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Leung K, Ma OC, Qin Z, Ting H, Lau AH, Lun KK, Chan HY, Wen GY, Ng JT, Chow L, Chu CY, Ho TS, Tsang K, Ng BFL, Fok MWM, Fang CXS, Lao L, Chen H. Acupuncture for de Quervain's tenosynovitis: A randomized controlled trial. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 104:154254. [PMID: 35728386 DOI: 10.1016/j.phymed.2022.154254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 05/24/2022] [Accepted: 06/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Acupuncture has been an alternative approach for de Quervain's tenosynovitis (DQt), but trial evidence is still lacking. PURPOSE This study aimed to assess the efficacy of acupuncture in patients with DQt. STUDY DESIGN A randomized controlled trial. METHODS A total of 68 subjects with DQt were recruited from outpatients of Department of Orthopaedics and Traumatology, and Chinese medicine clinics, The University of Hong Kong, and were randomized into the acupuncture group (n = 34) and the waitlist group (n = 34). Subjects in the acupuncture group received 5 acupuncture sessions over 2 weeks, followed by a 10-week follow-up. The waitlist control group received assessments only in the first 6 weeks of the waiting period and received the same acupuncture treatment and follow-up as the treatment group in the next 12 weeks. The primary outcome was the general pain intensity using the Visual Analogue Scale (VAS) at the end of treatment (week 2). Secondary outcomes were grip and pinch strengths of affected hands, the quick Disabilities of the Arm, Shoulder and Hand Score (Q-DASH), and the World Health Organization Quality of Life-brief Questionnaire (WHOQOL-BREF) at weeks 2 and 6. RESULTS From baseline to 2 weeks, the mean VAS score decreased by 19.5 points in the acupuncture group and by 3.4 points in the waitlist group. The difference for acupuncture vs waitlist control was -16.2 points (95% CI, -26.7 to -5.6, p = 0.003). Acupuncture effects sustained for 10 weeks (mean difference compared with baseline, -30.6; 95% CI, -39.6 to -21.7). Secondary outcomes showed that acupuncture reduced pain intensity, improved grip and pinch strength of affected hands, and Q-DASH scores, but not the scores of WHOQOL-BREF in patients. No serious adverse event occurred during the study period. CONCLUSIONS Our findings support that 2-week of acupuncture is safe and effective in the reduction of pain intensity, and improvement of strengths and disabilities of hand in DQt patients. Acupuncture also has long-term effects on DQt. TRIAL REGISTRATION This study was registered at clinicaltrials.gov (NCT03472443).
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Affiliation(s)
- Kinking Leung
- The Hong Kong Tuberculosis Association - The University of Hong Kong Chinese Medicine Clinic cum Training and Research Centre (Southern District), Hong Kong, China
| | - Oliver Chunho Ma
- The Hong Kong Tuberculosis Association - The University of Hong Kong Chinese Medicine Clinic cum Training and Research Centre (Southern District), Hong Kong, China
| | - Zongshi Qin
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
| | - Ho Ting
- The Hong Kong Tuberculosis Association - The University of Hong Kong Chinese Medicine Clinic cum Training and Research Centre (Southern District), Hong Kong, China
| | - Andrew Hokay Lau
- The Hong Kong Tuberculosis Association - The University of Hong Kong Chinese Medicine Clinic cum Training and Research Centre (Southern District), Hong Kong, China
| | - Kevin Kaifung Lun
- The Hong Kong Tuberculosis Association - The University of Hong Kong Chinese Medicine Clinic cum Training and Research Centre (Southern District), Hong Kong, China
| | - Hanna Yufaye Chan
- The Hong Kong Tuberculosis Association - The University of Hong Kong Chinese Medicine Clinic cum Training and Research Centre (Southern District), Hong Kong, China
| | - Grace Yagun Wen
- The Hong Kong Tuberculosis Association - The University of Hong Kong Chinese Medicine Clinic cum Training and Research Centre (Southern District), Hong Kong, China
| | - Jetson Tszkit Ng
- The Hong Kong Tuberculosis Association - The University of Hong Kong Chinese Medicine Clinic cum Training and Research Centre (Southern District), Hong Kong, China
| | - Lingfung Chow
- The Hong Kong Tuberculosis Association - The University of Hong Kong Chinese Medicine Clinic cum Training and Research Centre (Southern District), Hong Kong, China
| | - Cody Yuenting Chu
- The Hong Kong Tuberculosis Association - The University of Hong Kong Chinese Medicine Clinic cum Training and Research Centre (Southern District), Hong Kong, China
| | - Tracy Siuting Ho
- The Hong Kong Tuberculosis Association - The University of Hong Kong Chinese Medicine Clinic cum Training and Research Centre (Southern District), Hong Kong, China
| | - Katherine Tsang
- The Hong Kong Tuberculosis Association - The University of Hong Kong Chinese Medicine Clinic cum Training and Research Centre (Southern District), Hong Kong, China
| | | | - Margaret Woon Man Fok
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Christian Xin Shuo Fang
- Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Lixing Lao
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China; Virginia University of Integrative Medicine, Fairfax, USA
| | - Haiyong Chen
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China.
