# Effectiveness of warm acupuncture and moxibustion in the treatment of osteoarthritis: a retrospective study on clinical and molecular outcomes

## TL;DR

This study shows that warm acupuncture with moxibustion improves joint function and reduces pain and inflammation in osteoarthritis patients.

## Contribution

The study demonstrates the molecular and clinical effects of warm acupuncture and moxibustion on osteoarthritis through a retrospective cohort design.

## Key findings

- Warm acupuncture with moxibustion improved joint function and reduced pain in osteoarthritis patients.
- The treatment decreased inflammation and normalized connexin expression levels in OA patients.
- Post-treatment connexin levels were comparable to healthy controls.

## Abstract

Osteoarthritis (OA) is a degenerative joint disease that causes pain and mobility loss in older adults. This study aimed to examine changes in connexin Cx26, Cx43, and Cx45 expression in OA patients after warm acupuncture with moxibustion.

Records of 46 OA patients treated between March 2022 and December 2024 were reviewed, along with 46 age- and sex-matched healthy controls. This was a retrospective cohort study. Clinical scores [Lysholm knee score, visual analog scale (WOMAC)] were used to assess joint function, pain, and mobility. Warm acupuncture with moxibustion was applied following a standardized protocol, targeting specific acupoints, including Dubi (ST35), Zusanli (ST36), Yinlingquan (SP9), Yanglingquan (GB34), and Heding. The intervention was administered three times per week for 8 weeks. Laboratory data on bone metabolism markers [osteoprotegerin (OPG), and bone gla protein (BGP)], inflammatory mediators [MMP-1, MMP-3, prostaglandin E2, interleukin-1β, and tumor necrosis factor-α (TNF-α)], and the mRNA expression of Cx26, Cx43, and Cx45 were analyzed.

Post-treatment, the Lysholm knee score (LKSS) increased and the VAS and WOMAC scores decreased (P < 0.05). OPG and BGP levels increased, whereas MMP-1, MMP-3, PGE2, IL-1β, and TNF-α levels decreased (P < 0.05). Cx26 expression decreased, whereas Cx43 and Cx45 expression increased (P < 0.05). Connexin levels post-treatment were comparable to those of the controls (P > 0.05).

Warm acupuncture with moxibustion improved joint function, reduced pain and inflammation, and normalized connexin expression in OA patients. The standardized treatment protocol and the retrospective cohort design provide insight into the potential clinical benefits of this approach for OA management.