week for 3 weeks (total of 3 treatments), while the acupuncture group received treatment two times per week for 3 weeks (total of 6 treatments). The primary outcome was pain as assessed by a visual analogue scale (VAS). The secondary outcomes (intensity of current pain, stiffness, and physical function) were assessed using the short-form McGill Pain Questionnaire (SF-MPQ) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Assessments were performed at baseline, 1, 2, and 3 during treatment and at week 5 (2 weeks after the end of treatment). Results: Of the 24 participants, 23 completed the study. Both groups showed significant improvements in VAS, SF-MPQ, and WOMAC. However, there were no significant differences between the MA and acupuncture groups. No serious adverse event occurred and blood test results were within normal limits. Conclusion: Our results suggest that although both MA and acupuncture provide similar effects with regard to pain control in patients with KOA, MA may be more effective in providing pain relief because the same relief was obtained with fewer treatments. A large-scale clinical study is warranted to further clarify these findings.

키워드

참고문헌

  1. Berman BM, Singh BB, Lao L, Langenberg P, Li H, Hadhazy V, et al. A randomized trial of acupuncture as an adjunctive therapy in osteoarthritis of the knee. Rheumatology (Oxford). 1999;38:346-54. https://doi.org/10.1093/rheumatology/38.4.346
  2. Bateman DN, Kennedy JG. Non-steroidal anti-inflammatory drugs and elderly patients. BMJ. 1995;310:817-8. https://doi.org/10.1136/bmj.310.6983.817
  3. Manek NJ. Medical management of osteoarthritis. Mayo Clin Proc. 2001;76:533-9. https://doi.org/10.4065/76.5.533
  4. Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part I: Critical appraisal of existing treatment guidelines and systematic review of current research evidence. Osteoarthritis and Cartilage. 2007;15:981-1000. https://doi.org/10.1016/j.joca.2007.06.014
  5. McConnell S, Kolopack P, Davis AM. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): a review of its utility and measurement properties. Arthritis care & research. 2001;45:453-61. https://doi.org/10.1002/1529-0131(200110)45:5<453::AID-ART365>3.0.CO;2-W
  6. McGettigan P, Henry D. Cardiovascular risk and inhibition of cyclooxygenase: a systematic review of the observational studies of selective and nonselective inhibitors of cyclooxygenase 2. JAMA. 2006;296:1633-44. https://doi.org/10.1001/jama.296.13.jrv60011
  7. Blower A, Brooks A, Fenn G, Hill A, Pearce M, Morant S, et al. Emergency admissions for upper gastrointestinal disease and their relation to NSAID use. Aliment Pharmacol Ther. 1997;11:283-91. https://doi.org/10.1046/j.1365-2036.1997.d01-604.x
  8. Guo C, Liu N, Li X, Sun H, Hu B, Lu J, et al. Effect of acupotomy on nitric oxide synthase and beta-endorphin in third lumbar vertebrae transverse process syndrome model rats. Journal of Traditional Chinese Medicine. 2014;34:194-8. https://doi.org/10.1016/S0254-6272(14)60078-9
  9. Ma C, Wu S, Li G, Xiao X, Mai M, Yan T. Comparison of miniscalpel-needle release, acupuncture needling, and stretching exercise to trigger point in myofascial pain syndrome. Clin J Pain. 2010;26:251-7. https://doi.org/10.1097/AJP.0b013e3181b8cdc8
  10. Lee G, Kim D, Kim H, Yeom S, Kim H, Kim D. The study on the effect of acupotomy in lumbar HIVD. The Journal of Korean Acupuncture & Moxibustion Medicine society. 2008;25:183-90.
  11. Kim S. Clinical characteristics of poor responders to acupotomy and safety pretreatment management. The Acupuncture. 2008;25:117-25.
  12. Lee GM, Kim DH, Kim HW, Cho NG, Choi YS, Kim HS, et al. The Cilnical Study on the Effect of Acupotomy Osteoarthritis on knee Using Five-Finger Placed to Marking Position. The Acupuncture. 2008;25:197-202.
  13. Lin M, Li X, Liang W, Liu J, Guo J, Zheng J, et al. Needle-knife therapy improves the clinical symptoms of knee osteoarthritis by inhibiting the expression of inflammatory cytokines. Experimental and therapeutic medicine. 2014;7:835-42. https://doi.org/10.3892/etm.2014.1516
  14. The Acupuncture Compilation Committee. The Acupuncture and Moxibustion(Sang). Seoul. In: Anonymous : JipMoonDang. 2008;441-483.
  15. Shin SY, Seo DK, Kim SY, Seo JC, Seo YJ, Lee YJ, et al. The Effect of Chinemys reevesii Gray Pharmacopuncture for Women with Knee Osteoarthritis. The Acupuncture. 2015;32:163-73. https://doi.org/10.13045/acupunct.2015048
