[Randomized controlled clinical trials of red-hot filiform needle puncturing for knee ostarthritis and inflammatory cytokines in knee articular fluid in senile knee ostarthritis patients].

Objective: To observe the effect of red-hot filiform needle puncturing on the pain severity of knee ostarthritis (OA) and the inflammatory cytokine levels in the knee articular cavity (KAC) fluid in senile knee OA patients so as to find a better therapy for knee OA.

Methods: A total of 200 senile knee OA outpatients (who signed an informed consent) were randomized into treatment group and control group (n = 100/group) according to a random number table and their visiting sequence. Futu (LI 18), Neixiyan (EX-LE 4), Yanglingquan (GB 34), Yinlingquan (SP 9), Zusanli (ST 36), etc. on the affected side of the body were punctured with red-hot filiform needles (cauterized on an alcohol burner) or routine filiform needles, with the needles retained for 30 min. The treatment was conducted once every other day, 15 sessions altogether. Before and after the treatment, the patients' KAC fluid was sampled for assaying the contents of IL-1, IL-6 and tumor necrosis factor (TNF)-alpha with enzyme-linked immunosorbent assay (ELISA). The pain severity was tested by using visual analogue scale (VAS) and the comprehensive therapeutic effect was evaluated by using clinical symptoms and signs, functional activity and pain degrees.

Results: In comparison with pre-treatment, IL-1, IL-6 and TNF-alpha contents in KAC fluid were decreased significantly in both treatment and control groups (P < 0.01). The IL-1, IL-6 and TNF-alpha levels were considerably lower in the treatment group than in the control group following the treatment (P < 0.01), suggesting a marked relief of inflammation in the affected knee joint. Compared to pre-treatment, the severity scores of illness state of both treatment and control groups were decreased remarkably (P < 0.01), and the VAS score of the treatment group was significantly lower than that of the control group after the treatment (P < 0.05). Of the two 100 knee OA outpatients in the treatment and control groups, 29 (29%) and 21 (21%) were controlled in their symptoms and signs; 46 (46%) and 34 (34%) experienced apparent improvement; 18 (18%) and 29 (29%) were effective; 7 (7%) and 16 (16%) failed in the treatment. The comprehensive therapeutic effect of the treatment group was significantly superior to that of the control group (P < 0.01).

Conclusion: Red-hot filiform needle puncturing is superior to routine filiform needle puncturing in relieving senile knee OA and in reducing inflammatory cytokine levels in knee OA patients.