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Acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee: randomised controlled trial.

AbstractOBJECTIVES:
To analyse the efficacy of acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee, with respect to pain relief, reduction of stiffness, and increased physical function during treatment; modifications in the consumption of diclofenac during treatment; and changes in the patient's quality of life.
DESIGN:
Randomised, controlled, single blind trial, with blinded evaluation and statistical analysis of results.
SETTING:
Pain management unit in a public primary care centre in southern Spain, over a period of two years.
PARTICIPANTS:
97 outpatients presenting with osteoarthritis of the knee.
INTERVENTIONS:
Patients were randomly separated into two groups, one receiving acupuncture plus diclofenac (n = 48) and the other placebo acupuncture plus diclofenac (n = 49).
MAIN OUTCOME MEASURES:
The clinical variables examined included intensity of pain as measured by a visual analogue scale; pain, stiffness, and physical function subscales of the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index; dosage of diclofenac taken during treatment; and the profile of quality of life in the chronically ill (PQLC) instrument, evaluated before and after the treatment programme.
RESULTS:
88 patients completed the trial. In the intention to treat analysis, the WOMAC index presented a greater reduction in the intervention group than in the control group (mean difference 23.9, 95% confidence interval 15.0 to 32.8) The reduction was greater in the subscale of functional activity. The same result was observed in the pain visual analogue scale, with a reduction of 26.6 (18.5 to 34.8). The PQLC results indicate that acupuncture treatment produces significant changes in physical capability (P = 0.021) and psychological functioning (P = 0.046). Three patients reported bruising after the acupuncture sessions.
CONCLUSIONS:
Acupuncture plus diclofenac is more effective than placebo acupuncture plus diclofenac for the symptomatic treatment of osteoarthritis of the knee.
AuthorsJorge Vas, Camila Méndez, Emilio Perea-Milla, Evelia Vega, María Dolores Panadero, José María León, Miguel Angel Borge, Olga Gaspar, Francisco Sánchez-Rodríguez, Inmaculada Aguilar, Rosario Jurado
JournalBMJ (Clinical research ed.) (BMJ) Vol. 329 Issue 7476 Pg. 1216 (Nov 20 2004) ISSN: 1756-1833 [Electronic] England
PMID15494348 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Diclofenac
Topics
  • Acupuncture Therapy
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
  • Combined Modality Therapy
  • Diclofenac (therapeutic use)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis, Knee (drug therapy, therapy)
  • Pain (prevention & control)
  • Pain Measurement
  • Quality of Life
  • Single-Blind Method
  • Treatment Outcome

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