Effects of contralateral versus ipsilateral electroacupuncture for analgesia and rehabilitation after unilateral total knee arthroplasty: a randomized controlled trial.

PURPOSE: Total knee arthroplasty (TKA) is a treatment for advanced knee osteoarthritis. Since postoperative pain affects rehabilitation, this study aimed to determine whether electroacupuncture (EA) contralateral to the surgical site is more effective than ipsilateral EA or sham EA in terms of relieving postoperative pain and promoting post-TKA rehabilitation. METHODS: In this parallel, single-blind randomized controlled trial, 114 patients undergoing unilateral TKA were assigned to the contralateral EA (EA on the contralateral side + sham EA on the ipsilateral), ipsilateral EA (EA on the ipsilateral + sham EA on the contralateral side), or sham EA (sham EA on both sides) groups (n = 38 each). Treatment was performed once daily on postoperative days 1-3. The visual analog scale (VAS) scores, additional opioid doses via patient-controlled analgesia (PCA) pump, Hospital for Special Surgery (HSS) knee scores, active/passive range of motion (AROM/PROM), swelling around the knee joint, and Hamilton anxiety scale (HAMA) scores were used for postoperative evaluation. RESULTS: At 3 days postoperatively, the VAS scores, HSS scores, AROM/PROM, swelling around the knee, and HAMA scores in the contralateral EA and ipsilateral EA groups were significantly improved compared with baseline. In addition, VAS scores, HSS scores, PROM and swelling around the knee were significantly better in the contralateral and ipsilateral EA groups than in the sham EA group, but similar in the two true EA groups. Furthermore, PCA additional dose release was significantly higher in the sham EA group than in the two true EA groups (which did not significantly differ). At 10 days postoperatively, the HSS scores, AROM/PROM, and HAMA scores were better in the contralateral and ipsilateral EA groups than in the sham EA group, but similar in the two true EA groups. CONCLUSION: Contralateral EA is more effective than sham EA for treating postoperative pain following TKA, but has an analgesic effect similar to that of ipsilateral EA. TRIAL REGISTRATION NUMBER: ChiCTR1800020297 (Chinese Clinical Trial Registry).

Case report: Electroacupuncture for acute pain flare-up of knee osteoarthritis.

Acute pain flare-up of knee osteoarthritis (KOA) is a common disease in orthopedics and is mainly treated with analgesic drugs. Patients usually refuse to take western medicines orally owing to gastrointestinal side effects or unsatisfactory treatment results. We report the case of a 69-year-old woman who had an acute pain flare-up of right KOA induced by long-distance walking. As the patient refused medication, we used electroacupuncture (EA) to relieve her symptoms. EA with a 2-Hz frequency and a 1-2-mA intensity had an analgesic effect on the acute pain flare-up of KOA. After 12 weeks of EA intervention, the bone marrow edema-like lesions (BMLs) improved significantly, as depicted on magnetic resonance imaging of the knee joint. However, more powerful evidence is needed to understand the mechanism of the EA technique that alleviates BMLs of KOA.

[ZHANG Ren's experiences in treatment of diabetic retinopathy with acupuncture].

ZHANG Ren, the chief physician, believes that diabetic retinopathy is located at eye and closely related to qi and yin. He proposes the treatment principle of this disease, i.e. combination of the primary and the secondary, in which, taking the eye as the treatment target and focusing on the symptoms. Acupuncture is provided for activating blood circulation and resolving stasis at the extra points, e.g. Xinming and Shangjianming, and also meridian points, e.g. Cuanzhu (BL 2) and Tongziliao (GB 1). The comprehensive application is emphasized with filiform needle, dermal needle and acupoint injection. Moreover, the mental and physical conditions are treated simultaneously to regulate emotions and the preventive idea is suggested on early treatment and persistent treatment.

[ZHANG Ren's special penetrating needling method].

The clinical experience of ZHANG Ren's penetrating needling method for refractory diseases is summarized. In clinical practice, the penetrating needling method is usually divided into shallow penetrating needling method and deep penetrating needling method. The shallow penetrating method includes parallel penetrating method, cross penetrating method, relay penetrating method and multi-directional penetrating method. Deep penetrating needling method includes deep penetration at auricular area, deep penetration at back-shu points, deep penetration at buttocks and deep penetration at knees. The clinical application of penetrating needling method should be based on the symptoms and the operation essentials should be grasped, in which, the needling sensation could go to the affected area, one acupoint could be stimulated by different techniques to ensure the suppelementory effect.

[Clinical observation of different needle retention times for acute lumbar sprain treated with float needle].

OBJECTIVE: To observe the difference of the clinical effects of different needle retention times for acute lumbar sprain treated with float needle. METHODS: One hundred and twenty patients with acute lumbar sprain were randomly divided into a 6 h group, a 12 h group, a 24 h group and a western medication group, 30 cases in each one. In the three float needle groups, plastic hose was detained near the pressure pain point on the lumbar after subcutaneous scattering with float needle. The needle retention time was 6 h, 12 h and 24 h respectively. In the western medication group, 75 mg voltaren tablet was adopted orally every day and the treatment was given for four days. Visual analogue scale (VAS) and Oswestry dysfunction index (ODI) about low back pain were observed before and after treatment. Also, the comprehensive effect was assessed after treatment. RESULTS: After treatment, the VAS scores and the ODI scores were improved obviously than those before treatment in all groups (all P< 0. 05). In the three float needle groups, the VAS scores and the ODI scores were superior to those in the western medication group (all P<0. 05). The differences in VAS scores and ODI scores among the three float needle groups were not statistically significant after treatment (all P>0. 05). The effective rate in the 6 h, 12 h and 24 h group was 93. 3% (28/30), 90. 0% (27/30) and 93. 3% (28/30) respectively, which were better than 73. 3% (22/30) in the western medication group (all P<0. 05). CONCLUSION: The effect of float needle for acute lumbar sprain is better than voltaren, and there is no apparent difference in retention times.