Effectiveness of Acupuncture on Pain, Physical Function and Health-Related Quality of Life in Patients with Rheumatoid Arthritis: A Systematic Review of Quantitative Evidence
- 26 Downloads
To identify and synthesize the most recent available evidence of effectiveness of acupuncture on pain, physical function and health-related quality of life (HRQoL) in patients with rheumatoid arthritis (RA).
A comprehensive search of 12 Western and Chinese databases was undertaken from their inception up to end of 2016. Randomized controlled trials (RCTs), concerning patients with RA treated with needle acupuncture, written in English, Portuguese, German or Chinese were included. Primary outcomes included pain, physical function and HRQoL. Secondary outcomes included morning stiffness, functional impairment, number of tender and swollen joints and serum concentrations of inflamatory markers. Methodological quality was assessed by three independent reviewers using the standardized critical appraisal instrument from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument.
Twenty-two studies met the inclusion criteria. Of those, 9 studies were excluded after assessment of their methodological quality. The remaining 13 original RCTs included 974 patients. Ten of these studies published in China, showed favorable statistical significant effects of acupuncture in relieving symptoms of RA compared with controls.
Evidence suggests that acupuncture interventions may have a positive effect in pain relief, physical function and HRQoL in RA patients. However, due to the heterogeneity and methodologic limitations of the studies included in this systematic review, evidence is not strong enough to produce a best practice guideline.
Keywordsacupuncture rheumatoid arthritis quality of life pain physical function randomized clinical trial
Unable to display preview. Download preview PDF.
- 2.Young KE, Soussi I, Hemels M, Toumi M. A comparative study of orphan drug prices in Europe. J Market Access Health Policy 2017;5.Google Scholar
- 4.Lee JA, Son MJ, Choi J, Yun KJ, Jun JH, Lee MS. Bee venom acupuncture for rheumatoid arthritis: a systematic review protocol. BMJ Open 2014;23:4:e004602.Google Scholar
- 12.Gao J, Liu XG, Huang DJ, Tang Y, Zhou HY, Yin HY, et al. Involvement of the hypothalamuspituitary–adrenal axis in moxibustioninduced changes of NF–kappaB signaling in the synovial tissue in rheumatic arthritic rats. Acupuct Res 2010;35:198–203.Google Scholar
- 15.Karner M, Brazkiewicz F, Remppis A, Fischer J, Gerlach O, Stremmel W, et al. Objectifying specific acupuncture: a double–blinded randomised trial in osteoarthritis of the knee. Evid Based Complement Alternat Med 2013; Hindawi 2013:427265.Google Scholar
- 16.Seca S, Capelo P, Efferth, T, Doenitz C, Schroeder S, Anjos A, et al. Diagnosis and objective pain assessment of traditional Chinese medicine may be useful to demonstrate specific effects of acupuncture in low back pain: a prospective, randomized, controlled and single blinded pre–study. J Acupunct Tuina Sci 2013;11:155–159.CrossRefGoogle Scholar
- 18.Seca S, Kirch S, Cabrita AS, Greten HJ. Evaluation of the effect of acupuncture on hand pain, functional deficits and health–related quality of life in patients with rheumatoid arthritis—A study protocol for a multicenter, double–blind, randomized clinical trial. J Integr Med 2016:14:219–227.Google Scholar
- 22.Seca S, Miranda D, Cardoso D, Greten H, Cabrita A, Rodrigues MA. The effectiveness of acupuncture on pain, physical function and health–related quality of life in patients with rheumatoid arthritis: a systematic review protocol. JBI Database System Rev Implement Rep 2016;14:18–26.CrossRefGoogle Scholar
- 23.Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Chapter 3: Systematic reviews of effectiveness. In: Aromataris E, Munn Z, eds. Joanna Briggs Institute Reviewer’s Manual. The Joanna Briggs Institute, 2017. Available from https://reviewersmanual.joannabriggs.org/Google Scholar
- 24.Bernateck M, Becker M, Schwake C, Hoy L, Passie T, Parlesak A, et al. Adjuvant auricular electroacupuncture and autogenic training in rheumatoid arthritis: a randomized controlled trial. Auricular acupuncture and autogenic training in rheumatoid arthritis. Forsch Komplementmed 2008;15:187–193.Google Scholar
- 26.Wan J, Xiong Z, Sun J. Clinical efficacy observation on hand finger joint pain by acupuncture Eight Xie points combined with Western medicines. In: Proceedings on the 10th national integrated Chinese and Western medicine on rheumatoid arthritis. Wuhan: 2012.Google Scholar
- 27.Zhu Y. Clinical efficacy observation and quality of life evaluation on rheumatoid arthritis. patients treated with acupuncture. Chin J Tradit Chin Med 2014;26:249–250.Google Scholar
- 28.Ouyang B, Gao J, Che J, Zhang Y, Li J, Hu T, et al. Influence of electroacupuncture on arthritic pain and quality of life in active rheumatoid arthritis patients. J Tradit Chin Med (Chin) 2010;51:1097–1100.Google Scholar
- 29.Zhou J, Zhu Q. Effects of acupuncture on the rheumatoid arthritis. Chin J Rheumatol (Chin) 2000;4:169–171.Google Scholar
- 30.Wang S, Mao X, Zhou X, Zhao J, Hong Q. Observations on the efficacies of acupuncture plus moxibustion versus acupuncture plus TDP lamp in treating rheumatoid arthritis. Shanghai J Acupunct Moxibust (Chin) 2014;33.1144–1146.Google Scholar
- 31.Xie Z, Luo J, Chen B. Clinical efficacy of modified mild moxibustion therapy in the treatment of 70 cases of rheumatoid arthritis. Hainan Med J (Chin) 2015;26:1272–1276.Google Scholar
- 33.Sun YT, Wei M, Jiang XL, Liu ZX, Yang JC. Clinical study of rheumatoid arthritis with midnight–noon ebb–flow acupoint selection. China J Tradit Chin Med Pharm (Chin) 2009;24:227–229.Google Scholar