Systematic Review and Meta-analysis of Electoacupunture Efficacy on Acute Gout

Article information

J Korean Med. 2022;43(2):92-109

Publication date (electronic) : 2022 June 1

doi : https://doi.org/10.13048/jkm.22022

Ji Hye Hwang ¹

, Aejin Song ²

, Ho-Sueb Song ¹^,

¹Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Gachon University

²Gachon Institute of Korean Medicine

Correspondence to: Ho-Sueb Song, Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Gachon University,, Seongnam 13120, Korea, Tel:+82-32-770-1342

Received 2022 April 12; Revised 2022 May 23; Accepted 2022 May 25.

Abstract

Objectives

The objective of this study was to appraise the effect of electroacupuncture (EA) for the treatment of acute gout.

Methods

Since no suitable study could be found in the domestic database, we performed a literature search up to the end of December 2020 using four international electronic databases. Randomized controlled trials (RCTs) evaluating the effectiveness of EA in the treatment of acute gout were included. The risk of bias was evaluated from the Cochrane risk of bias tool.

Results

Eight appropriate RCTs were included and analyzed. Three evaluation tools were mainly used: Total Effective Rate (TER), Uric acid (UA), and Pain score (VAS). In the case of TER, in all eight cases, electroacupuncture alone and combined treatment showed a statistically significant level of improvement compared to Western medicine treatment. In the case of VAS score, electroacupuncture alone and combined treatment showed a more significant effect than Western medicine treatment. In the case of UA level, electroacupuncture combined treatment showed a more significant effect than western medicine treatment. Although not all three evaluation tools were used in all studies, the majority of studies showed that electroacupuncture was effective for acute gout patients.

Conclusions

The results of this study suggest that EA treatment may be effective for acute gout. It should be noted, however, that the studies included in this study were geographically biased, small in number, and mostly at high risk of bias. More well-designed studies are needed in the future.

Keywords: Gout; Acupunture; Electroacupuncture; Acute gouty arthritis; Systematic review; Randomized controlled trial; Meta-analysis

Fig. 1

A flow chart describing the trial selection process.

Fig. 2

Risk of bias summary (A) and graph (B)

A. +: low risk of bias, −: high risk of bias, ?: unclear risk of bias.

Fig. 3

Meta analysis outcome of total efficiency rate between electroacupuncture alone or combined treatment vs. western medicine treatment.

A. Electroacupuncture vs. Western medicine treatment, B. Electroacupuncture+Blood-letting puncture vs. Western medicine treatment, C. Electroacupuncture+Blood-letting puncture+Moxibustion vs. Western medicine treatment, D. Electroacupuncture+Pharmacopuncture vs. Western medicine treatment.

Fig. 4

Meta analysis outcome of pain score (VAS) between electroacupuncture alone or combined treatment vs. western medicine treatment.

Fig. 5

Meta analysis outcome of uric acid between electroacupuncture alone or combined treatment vs. western medicine treatment.

Table 1

Summary of the Randomized Controlled Trials of Electroacupuncture alone or combined treatment for acute gout

Table 2

Electroacupuncture Treatment method

Acknowledgments

This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), which is funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HF20C0179).

References

1. Lee EB. 2011;Clinical Manifestations and Diagnosis of Gout. Korean J Med 80(3):255–259.

2. Roddy E, Doherty M. 2010;Gout. Epidemiology of gout. Arthritis research & therapy 12(6):1–11.

3. Chai W, Tai Y, Shao X, Liang Y, Zheng GQ, Wang P, et al. 2018;Electroacupuncture alleviates pain responses and inflammation in a rat model of acute gout arthritis. Evidence-Based Complementary and Alternative Medicine 2018;:2598975. https://doi.org/10.1155/2018/2598975 .

4. Dalbeth N, Haskard DO. 2005;Mechanisms of inflammation in gout. Rheumatology 44(9):1090–1096. https://doi.org/10.1093/rheumatology/keh640 .

5. Terkeltaub RA. 2003;Gout. The New England Journal of Medicine 349(17):1647–1655. https://doi.org/10.1056/NEJMcp030733 .

6. Song JS. 2016;Recent advances in management of gout. J Korean Med Assoc 59(5):379–384. https://doi.org/10.5124/jkma.2016.59.5.379 .

7. Terkeltaub R. 2010;Update on gout: new therapeutic strategies and options. Nature Reviews Rheumatology 6(1):30–38. https://doi.org/10.1038/nrrheum.2009.236 .

8. Bishop FL, Barlow F, Coghlan B, Lee P, Lewith GT. 2011;Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK. BMC Health Serv Res 11:129. https://doi.org/10.1186/1472-6963-11-129 .

