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J Acupunct Res > Volume 32(3); 2015 > Article
Shin, Seo, Kim, Seo, Seo, Lee, Bin, Jung, Song, Yoon, Kim, and Jang: The Effect of Chinemys reevesii Gray Pharmacopuncture for Women with Knee Osteoarthritis
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Abstract

Objectives:

The aim of this study is to determine whether Chinemys reevesii Gray pharmacopuncture is a clinically effective treatment for women with knee osteoarthritis.

Methods:

Female patients with knee osteoarthritis were recruited from May 1st, 2014 to April 15th, 2015 at the Department of Acupuncture & Moxibustion Medicine of Dong-Eui University Korean Medical Hospital. Patients were randomly assigned to two groups. 4.0 ml of Chinemys reevesii Gray pharmacopuncture was injected at acupuncture points of the experimental group(n = 24) twice a week for three weeks. The control group(n = 24) received 5 % dextrose injections in order to identically stimulate the same acupuncture points of ST35, ST34, SP9, SP10, GB34, LR8, EX-LE4, and EX-LE2. The Short-Form McGill Pain Questionnaire(SF-MPQ), the Korean Western Ontario and McMaster Universities Osteoarthritis Index(KWOMAC), and the European Quality of Life-5 Dimensions(EQ-5D) were recorded to evaluate treatment efficacy at first visit, after two weeks and four weeks from the initial visit.

Results:

40 patients completed the trial. The experimental group showed more significant improvement than the control group in the scores of SF-MPQ, KWOMAC, and EQ-5D. However, there was no significant difference between groups in a few of the assessment scales.

Conclusions:

Chinemys reevesii Gray pharmacopuncture can be an effective treatment in control of pain, improvement in function and health-related quality of life for women with knee osteoarthritis.

Table 1
General Characteristics
A Group (n=20) B Group (n=20) p-value
Age 62.50±5.81 61.75±6.60 0.820*
Affected part (Both/Left/Right) 20(11/5/4) 20(11/5/4) 1.000***
SF-MPQ Sensory 12.20±6.08 11.20±6.85 0.445*
Affective 2.25±2.43 2.30±3.25 0.445*
VAS 5.35±1.42 5.30±1.13 0.862*
PPI 2.30±0.87 2.20±0.89 0.904*
KWOMAC 31.10±12.77 32.05±18.79 0.698*
EQ-5D 8.75±1.29 8.75±1.21 1.000**

Values represent number or mean±standard deviation.

* using Mann-Whitney U test, p > 0.05.

** using Student’s t-test, p > 0.05.

*** using Chi-square test, p > 0.05.

Table 2
Average of SF-MPQ in Each Group
Group A Group B
Sensory P0 12.20±6.08 11.20±6.85
P1 7.10±3.97 8.20±6.31
P2 5.00±4.10 7.80±6.80
Affective P0 2.25±2.43 2.30±3.25
P1 1.05±1.23 1.85±2.56
P2 0.95±1.19 1.85±2.43
VAS P0 5.35±1.42 5.30±1.13
P1 3.70±1.42 4.45±1.50
P2 2.55±1.54 4.35±1.57
PPI P0 2.30±0.87 2.20±0.89
P1 1.75±0.64 1.90±0.85
P2 1.20±0.41 1.65±0.67

P0 : score before treatment.

P1 : score after two weeks from first visit.

P2 : score after four weeks from first visit(score after one week from final treatment).

Values represent mean±standard deviation.

Table 3
Improvement of SF-MPQ in Each Group According to Treatment Period
Group A Group B
Z or t p-value Z or t p-value
Sensory P01 −3.417 0.001* −3.190 0.001*
P12 4.273 0.000** −1.235 0.217
P02 −3.830 0.000* −3.476 0.001*
Affective P01 −2.111 0.035* −0.851 0.395
P12 −0.491 0.623 0.000 1.000
P02 −2.214 0.027* −0.543 0.587
VAS P01 6.773 0.000** −2.549 0.011*
P12 −3.493 0.000* −0.541 0.589
P02 −3.950 0.000* −2.708 0.007*
PPI P01 −2.887 0.004* −1.350 0.177
P12 −3.051 0.002* −1.890 0.059
P02 −3.700 0.000* −2.810 0.005*

P01 : period from the first visit to the second week.

