Heat and acupuncture restore mobility in knee osteoarthritis (HARMOKnee): A pragmatic integrated care, randomized controlled study.

IF 3.5 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine Pub Date : 2025-10-01 Epub Date: 2025-08-05 DOI:10.1016/j.ctim.2025.103223

Hui Ping Ng, Chun Yue Tan, Chien Joo Lim, Tong Leng Tan, Su-Yin Yang, Gillian Szu Chew Long, Siang Ing Tan, Yu Chun Chua, Yew Wai Yan, Derrick Bing Quan Soh, Tong Hwee Goh, Pu Jue Ng, Yee Teck Ng, Swee Boey Kuan, Bo Siang Teo, Keng He Kong, Gloria Ho, Hui Qi Koh, Michelle Jessica Pereira, Bryan Yijia Tan

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引用次数: 0

Abstract

Background: Acupuncture has increasingly gained popularity as alternative approach to conventional care for knee osteoarthritis (KOA) management. We conducted a pragmatic randomized controlled study to evaluate the clinical and health utility outcomes of acupuncture and heat therapy in conjunction with standard care for KOA.

Methods: Community-ambulating KOA patients of 45 years or older were randomly assigned to the intervention or control (SC) group. The HARMOKnee group received 12 acupuncture and heat treatments in addition to standard care for six weeks. We evaluated the Knee Injury and Osteoarthritis and Outcome Score-12 (KOOS-12) at baseline, 6-, 12- and 24-week. Secondary outcomes including Pain, Enjoyment of Life and General Activity (PEG) scores, Patient Health Questionnaire-4 (PHQ-4), and TCM syndrome differentiation were evaluated. Comparative analysis was performed using mixed-effect models.

Results: Among 101 participants (HARMOKnee=50; SC=51), the mean age was 63.99 ± 7.03 years, and KOA duration was 5.07 ± 6.35 years. There was a significant intervention-time interaction, favouring HARMOKnee group, for the KOOS-12 total score [Coef= 6.43, 95 %CI: 0.72, 12.14; p = 0.027], KOOS-12 quality of life (QOL) domain-score [Coef= 8.50, 95 %CI: 1.28, 15.73; p = 0.021], and PEG overall score [Coef= -1.32, 95 %CI: -2.14, -0.49; p = 0.002] at 6-week. No between-group differences were identified at other time-points. The HARMOKnee group demonstrated considerable pain reduction and improved knee flexion and extension after 12 treatments (0.001 < p < 0.014). This treatment approach markedly enhanced knee flexion in patients with Kidney yang deficiency with phlegm and blood stasis syndrome.

Conclusions: HARMOKnee provides short-term pain-management benefits to KOA patients compared to standard care alone, particularly in patients with Kidney yang deficiency with phlegm and blood stasis syndrome.

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热和针灸恢复膝关节骨关节炎的活动能力（HARMOKnee）：一项实用的综合护理，随机对照研究。

背景：针灸作为治疗膝骨关节炎（KOA）的替代方法越来越受欢迎。我们进行了一项实用的随机对照研究，以评估针灸和热疗法结合标准护理对KOA的临床和健康效用结果。方法：将45岁及以上的社区活动KOA患者随机分为干预组或对照组。在标准治疗的基础上，HARMOKnee组接受了12项针灸和热治疗，为期6周。我们在基线、6周、12周和24周评估膝关节损伤和骨关节炎以及预后评分-12 （KOOS-12）。次要结局包括疼痛、生活享受和一般活动（PEG）评分、患者健康问卷-4 （PHQ-4）和中医辨证。采用混合效应模型进行对比分析。结果：101名参与者(HARMOKnee=50；SC=51)，平均年龄63.99±7.03岁，KOA持续时间5.07±6.35年。KOOS-12总分与干预时间存在显著的相互作用，有利于HARMOKnee组[Coef=6.43, 95%CI:0.72, 12.14；p=0.027]， KOOS-12生活质量（QOL）域评分[Coef=8.50, 95%CI:1.28, 15.73；p=0.021]， PEG总分[Coef=-1.32, 95%CI:-2.14, -0.49；P =0.002]。在其他时间点未发现组间差异。经过12次治疗，HARMOKnee组表现出明显的疼痛减轻和膝关节屈伸改善（0.001）。结论：与单独标准治疗相比，HARMOKnee对KOA患者的短期疼痛管理有好处，特别是对肾阳虚痰瘀证患者。试验注册：ClinicalTrials.gov NCT05507619；https://clinicaltrials.gov/study/NCT05507619国际注册报告标识符（IRRID）： DERR1-10.2196/54352。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Complementary therapies in medicine 医学-全科医学与补充医学

CiteScore

8.60

自引率

2.80%

发文量

101

审稿时长

112 days

期刊介绍： Complementary Therapies in Medicine is an international, peer-reviewed journal that has considerable appeal to anyone who seeks objective and critical information on complementary therapies or who wishes to deepen their understanding of these approaches. It will be of particular interest to healthcare practitioners including family practitioners, complementary therapists, nurses, and physiotherapists; to academics including social scientists and CAM researchers; to healthcare managers; and to patients. Complementary Therapies in Medicine aims to publish valid, relevant and rigorous research and serious discussion articles with the main purpose of improving healthcare.