9. Zhao ZQ. 2008;Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 85:355–375. https://doi.org/10.1016/j.pneurobio.2008.05.004 .

10. Carlsson CPO. 2002;Acupuncture mechanisms for clinical long-term effects, a hypothesis. Int Congr Ser 1238:31–47. https://doi.org/10.1016/s0531-5131(02)00407-7 .

11. Hui KK, Liu J, Marina O, Napadow V, Haselgrove C, Kwong KK, et al. 2005;The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture stimulation at ST 36 as evidenced by fMRI. Neuroimage 27:479–496. https://doi.org/10.1016/j.neuroimage.2005.04.037 .

12. Feng Y, Lin H, Zhang Y, Li L, Wu X, Wang T, et al. 2008;Electroacupuncture promotes insulin-like growth factors system in ovariectomized osteoporosis rats. Am J Chin Med 36:889–897. https://doi.org/10.1142/s0192415x08006326 .

13. Korean Acupuncture & Moxibution Society. 2020. Acupuncture Medicine Paju, Korea: Hanmi Medical Publishing Co.

14. Lee WB, Woo SH, Min BI, Cho SH. 2013;Acupuncture for gouty arthritis: a concise report of a systematic and meta-analysis approach. Rheumatology (Oxford) 52:1225–1232. https://doi.org/10.1093/rheumatology/ket013 .

15. Lu WW, Zhang JM, Lv ZT, Chen AM. 2016;Update on the clinical effect of acupuncture therapy in patients with gouty arthritis: systematic review and meta-analysis. Evid Based Complement Alternative Med 2016:9451670. https://doi.org/10.1155/2016/9451670 .

16. Kim SW, Kim KJ, Im CK. 2012;Analysis on the research situations on gout in oriental medicines. Journal of East-West Medicine 37(4):21–29.

17. Kim SW, Byun SH, Kim KJ, Kim SH. 2015;Analysis on the gout-related experiment literatures in Korean medicine. Journal of East-West Medicine 40(4):15–27.

18. Kim SY, Park JE, Seo HJ, Lee YJ, Jang BH, Son HJ, Suh HS, Shin CM. 2011. NECA’s guidance for undertaking systematic reviews and meta-analysis for intervention 1st edth ed. Seoul:National Evidence-based Healthcare Collaborating Agency. p. 24–5. p. 64–75.

19. Xie JY, Li ZH, Luo HY, Li QX. 2007;Therapeutic observation on the acute goute arthritis mainly treated with electro acupuncture. Journal of Clinical Acupuncture and Moxibustion 23(10):23–24.

20. Yin YZ, Zhang HX, Zhang TF. 2005;Clinical observation on electroacupuncture combined with medicine for treatment of acute gouty arthritis. Chinese Acupuncture and Moxibustion 25(10):683.

21. Zou R, Zhang HX, Zhang TF, Xu Y. 2006;Treatment of acute gouty arthritis with electroacupuncture at different frequencies versus medication. Chinese Journal of Clinical Rehabilitation 10(43):188–189. https://doi.org/10.13703/j.0255-2930.2005.10.006 .

22. Jin Z, Zhang BB. 2012;Electroacupuncture plus Blood-letting Puncture in the Treatment of Acute Gouty Arthritis. Journal of Clinical Acupuncture and Moxibustion 28(02):37–39.

23. Yan HD. 2018;Observation on curative effect of Yang needling combined with bloodletting in the treatment of acute gouty arthritis. Journal of Guangxi University of Chinese Medicine 21(02):41–44.

24. Zhong WQ. 2009;Treatment of 34 Cases of Acute Gouty Arthritis with Acupuncture and Jing Point Bloodletting. The Journal of Practical Medicine 25(15):2580–2581.

25. Guo QY. 2017;Observation of Therapeutic Effect of Triple Therapy on Acute Gouty Arthritis. Journal of Practical Traditional Chinese Medicine 33(07):837–838.

26. Zou R, Zhang HX, Zhang TF, Xu Y. 2007;Observation on therapeutic effect of electroacupuncture combined with acupoint-injection on acute gouty arthritis. Chinese Acupuncture & Moxibustion 01:15–17. https://doi.org/10.13703/j.0255-2930.2007.01.009 .

27. Health Insurance Review and Assessment Service. 2018. 100 Disease Statistics in Daily Life 84–85. Available from URL: https://opendata.hira.or.kr/home.do .

28. Park JH, Lee JH, Lee SH, Shin JY, Kim TH. 2020;Adverse events related to electroacupuncture: a systematic review of single case studies and case series. Acupuncture in Medicine 38(6):407–416. https://doi.org/10.1177/0964528420920287 .

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