P12 : period form the second week to the fourth week.

P02 : period from the first visit to the fourth week.

* p-value < 0.05 by Wilcoxon signed rank test.

** p-value < 0.05 by paired t-test.

Table 4
Comparison of the Improvement of SF-MPQ between Group A and B
Group A Group B Z or t p-value
Sensory P01 5.10±5.95 3.00±3.60 −0.968 0.341
P12 2.10±2.20 0.40±2.19 −2.004 0.049*
P02 7.20±5.55 3.40±4.12 −2.868 0.004*
Affective P01 1.20±2.40 0.45±2.11 −1.379 0.211
P12 0.10±0.97 0.00±0.56 −0.485 0.698
P02 1.30±2.68 0.45±1.99 −1.612 0.127
VAS P01 1.65±1.09 0.85±1.31 −2.468 0.017*
P12 1.15±0.88 0.10±0.79 −3.544 0.001*
P02 2.80±1.44 0.95±1.40 −3.788 0.000*
PPI P01 0.55±0.76 0.30±0.92 −0.802 0.478
P12 0.55±0.61 0.25±0.55 −1.845 0.127
P02 1.10±0.91 0.55±0.69 −2.156 0.049*

P01 : period from the first visit to the second week.

P12 : period from the second week to the fourth week.

P02 : period from the first visit to the fourth week.

* p-value < 0.05 by Mann-Whitney U test.

Table 5
Average of KWOMAC in Each Group
Group A Group B
P0 31.10±12.77 32.05±18.79
P1 23.15±10.74 28.90±17.10
P2 17.05±8.84 28.00±18.44

P0 : score before treatment.

P1 : score after two weeks from first visit.

P2 : score after four weeks from first visit(score after one week from final treatment).

Values represent mean±standard deviation.

Table 6
Improvement of KWOMAC in Each Group According to Treatment Period
Group A Group B

Z or t p-value Z or t p-value
P01 3.287 0.004** 2.084 0.051
P12 −3.928 0.000* 0.688 0.500
P02 −3.922 0.000* 1.915 0.071

P01 : period from the first visit to the second week.

P12 : period form the second week to the fourth week.

P02 : period from the first visit to the fourth week.

* p-value < 0.05 by Wilcoxon signed rank test.

** p-value < 0.05 by paired t-test.

Table 7
Comparison of the Improvement of KWOMAC between Group A and B
Group A Group B Z or t p-value
P01 7.95±10.82 3.15±6.76 1.683 0.101
P12 6.10±5.42 0.90±5.85 −3.337 0.001*
P02 14.05±9.83 4.05±9.46 −3.507 0.000*

P01 : period from the first visit to the second week.

P12 : period from the second week to the fourth week.

P02 : period from the first visit to the fourth week.

* p-value < 0.05 by Mann-Whitney U test.

Table 8
Average of EQ-5D in Each Group
Group A Group B
P0 8.75±1.29 8.75±1.21
P1 8.50±1.15 8.60±1.70
P2 7.75±1.29 8.65±1.35

P0 : score before treatment.

P1 : score after two weeks from first visit.

P2 : score after four weeks from first visit(score after one week from final treatment).

Values represent mean±standard deviation.

Table 9
Improvement of EQ-5D in Each Group According to Treatment Period
Group A Group B

Z or t p-value Z or t p-value
P01 −0.643 0.520 −0.755 0.450
P12 −3.066 0.002* −0.432 0.666
P02 −2.958 0.003* 0.400 0.694

P01 : period from the first visit to the second week.

P12 : period form the second week to the fourth week.

P02 : period from the first visit to the fourth week.

* p-value < 0.05 by Wilcoxon signed rank test.

Table 10
Comparison of the Improvement of EQ-5D between Group A and B
Group A Group B Z or t p-value
P01 0.25±1.37 0.15±1.27 −0.459 0.659
P12 0.75±0.85 −0.05±1.05 −2.798 0.008*
P02 1.00±1.12 0.10±1.12 −2.412 0.020*

P01 : period from the first visit to the second week.

P12 : period from the second week. to the fourth week.

P02 : period from the first visit to the fourth week.

* p-value < 0.05 by Mann-Whitney U test.

VI.
VI.

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