Acupuncture in Knee Osteoarthritis: A Narrative Review of Clinical Efficacy and Neuroimmune-Endocrine Mechanisms.

IF 2.5 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Pain Research Pub Date : 2025-09-25 eCollection Date: 2025-01-01 DOI:10.2147/JPR.S546687

Junru Jiao, Baoqiang Dong, Yiyan Han, Qu Zheng, Xingxing Lin

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Abstract

Purpose: Knee osteoarthritis (KOA) is a leading cause of global pain and disability and warrants complementary therapy. This review provides evidence of the clinical efficacy of acupuncture and the multisystem regulatory mechanisms of KOA.

Methods: We analyzed clinical trials and mechanistic studies of acupuncture in the treatment of KOA.

Results: Acupuncture-particularly electroacupuncture (EA) significantly reduced pain (VAS/WOMAC) compared with sham acupuncture and conventional care (P < 0.05). Clinical trials demonstrate that combining acupuncture with exercise significantly enhances functional outcomes. Mechanistically, acupuncture modulates neuroendocrine pathways through three key actions: (1) suppressing pro-inflammatory cytokines (eg, TNF-α, IL-1β); (2) activating the Melatonin/cAMP/PKA/CREB signaling cascade; (3) altering functional connectivity in central pain-processing regions. Controversies persist regarding the mechanisms, optimal techniques, and outcome standardization.

Conclusion: Acupuncture is an effective complementary therapy for KOA. Future research should prioritize long-term efficacy, personalized protocols, technology integration, and multidisciplinary strategies.

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针灸治疗膝骨关节炎：临床疗效及神经免疫内分泌机制综述。

目的：膝骨关节炎（KOA）是全球疼痛和残疾的主要原因，需要补充治疗。本文综述了针灸的临床疗效和KOA的多系统调控机制。方法：对针刺治疗KOA的临床试验和机制研究进行分析。结果：针刺特别是电针（EA）与假针和常规护理相比，显著减轻疼痛（VAS/WOMAC）（P < 0.05）。临床试验表明，针灸与运动相结合可显著提高功能预后。在机制上，针灸通过三个关键作用调节神经内分泌通路：(1)抑制促炎细胞因子（如TNF-α、IL-1β）；(2)激活褪黑素/cAMP/PKA/CREB信号级联；(3)改变中枢性疼痛处理区的功能连通性。关于机制、最佳技术和结果标准化的争议仍然存在。结论：针刺是治疗KOA的有效补充疗法。未来的研究应优先考虑长期疗效、个性化方案、技术整合和多学科策略。

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

Journal of Pain Research CLINICAL NEUROLOGY-

CiteScore

4.50

自引率

3.70%

发文量

411

审稿时长

16 weeks

期刊介绍： Journal of Pain Research is an international, peer-reviewed, open access journal that welcomes laboratory and clinical findings in the fields of pain research and the prevention and management of pain. Original research, reviews, symposium reports, hypothesis formation and commentaries are all considered for publication. Additionally, the journal now welcomes the submission of pain-policy-related editorials and commentaries, particularly in regard to ethical, regulatory, forensic, and other legal issues in pain medicine, and to the education of pain practitioners and researchers.