| Abstract | OBJECTIVES: 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. |
| Authors | Jorge 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
(Affiliation: Pain Treatment Unit, Centro de Salud Dos Hermanas A (Distrito Sanitario Sevilla-Sur), 41700 Dos Hermanas, Spain. jvas at acmas.com)
|
| Journal | BMJ (Clinical research ed.)
(BMJ)
Vol. 329
Issue 7476
Pg. 1216
(Nov 20 2004)
ISSN: 1468-5833 England |
| PMID | 15494348
(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
|
