Efficacy of five-step shoulder manipulation for rotator cuff-related shoulder pain: protocol for a multicenter randomized controlled trial.

BACKGROUND: Rotator cuff-related shoulder pain (RCRSP) is the most common cause of shoulder disorders. In China, manipulation has been used extensively for the treatment of patients with RCRSP. However, high-quality clinical evidence to support the therapeutic effect of manipulation is still limited. METHODS: A multicenter, participant-, outcome assessor-, and data analyst-blinded, randomized, placebo-controlled trial will be conducted. A total of 280 participants with RCRSP will be recruited from three hospitals and randomly assigned to a five-step shoulder manipulation (FSM) group or a sham manipulation (SM) group. Each group will receive four weekly treatment sessions, with all participants performing exercises at home for 12 weeks. Assessments, namely the Constant-Murley score, visual analog scale, range of motion, and 36-Item Short Form Survey, will be made at baseline, 4, 12, 18, and 24 weeks. Adverse events during the study will also be recorded. DISCUSSION: This is a pragmatic clinical trial to evaluate the efficacy and safety of FSM in patients with RCRSP. The findings of this study will provide worthy clinical evidence for manual therapy for RCRSP. TRIAL REGISTRATION: China Registered Clinical Trial Registration Center ChiCTR2000037577. Registered on 29 August 2020.

To Explore the Mechanism of "Fuzi-Guizhi" for the Treatment of Osteoarthritis on the Basis of Network Pharmacology and Molecular Docking.

OBJECTIVE: The objective of this study is to analyze and verify the main drug components and targets of "Fuzi-Guizhi" in the treatment of osteoarthritis by using the network pharmacology platform. METHODS: The integrated pharmacology of "Fuzi-Guizhi" was analyzed by using the platform of integrated pharmacology of traditional Chinese medicine to explore its mechanism in the treatment of osteoarthritis. By establishing an arthritis model in vitro, the pharmacological effect of "aconitecassia twigs" on articular cartilage was evaluated and conducted for molecular docking. RESULTS: 28 candidate active components, 37 compound targets, and 583 osteoarthritis-related potential targets were screened, and 10 key target processes were screened in the protein interaction network model. Enrichment analysis showed that the 10 core targets involved 958 GO biologic function items and 76 KEGG signal pathways, which were mainly related to apoptosis and mitochondrial functional metabolism and "Fuzi-Guizhi" drug-containing serum inhibited the expression of Caspase-3 mRNA and protein in chondrocytes and promoted the synthesis of ATP. CONCLUSION: Our research is preliminary that the mechanism of action of "Fuzi-Guizhi" may inhibit chondrocyte degeneration by resisting mitochondrial apoptosis, and further experimental research is required to determine.

[Comparative observation on hip osteoarthritis treated with electroacupuncture and medication].

OBJECTIVE: To observe the differences of effect of electroacupuncture and medication on hip osteoarthritis. METHODS: Sixty cases were randomly divided into an electroacupuncture group and a medication group, 30 cases in each one. In electroacupuncture group, electroacupuncture was applied at Biguan (ST 31), Juliao (GB 29), Zuwuli (LR 10) and Yinlian (LR 11). In medication group, Diclofenac Sodium was prescribed for oral administration. One month after treatment, Visual Analogue Scale (VAS) and Harris score were compared between two groups. RESULTS: VAS scores were 67.83 +/- 8.48 and 55.83 +/- 9.66 before and after treatment in electroacupuncture group, and were 68.67 +/- 8.09 and 61.50 +/- 7.78 in medication group separately. VAS pain scores after treatment were reduced remarkably in two groups (both P < 0.001), but the score was reduced much more remarkably in electroacupuncture group as compared with medication group. In electroacupuncture group, after treatment, Harris total score, the single scores of joint pain, function and motion range increased apparently as compared with those before treatment (all P < 0.001). In medication group, after treatment, Harris total score and pain score increased remarkably as compared with those before treatment (both P < 0.001). Harris total score, pain score and function score after treatment in electroacupuncture group increased much more remarkably as compared with those in medication group (all P < 0.05). CONCLUSION: Electroacupuncture can treat effectively hip osteoarthritis, relieve joint pain and improve joint function. The efficacy of it is superior to that of oral administration of Diclofenac Sodium.