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Lam WC, Au KY, Qin Z, Wu FM, Chong CO, Jiang F, He Y, Ng BFL, Yeung WF, Lao L, Chen H. Superficial Needling Acupuncture vs Sham Acupuncture for Knee Osteoarthritis: A Randomized Controlled Trial. Am J Med 2021; 134:1286-1294.e2. [PMID: 34126097 DOI: 10.1016/j.amjmed.2021.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/17/2021] [Accepted: 05/06/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Acupuncture has been an alternative approach for pain management, but trial evidence is conflicting. METHODS Eighty-six patients with knee osteoarthritis were randomly assigned in a 1:1 ratio from June 14, 2017, to January 20, 2019, to receive either superficial needling acupuncture treatment or sham acupuncture for 10 sessions over a 4-week treatment period, followed by a 6-week follow-up period. The primary outcome was the change of pain intensity at week 4 measured using a 100-mm visual analogue scale. Secondary outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index and 36-Item Short Form Health Survey. RESULTS At the end of the 4-week treatment period, mean changes in the visual analogue scale were -30.8 (95% confidence interval [CI], -38.2 to -23.0; p <.001) in the acupuncture group and -26.7 (95% CI, -34.4 to -18.8; P <.001) in the sham group. The difference between the acupuncture group and the sham group was -4.1 (95% CI, -14.4 to 6.2; P = 0.431). At week 10, the difference between the groups was -2.2 (95% CI, -13.1 to 8.8; P =0.699). There was no statistically significant difference in Western Ontario and McMaster Universities Osteoarthritis Index subscores (pain, stiffness, and physical function) and 36-Item Short Form Health Survey-related outcomes across groups from weeks 2 to 10. The incidence of treatment-related adverse events was 4.4% in the acupuncture group and 0.8% in the sham acupuncture group. All adverse events were classified as mild. CONCLUSION Acupuncture for 4 weeks is not superior to non-penetrating sham acupuncture. The current study cannot confirm that superficial acupuncture has efficacy for the treatment of knee osteoarthritis.
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Affiliation(s)
- Wing Chung Lam
- The Hong Kong Tuberculosis Association Chinese Medicine Clinic cum Training Centre of the University of Hong Kong (Wan Chai District), China
| | - Kwok Yin Au
- Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, China
| | - Zongshi Qin
- School of Chinese Medicine, The University of Hong Kong, China
| | - Fung Man Wu
- The Hong Kong Tuberculosis Association Chinese Medicine Clinic cum Training Centre of the University of Hong Kong (Wan Chai District), China
| | - Chiu On Chong
- The Hong Kong Tuberculosis Association Chinese Medicine Clinic cum Training Centre of the University of Hong Kong (Wan Chai District), China
| | - Fei Jiang
- Department of Statistics & Actuarial Science, The University of Hong Kong, China
| | - Yue He
- Department of Statistics & Actuarial Science, The University of Hong Kong, China
| | | | - Wing-Fai Yeung
- The School of Nursing, The Hong Kong Polytechnic University, China
| | - Lixing Lao
- School of Chinese Medicine, The University of Hong Kong, China; Virginia University of Integrative Medicine, Fairfax, Virginia
| | - Haiyong Chen
- School of Chinese Medicine, The University of Hong Kong, China.
