Acupuncture outperforms diclofenac sodium for the treatment of gout. Yangchun City Hospital of Traditional Chinese Medicine researchers compared the effectiveness of acupuncture plus a Chinese herbal wash with diclofenac sodium drug therapy for the treatment of acute gout. Diclofenac sodium is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain, inflammation, and stiffness caused by arthritis. Patients receiving acupuncture plus the Chinese herbal wash had a 93.33% total effective rate. Another group of patients receiving diclofenac sodium drug therapy had a 76.67% total effective rate. [1]

Primary outcome measures for the study included the Visual Analogue Scale (VAS), serum uric acid, erythrocyte sedimentation rate, and C-reactive protein. The VAS is used to measure the improvement of pain intensity. Uric acid (UA) is produced by the body, including from the digestion of purine rich foods. High levels of UA can be a sign of gout.

The erythrocyte sedimentation rate (ESR) test is used to detect inflammatory activity in the body. Elevated ESR results can indicate active inflammatory diseases. C-reactive protein (CRP) is a marker of inflammation. The CRP level in the blood increases if there is inflammation.

There was no significant difference between the two groups in VAS scores, UA, ESR and CRP before treatment (p>0.05). One week after treatment, the VAS score of the acupuncture treatment group was lower than that of the drug group, and the difference was statistically significant (p<0.05). After treatment, the levels of UA, ESR, and CRP in the acupuncture treatment group were significantly lower than those in the drug group (P <0.05). The results of the randomized clinical trial finds acupuncture plus an herbal wash is more effective than the drug protocol for the relief of pain and inflammation due to gout.

 

Design
Researchers (Li et al.) used the following study design. A total of 60 patients diagnosed with acute gout were treated and evaluated in this study. The patients received anti-gout treatment between December 2017 and November 2018. They were randomly divided into an acupuncture treatment group and a drug group, with 30 patients in each group. For the drug group patients, diclofenac sodium was administered. The acupuncture treatment group received acupuncture in addition to a Chinese herbal wash recipe.

The statistical breakdown for each randomized group was as follows. The acupuncture treatment group was comprised of 25 males and 5 females. The average age in the acupuncture treatment group was 50.44 years. The average course of disease in the acupuncture treatment group was 4.18 years. The drug group was comprised of 26 males and 4 females. The average age in the acupuncture treatment group was 49.42 years. The average course of disease in the acupuncture treatment group was 4.35 years. There were no significant statistical differences (p> 0.05) in gender, age, and course of disease relevant to patient outcome measures for patients initially admitted to the study.

 

Acupuncture Treatment
For the drug group, patients received 75 mg of diclofenac sodium tablets, once per day, for a total of 7 consecutive days. The acupuncture treatment group patients received acupuncture and a Chinese herbal wash. The primary acupoints used for the acupuncture treatment group included the following:

  • SP6 (Sanyinjiao)
  • SP9 (Yinlingquan)
  • LI11 (Quchi)
  • ST36 (Zusanli)

Additional acupoints were added based on symptom presentation. For toe joint pain, the following acupoints were added:

For ankle pain, the following acupoints were added:

  • GB40 (Qiuxu)
  • KI6 (Zhaohai)
  • ST41 (Jiexi)

For knee pain, the following acupoints were added:

  • GB34 (Yanglingquan)
  • ST35 (Dubi)
  • SP10 (Xuehai)

For upper limb pain, the following acupoints were added:

  • LI15 (Jianyu)
  • LU5 (Chize)
  • LI10 (Shousanli)
  • TB5 (Waiguan)
  • LI4 (Hegu)

Treatment commenced with patients in a supine position. After disinfection of the acupoint sites, a 0.30 mm x 40 mm disposable filiform needle was inserted into each acupoint with a high needle entry speed. After reaching a standard depth, the needle was lifted, thrust, and rotated to achieve deqi. Once a deqi sensation was obtained, the needles were retained for 30 minutes. One acupuncture session was conducted daily, for a total of 7 consecutive days. The Chinese herbal wash recipe used in the study included the following ingredients:

  • Luo Shi Teng 30 g
  • Hai Feng Teng 30 g
  • Ren Dong Teng 30 g
  • Hei Lao Hu 30 g
  • Liang Mian Zhen 30 g
  • Dan Shen 30 g
  • Cang Zhu 10 g
  • Huang Bai 15 g
  • Yi Yi Ren 30 g
  • Niu Xi 15 g

The above herbs were cooked in a pot on slow fire (wen huo) for 20 minutes to obtain a 1000 ml decoction. The affected area was washed by the decoction with clean cotton gauze or towel, once per day, for a total of 7 consecutive days.

 

Results
The research confirms that acupuncture plus a Chinese herbal wash outperforms diclofenac sodium for the treatment of acute gout. The biochemical tests demonstrate that acupuncture reduces biomarkers associated with pain and inflammation. The scientifically validated results indicate that acupuncture is a valuable treatment option for patients with gout.

 

Reference:
1. Li SC, Huang XP, Xie JN, Zhang JH. Observation on the Curative Effect of Acupuncture Combined with Chinese Medicine External Washing in the Treatment of Acute Gout Arthritis[J]. Asia-Pacific Traditional Medicine, 2019, 15(07):119-121.

 

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