Correlation between acupuncture dose and effectiveness in the treatment of knee osteoarthritis: a systematic review
https://doi.org/10.1136/acupmed-2017-011608
Article Information
Volume: 37 issue: 5, page(s): 261-267
Article first published online: July 4, 2019; Issue published: October 1, 2019
Ning Sun1, Jian Feng Tu1, Lu Lu Lin1, Yong Ting Li1, Jing Weng Yang1, Guang Xia Shi2, Li Xing Lao3, Cun Zhi Liu1
1Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
2Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University, Beijing, China
3School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
Corresponding Author:
Li Xing Lao, School of Chinese Medicine, The University of Hong Kong, China. Email: lxlao1@hku.hkCun Zhi Liu, Department of Acupuncture and Moxibustion, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China. Email: lcz623780@126.com
Abstract
Background:
Acupuncture is a widely used treatment for knee osteoarthritis, but evidence of its effectiveness from randomised controlled trials (RCTs) is contradictory.
Objective:
To systematically review RCTs to determine whether the effect of acupuncture is dose dependent for symptom management in knee osteoarthritis.
Methods:
Seven English/Chinese databases were searched through January 2017. Study quality was assessed using the Cochrane Collaboration tool. Slavin’s qualitative best-evidence synthesis approach was used to provide methodological rigour. Included RCTs were separated into three categories according to the dose of acupuncture treatment: high dosage (HD), medium dosage (MD) and low dosage (LD). Correlation between dose and effect of treatment was analysed.
Results:
Eight RCTs with a total of 2106 subjects met the eligibility criteria. Numbers of studies using the various doses of acupuncture were 1 for LD, 1 for MD and 6 for HD, respectively. Compared with LD and MD acupuncture treatments, strong evidence showed that there was a positive correlation between HD acupuncture treatment and positive outcomes.
Conclusion:
The effect of acupuncture may be associated with dose of acupuncture, with a higher dosage related to better treatment outcomes in terms of relief of pain and dysfunction in patients with knee osteoarthritis.