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Huang S, Hu M, Ng EHY, Stener-Victorin E, Zheng Y, Wen Q, Wang C, Lai M, Li J, Gao X, Wang X, Hu Z, Xia T, Hu R, Liu J, Wen X, Li S, Quan K, Liang X, Shang H, Ma H, Qiao J. A multicenter randomized trial of personalized acupuncture, fixed acupuncture, letrozole, and placebo letrozole on live birth in infertile women with polycystic ovary syndrome. Trials 2020; 21:239. [PMID: 32131886 PMCID: PMC7057514 DOI: 10.1186/s13063-020-4154-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 02/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background Traditional Chinese medicine (TCM) usually involves syndrome differentiation and treatment. Acupuncture, one form of TCM, requires the selection of appropriate acupoints and needling techniques, but many clinical trials on acupuncture have used fixed acupuncture protocols without accounting for individual patient differences. We have designed a multicenter randomized controlled trial (RCT) to evaluate whether personalized or fixed acupuncture increases the likelihood of live births in infertile women with polycystic ovary syndrome (PCOS) compared with letrozole or placebo letrozole. We hypothesize that letrozole is more effective than personalized acupuncture, which in turn is more effective than fixed acupuncture, and that placebo letrozole is the least effective intervention. Moreover, we hypothesize that personalized acupuncture is more likely to reduce the miscarriage rate and the risk of pregnancy complications compared with letrozole. Methods/design The study is designed as an assessor-blinded RCT. A total of 1100 infertile women with PCOS will be recruited from 28 hospitals and randomly allocated to 4 groups: personalized acupuncture, fixed acupuncture, letrozole, or placebo letrozole. They will receive treatment for 16 weeks, and the primary outcome is live birth. Secondary outcomes include ovulation rate, conception rate, pregnancy rate, pregnancy loss rate, changes in hormonal and metabolic parameters, and changes in quality of life scores. Adverse events will be recorded throughout the trial. All statistical analyses will be performed using IBM SPSS Statistics version 21.0 software (IBM Corp., Armonk, NY, USA), and a P value < 0.05 will be considered statistically significant. Discussion This study will be the first multicenter RCT to compare the effect of personalized or fixed acupuncture with letrozole or placebo letrozole on live birth in infertile women with PCOS. The findings will inform whether personalized acupuncture therapy can be considered an alternative treatment to improve the live birth rate in infertile women with PCOS. Trial registration ClinicalTrials.gov, NCT03625531. Registered on July 13, 2018. Chinese Clinical Trial Registry, ChiCTR1800017304. Registered on July 23, 2018.
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Affiliation(s)
- Shiya Huang
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Min Hu
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ernest Hung Yu Ng
- Department of Obstetrics and Gynecology, University of Hong Kong, Hong Kong, Special Administrative Region, China
| | - Elisabet Stener-Victorin
- Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Yanhua Zheng
- Department of Traditional Chinese Medicine, Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Qidan Wen
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Cong Wang
- Department of Traditional Therapy, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, China
| | - Maohua Lai
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Juan Li
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xingcheng Gao
- Department of Urology, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xinhua Wang
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhenxing Hu
- Department of Gynecology, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, Jiangsu, China
| | - Tian Xia
- Center for Reproductive Medicine, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Rongkui Hu
- Department of Reproductive Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jianping Liu
- Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China.,Centre for Evidence Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaohui Wen
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shuna Li
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Kewei Quan
- Department of Obstetrics and Gynecology, Dongguan Hospital of Traditional Chinese Medicine, Dongguan, Guangdong, China
| | - Xingyan Liang
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hongcai Shang
- Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China.,Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Hongxia Ma
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China. .,Institute of Integration of Traditional Chinese Medicine and Western Medicine, Guangzhou Medical University, Guangzhou, Guangdong, China.
| | - Jie Qiao
- Department of Obstetrics and Gynecology, Third Hospital, Peking University, Beijing, China.
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