  16. Min W, Yeo S, Kim E, Song HS, Koo S, Lee J, et al. Comparison of warm-needling and acupuncture for knee osteoarthritis: a randomized controlled trial. Korean Journal of Acupuncture. 2013;30:64-72. https://doi.org/10.14406/acu.2013.30.1.064
  17. Jung HC, Jeong SH. Clinical Study of Knee Joint Osteoarthritis Patients on the Effect of Korean Traditional Medicine Treatment with Acupuncture, Cupping, Physical Therapy and Ganghwalijetong-yeum(Qianghuochutong-yin) : Case Series. The Journal of the Society of Korean Medicine Diagnostics. 2015;19:125-32.
  18. Revill S, Robinson J, Rosen M, Hogg M. The reliability of a linear analogue for evaluating pain. Anaesthesia. 1976;31:1191-8. https://doi.org/10.1111/j.1365-2044.1976.tb11971.x
  19. Carlsson AM. Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain. 1983;16:87-101. https://doi.org/10.1016/0304-3959(83)90088-X
  20. Melzack R. The short-form McGill pain questionnaire. Pain. 1987;30:191-7. https://doi.org/10.1016/0304-3959(87)91074-8
  21. Burckhardt CS. The use of the McGill Pain Questionnaire in assessing arthritis pain. Pain. 1984;19:305-14. https://doi.org/10.1016/0304-3959(84)90007-1
  22. Roos, M Klassbo, LS Lohmander, EM. WOMAC Osteoarthritis Index: Reliability, validity, and responsiveness in patients with arthroscopically assessed osteoarthritis. Scand J Rheumatol. 1999;28:210-5. https://doi.org/10.1080/03009749950155562
  23. Food and Drug Administration. Guidance for industry: E9 statistical principles for clinical trials. Food and Drug Administration: Rockville, Maryland, USA; 1998.
  24. Ma C, Wu S, Li G, Xiao X, Mai M, Yan T. Comparison of miniscalpel-needle release, acupuncture needling, and stretching exercise to trigger point in myofascial pain syndrome. Clin J Pain. 2010;26:251-7. https://doi.org/10.1097/AJP.0b013e3181b8cdc8
  25. Kim HS, Heo WY, Hyun MK, Kim JS, Gang IA. Four case of partial tear of supraspinatus tendon treated by acupotomy combined oriental medical treatments. The Acupuncture. 2014;31:167-76. https://doi.org/10.13045/acupunct.2014017
  26. Kim HS, Kim SY, Kim HJ, Kim ES, Kim YI. The Effect of Acupotomy on Lumbar Herniated Intervertebral Disc: Report of a Case Series. The Acupuncture. 2015;32:185-95. https://doi.org/10.13045/acupunct.2015050
  27. Kim JI, Kim HS, Park GN, Jeon JH, Kim JH, Kim YI. Miniscalpel Needle Therapy with Integrative Korean Medical Treatment for Carpal Tunnel or Tarsal Tunnel Syndrome: Case Series of Three Patients. The Acupuncture. 2017;34:139-52. https://doi.org/10.13045/acupunct.2017100
  28. Jun S, Lee JH, Gong HM, Chung YJ, Kim JR, Park CA, et al. The Effects of Miniscalpel Acupuncture on Cervicogenic Headache: A report of three cases. The Acupuncture. 2017;34:131-8. https://doi.org/10.13045/acupunct.2017099
  29. Lin M, Li X, Liang W, Liu J, Guo J, Zheng J, et al. Needle-knife therapy improves the clinical symptoms of knee osteoarthritis by inhibiting the expression of inflammatory cytokines. Experimental and therapeutic medicine. 2014;7:835-42. https://doi.org/10.3892/etm.2014.1516
  30. Park MS, Oh SJ, Lee JH, Jun SA, Gong HM, Choi SH, et al. Miniscalpel Acupuncture Treatment on a Knee Degenerative Osteoarthritis Patient, Who does not Responded to Acupuncture Treatment. The Acupuncture. 2016;33:161-8. https://doi.org/10.13045/acupunct.2016043
  31. Dieppe PA, Lohmander LS. Pathogenesis and management of pain in osteoarthritis. The Lancet. 2005;365:965-73. https://doi.org/10.1016/S0140-6736(05)71086-2
  32. Yuan P, Liu D, Chu X, Hao Y, Chao Z, Qiang Q. Effects of Preventive Administration of Juanbi Capsules on TNF-$\alpha$ IL-1 And IL-6 Contents of Joint Fluid in the Rabbit with Knee Osteoarthritis. Journal of Traditional Chinese Medicine. 2010;30:254-8. https://doi.org/10.1016/S0254-6272(10)60052-0
  33. Fernandes JC, Martel‐Pelletier J, Pelletier J. The role of cytokines in osteoarthritis pathophysiology. Biorheology. 2002;39:237-46.
  34. Goldring MB, Berenbaum F. The regulation of chondrocyte function by proinflammatory mediators. Clin Orthop. 2004;427:S37-46. https://doi.org/10.1097/01.blo.0000144484.69656.e4
  35. Smith RL, Allison AC, Schurman DJ. Induction of Articular Cartilage Degradation by Recombinant Interleukin $l{\alpha}$ and $1{\beta}$. Connect Tissue Res. 1989;18:307-16. https://doi.org/10.3109/03008208909019079