Acupuncture is found effective for the treatment of acute gout attacks. An important acupuncture technique was found particularly helpful in the reduction of pain and inflammation. In findings published in research entitled Clinical Observation on Treatment of Acute Gout With Acupuncture, the surround-acupuncture technique significantly boosted treatment efficacy for acute gout attack relief. The study demonstrates that acupuncture, especially the surround-needling technique, improves blood circulation and reduces inflammation.
According to Traditional Chinese Medicine (TCM) principles, acupuncture was found effective for the alleviation of dampness and heat during acute gout attacks. While seemingly archaic and mysterious, the terms dampness and heat have direct correlates in current biomedical semantics. Dampness refers to swelling and edema associated with gout, including uric acid crystal buildup in tissues. Heat is a broad term often referring to inflammation. The Latin terms defining the key components of inflammation (rubor, dolor, calor, tumor) date back to writings from Roman civilization and refer to redness, pain, heat, and swelling. In many ways, the terms dampness and heat are the ancient Chinese correlates of the Latin terminology for inflammation.
Gout is caused by elevated levels of uric acid in the blood. Uric acid crystal deposits precipitate gout attacks. The crystals tend to lodge in tendons, joints, and other tissues and lead to inflammation. [2] Acute treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and steroids. The research includes a comparative note between acupuncture and drug therapy regarding the long-term adverse effects associated with pharmaceutical drug ingestion, “medications at high doses and for extended periods is not safe for the kidneys and the liver…. acupuncture has a low rate of adverse effects, and it doesn’t harm the liver and kidneys.” [3]
The Shengzhen Longgang TCM hospital research was conducted as a controlled clinical trial. The research demonstrates that acupuncture produces superior patient outcomes to the use of indomethacin tablets for the treatment of acute gout attacks. Indomethacin is an NSAID that reduces hormone levels in the body that are responsible for inflammation. Acupuncture produced a 92.5% total treatment effective rate for the treatment of acute gout. Indomethacin tablets achieved an 82.5% total treatment effective rate.
A sample size of 80 patients with acute gout was treated and evaluated in this study. The patients were diagnosed with acute gout between May of 2014 and May of 2015. Patients were randomly divided into an acupuncture group and a medication group, with 40 patients in each group. There were 36 male patients and 4 female patients in the acupuncture treatment group. The youngest patient was 22 years old, the oldest was 62 years old. The average age was 43.1 years. For the medication control group, there were 36 male patients and 4 female patients. The youngest patient was 21 years old and the oldest was 62 years of age. The average age was 45 years. There were no significant statistical differences in terms of gender and age relevant to patient outcome measures. Before the treatment sessions, patients in both groups were asked to avoid food that may affect the results, including protein rich, high fat, and spicy foods. Patients were also advised to take more vegetable protein, fruits, and to drink more water.
For the medication group, patients received 75 mg of indomethacin enteric-coated tablets after each meal. Tablets were orally administered twice per day, 10 days in total. In the same study, the treatment group underwent acupuncture. Acupoints for all patients in the treatment group included the following:
SP6 (Sanyinjiao)
TB6 (Zhigou)
ST36 (Zusanli)
ST44 (Neiting)
SP9 (Yinlingquan)
ST43 (Xiangu)
Ashi points
Additional secondary acupuncture points were added based on differential diagnostics. For gout in the elbow, the following acupoints were added:
LI4 (Hegu)
LI11 (Quchi)
For gout in the knee joints, the following acupoints were added:
GB34 (Yanglingquan)
SP10 (Xuehai)
EX-LE5 (Xiyan)
For gout in the big toe joint, the following acupoint was added:
LV3 (Taichong)
For gout in the wrist, the following acupoints were added:
TB5 (Waiguan)
TB4 (Yangchi)
LI4 (Hegu)
Upon disinfection, all acupoints (with the exception of Ashi points) were needled perpendicularly. Ashi points were applied with the surround-needling technique, with several needles inserted obliquely directed toward one central point. After insertion, needles were rotated, lifted, and thrust rapidly to acquire a deqi sensation. The needle retention time was 30 minutes per acupuncture session, during which the acupuncture needles were manipulated every 10 minutes. Acupuncture therapy was conducted one time per day for 10 days. After treatment completion, the treatment efficacy for each patient was categorized into 1 of 4 tiers:
Recovery: Complete absence of gout and the accompanying symptoms. Patients can do physical work without joint movement reduction.
Significantly effective: Absence of most symptoms. Patients can do some physical work with slight joint movement reduction.
Effective: Absence of most symptoms. Patient can do physical work with some joint movement reduction.
Not effective: No improvement.
The acupuncture treatment group had a total treatment efficacy rate of 92.5%. The medication control group obtained an 82.5% total treatment effective rate. The results demonstrate that consistent and frequent acupuncture yields significant positive patient outcomes for patients with acute gout. The research includes a TCM view of gout. Acute gout is characterized by sudden attacks of redness, tenderness, heat, and swelling of joints. Patients usually present with a red tongue with a greasy coating, bitter taste in the mouth, dry stools, and dark urine. The pulse tends to be slippery, wiry, and rapid. In Traditional Chinese Medicine, acute gout falls under the Shi Re Bi class of disorders. According to TCM principles, acute gout is the accumulation of stasis and heat or phlegm-dampness in the joints. The treatment principle is to dredge the meridians to remove excess dampness and heat.
For the treatment of acute gout, it is noted that the surround-needling technique plays an important role. In this technique, several needles are inserted toward one single point to provide strong stimulation and a pronounced deqi sensation. Surround-needling activates local blood circulation, softens hardness and masses, and clears heat and dampness. The research indicates that three acupoints are important for dredging the meridians and reinforcing the spleen qi to resolve dampness: ST36, SP9, ST43. The conclusion of the investigation is that acupuncture produces significant improvements in patient outcomes. The research includes the following summary, “The acupuncture treatment protocol outperformed the conventional medication by a significant margin. The results of this investigation indicates that acupuncture is safe and effective for the treatment of acute gout.” [3]
References 1. Li GS, Clinical Observation on Treatment of Acute Gout with Acupuncture. China Prescription Drug [J]. 2016(1):106-107.
2. Chen LX, Schumacher HR (October 2008). "Gout: an evidence-based review". J Clin Rheumatol. 14 (5 Suppl): S55–62.
3. Li GS, China Prescription Drug. 2016(1):106-107.
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