Clinical Efficacy of Acupuncture on Rheumatoid Arthritis and Associated Mechanisms: A Systemic Review.

Pei-Chi Chou,Heng-Yi Chu

doi:10.1155/2018/8596918

Abstract

Objective The objective of this review is to investigate the detailed existing scientific information about the clinical efficacy of acupuncture on rheumatoid arthritis (RA) conditions and to reveal the proposed mechanisms. Methods We searched the PubMed, EMBASE, Cochrane, AMED (Allied and Complementary Medicine), NCCAM (The National Center for Complementary and Alternative Medicine), and CNKI (China National Knowledge Infrastructure) databases to identify relevant monographs and related references from 1974 to 2018. Chinese journals and theses/dissertations were hand searched. Results 43 studies were recruited. Each research was analyzed for study design, subject characteristics, intervention, selected acupoints, assessment parameters, proposed mechanisms, and results/conclusions. Conclusions In our review, we concluded that acupuncture alone or combined with other treatment modalities is beneficial to the clinical conditions of RA without adverse effects reported and can improve function and quality of life and is worth trying. Several important possible mechanisms were summarized including anti-inflammatory effect, antioxidative effect, and regulation of immune system function. However, there is still inconsistency regarding the clinical efficacy and lack of well-designed human/animal double-blinded RCTs. Future discussion for further agreement on taking traditional Chinese medicine (TCM) theory into consideration as much as possible is a top priority.

Highlights

Rheumatoid arthritis (RA) is the most common inflammatory arthritis and has been known as a chronic and autoimmune disease involving inflammatory condition characterized with symmetrical and persistent synovitis and destructive polyarthritis [1]
The mainstream of the management regarding RA is the use of nonsteroid anti-inflammatory drugs, disease-modifying antirheumatic drugs, analgesics, and biological agents [3]
The study designs, subjects’ characteristics and sample size, acupuncture and other intervention types, applied acupuncture points and their meridians, parameters used for comparison, proposed mechanisms, and the results/suggestions/conclusions of the researches were summarized in Table 1 classified in an order of the year when the study was done

Summary

Introduction

Rheumatoid arthritis (RA) is the most common inflammatory arthritis and has been known as a chronic and autoimmune disease involving inflammatory condition characterized with symmetrical and persistent synovitis and destructive polyarthritis [1]. As many factors like susceptibility genes, disease-causing immune cells, cytokine, and signal transduction networks are involved in the pathogenesis of RA [5], the treatment of RA has always been a challenge. The mainstream of the management regarding RA is the use of nonsteroid anti-inflammatory drugs, disease-modifying antirheumatic drugs, analgesics, and biological agents [3]. Given the fact of the expanding awareness of unwanted side effects of pharmaceutical treatment, there has been an increased utilization of acupuncture as a contemporary healthcare option which has been reported as a kind of safe management [7, 8]

Methods

Results

Discussion

Conclusion