Shuci method of electroacupuncture improves self-perception and quality of life in patients with knee osteoarthritis: a multicenter randomized controlled trial.

BACKGROUND

Knee osteoarthritis (KOA) is a common chronic disease characterized by degenerative damage and disability of the knee joint. Current treatment options for KOA have considerable limitations. The Shuci theory for treating KOA within the traditional Chinese acupuncture medical system has evolved into a specific modern therapy: the Shuci method of electroacupuncture. Although it has been widely applied at the level of clinical experience, high-level evidence remains lacking.

METHODS

In this multicenter, patient- and assessor-blinded, superiority randomized controlled trial, 110 patients with KOA were randomly assigned in a 1:1 ratio to an electroacupuncture (EA) group or a sham EA (SEA) group, receiving treatment three times per week for two consecutive weeks. Acupuncture was performed following the Shuci theory. Patients were assessed at baseline and after completing treatment. The primary outcome was response as defined by the Clinical Global Impressions scale - Improvement. Secondary outcomes included the Visual Analogue Scale (VAS), pressure pain threshold (PPT), and Knee Injury and Osteoarthritis Outcome Score (KOOS). In accordance with the Intention-to-Treat principle, all randomized patients formed the primary analysis set. The primary outcome was analyzed using a Z-test for proportions. Secondary outcomes were analyzed using a mixed-effects model.

RESULTS

After treatment, the response rate was 76.4% (42 of 55) in the EA group and 27.3% (15 of 55) in the SEA group, with a between-group difference of 49.1% (95% CI: 32.8, 65.4%; p < 0.001). The mixed-effects model analysis revealed that the EA group showed significantly greater improvements than the SEA group in VAS [Difference (95% CI): -2.1 (-2.6, -1.6); p < 0.001], PPT [20.1 (14.9, 25.3); p < 0.001], KOOS-pain [23.3 (18.3, 28.3); p < 0.001], KOOS-Symptoms [16.8 (10.8, 22.8); p < 0.001], KOOS-Activities of daily living [7.2 (0.1, 14.3); p = 0.046], and KOOS-Knee-related quality of life [7.6 (3.0, 12.2); p = 0.001].

CONCLUSION

We preliminarily confirmed the temporary efficacy of the Shuci method of electroacupuncture for KOA.

CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn, ChiCTR2300078135.