Therapeutic Effect of Combined Therapy of Tui-na and Oral Chinese Medicine on Osteoarthritis of Knee – a Randomized Controlled Trial

AbstractBackground Knee osteoarthritis (KOA) is a common degenerative joint condition that causes disability and pain in the elderly population. The prevalence of KOA among persons aged 63 or above is approximately 30%. Previous studies have reported the positive effect of Tui-na treatment and the Chinese herbal formula Du-Huo-Ji-Sheng Decoction (DHJSD) for KOA treatment. However, the therapeutic effects of the combination of these two methods are unknown. The current study aims to evaluate the therapeutic effect of the combined therapy of Tui-na and oral administration of DHJSD on KOA using a randomized controlled design. Methods We conducted a prospective, randomized, wait-list controlled clinical trial. Seventy study subjects with KOA were randomly assigned to the treatment and wait-list control groups in a 1:1 ratio. Both the treatment and wait-list control groups received eight sessions of Tui-na manipulation for 4 weeks. The DHJSD were given to the study subjects in the treatment group, but not the wait-list group. Outcomes were assessed using the WOMAC score and EQ-5D-5L, a health-related quality of life with 5-level EQ-5D version. Results The analysis of WOMAC scores and EQ-5D-5L in both groups showed statistically significant improvement with time. The mean WOMAC Pain subscale score was significantly lower in the treatment group than in the wait-list control group at week 8 follow up (P = 0.048). The mean WOMAC Stiffness subscale score was significantly lower in the treatment group than in the wait-list control group at week 2 and week 8 follow up (P = 0.035 and 0.008). The mean EQ-5D index value was significantly improved in the treatment group than in the wait-list control group at week 2 (P = 0.022). No significant adverse effects were found during the trial. Conclusion Combined Tui-na and the herbal medication were effective in relieving pain and improving stiffness as well as quality of life (QOL) in patients with KOA. The combined treatment was generally safe and well tolerated. Trial registration The study was registered at the ClinicalTrials.gov (website: https://clinicaltrials.gov/ct2/show/NCT04492670, registry number: NCT04492670), registered on 30 July 2020.