Insights & Discussion
Strong electroacupuncture for at least two weeks improves chronic pain management in knee osteoarthritis patients better than weak or sham electroacupuncture.
In this investigation, a multicenter, three-arm parallel, single-blind randomized controlled trial was conducted in which 301 patients suffering from knee osteoarthritis were randomly divided into three groups based on the electroacupuncture current intensity: strong, weak, and sham. Treatments were carried out in five sessions per week over a two-week period. The impact of these treatments was primarily measured by assessing the Visual Analog Scale, conditioned pain modulation function, and the Western Ontario and McMaster Universities Osteoarthritis Index.
After a week of electroacupuncture, a clinically significant improvement was observed in Visual Analog Scale scores and Western Ontario and McMaster Universities Osteoarthritis Index scores, but not in conditioned pain modulation function. However, after two weeks of treatment, improvements were seen in all three primary outcomes when compared to baseline. In terms of enhancing conditioned pain modulation function specifically, both weak and strong electroacupuncture outperformed the sham option, with strong electroacupuncture showing superiority to weak, and resulted in better pain management.
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Moxibustion, a form of traditional Chinese medicine, appears to be an effective and safe treatment for knee osteoarthritis.
2022 Frontiers in Physiology An Overview of Systematic Reviews of Moxibustion for Knee Osteoarthritis Yin S, Zhu F, Li Z, Che D, Li L, Feng J, et al.
Systematic Review Knee Osteoarthritis Moxibustion
The researchers used a series of databases including Embase, PubMed, Web of Science, Cochrane Library, and others to carry out a comprehensive evaluation of previous systematic reviews on the treatment of knee osteoarthritis with moxibustion. They employed the Measurement Tool to Assess Systematic Reviews 2 to assess the methodological quality, Preferred Reporting Item for Systematic Reviews and Meta-analyses for reporting quality, and ROBIS Tool to evaluate the risk of bias in the systematic reviews. They also assessed the strength of evidence with the Grading of Recommendations Assessment, Development and Evaluation tool and carried out a meta-analysis of the total effectiveness rate.
From this process, 10 systematic reviews were selected that had met their criteria. These reviews included the results of 57 randomized controlled trials involving a total of 5,149 participants. However, these reviews were found to have several critical deficiencies, scoring low on the quality scale used. Despite this, moxibustion, and its combination treatment, were shown to improve the total effectiveness rate in knee osteoarthritis. Eight of the reviews had reported adverse events but none were classified as serious in either the moxibustion group or control group.
The Gui Zhi-Shao Yao herb pair in traditional Chinese medicine potentially treats chronic pain, anxiety, and depression through interactions with nine key targets.
2022 Annals of Medicine A network pharmacology approach to predict potential targets and mechanisms of “Ramulus Cinnamomi (cassiae) – Paeonia lactiflora” herb pair in the treatment of chronic pain with comorbid anxiety and depression Pan HT, Xi ZQ, Wei XQ, Wang K
Network Pharmacology Anxiety Depression Shao Yao
The methodology in this research utilised network pharmacology to explore the active components of the "Gui Zhi-Shao Yao" herb pair and their possible targets. Initially, 15 active compounds were identified through a series of analysis which revealed about 130 potential targets. By considering the intersections between the targets of the "Gui Zhi-Shao Yao" herb pair and chronic pain, anxiety disorder, and mental depression, nine vital targets were identified and listed in order of importance.
The results discussion revealed that the "Gui Zhi-Shao Yao" herb pairing acted on the nine identified key targets to alleviate chronic pain, anxiety, and depression. Gene ontology and pathway analysis demonstrated that there were 11 primary pathways, including AGE-RAGE signalling pathway, IL-17 signalling pathway, and TNF signalling pathway. These pathways appear to be actively involved in the pathological processes, providing a holistic understanding of how the "Gui Zhi-Shao Yao" herb pair functions therapeutically.
Acupuncture appears to have an effect on diabetic peripheral neuropathy, effectively improving nerve conduction and clinical symptoms.
2021 Journal of Clinical Pharmacy and Therapeutics Acupuncture treatment of diabetic peripheral neuropathy: An overview of systematic reviews Yu B, Li M, Huang H, Ma S, Huang K, Zhong Z, et al.
Systematic Review Diabetic Neuropathy Type 2 Diabetes
Acupuncture appears to have an effect on DPN, effectively improving nerve conduction and clinical symptoms. Although the methodological quality of the included studies was generally very low and defects were frequent, our study highlights areas where improvement in methodology is required. There is a need for further study of the pathogenesis of DPN, and for developing a unified standard for methods of acupuncture treatment, acupoint selection, and adverse reactions reporting. Traditional Chinese medical practices such as acupuncture should adopt an evidence-based approach to provide greater confidence in their use.
Turmeric curcuminoids are associated with better pain relief than NSAIDs in knee osteoarthritis.
2021 Complementary Therapies in Medicine The efficacy of high- and low-dose curcumin in knee osteoarthritis: A systematic review and meta-analysis An-Fang Hsiao, Yi-Chieh Lien, I-Shiang Tzeng, Chien-Ting Liu, Sheng-Hsun Chou, Yi-Shiung Horng
Systematic Review Arthritis Knee Osteoarthritis Turmeric
The meta-analysis results showed that curcuminoids were significantly more effective than comparators regarding visual analogue scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain scores.
However, no significant difference in pain relief or AEs between the high-dose (daily dose ≥1000 mg or total dose ≥42 gm) and low-dose (daily dose <1000 mg or total dose <42 gm) curcuminoid treatments was observed.
When comparing curcumininoids versus NSAIDs, a significant difference in VAS pain was found. For AE analysis, three of our included studies used NSAIDs as comparators, with all reporting higher AE rates in the NSAID group, though significance was reached in only one study.
Pomegranate peel extract supplementation can decrease total cholesterol and triglyceride levels while boosting antioxidant status in obese women with knee osteoarthritis.
2021 Advances in Integrative Medicine Effects of pomegranate (Punica granatum L.) peel extract supplementation on serum lipid profile and oxidative stress in obese women with knee osteoarthritis: A double blind, randomized, placebo controlled study Haghighian MK, Rafraf M, Hemmati S, Haghravan S, Asghari-Jafarabadi M
Randomised Controlled Trial Knee Osteoarthritis Pomegranate Peel
The research was a randomized, double-blind placebo-controlled trial involving 66 obese women aged 38 to 60 years old with knee osteoarthritis. These participants were split into two groups, the intervention group and control group, each containing 33 members. The intervention group received pomegranate peel extract capsules (500 mg) twice daily for 8 weeks including standard drug therapy while the control group was given a placebo during the same period. All participants' fasting blood samples, anthropometric measurements, dietary intake data, and physical activity levels were collected both before the start and at the end of the trial.
Results analysis showed that pomegranate peel extract supplementation brought down levels of serum total cholesterol, triglyceride and an oxidative stress marker while enhancing levels of some antioxidant enzymes and the overall antioxidant capacity when compared to the control group. However, there were no noticeable alterations between the two groups in terms of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and body mass index by the end of the experiment.
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