本研究目的主要在於探討電針治療使用於不同程度的退化性膝 關節炎療效的差異，共收集可用資料 83 隻膝蓋，包含實驗組有 50 隻 膝蓋，A 組有 37 隻，B 組有 13 隻。對照組有 33 隻膝蓋，C 組有 25 隻，D 組有 8 隻。
本研究初步將退化性膝關節炎在不同 X-ray 程度下的地面反作用 力 Fz 分量圖形加以歸納，證明退化程度越嚴重者，圖形和正常值比 較差異越大，其物理量變化解釋可供臨床及進一步研究參考。
經過電針治療後實驗組步態曲線明顯改善樣本占 30%，顯示電針 治療各種程度的退化性膝關節炎有一定程度立即而明顯的療效。無明 顯差異者經統計分析發現治療後壓力中心可在患側下肢內快速轉 移，下肢對體重的適應時間縮短，適應力增強。站立期時間、可承受 體重時間及站立期的總能量皆增加，身體重心上下移動的加速度增 加，關節肌肉承受突然變化力量的能力增加，且皆具統計上的意義。
其他參數雖無顯著差異，但仍有改善的趨勢，同時 B 組治療結果顯示 X-ray 分級退化程度較嚴重、疼痛症狀較明顯者，電針的立即療效可 能就不顯著，需要持續的治療。
對照組各參數的治療前後比較在統計上皆無顯著差異，同時參數 群呈現沒有規律的現象，表示偽電針治療對退化性膝關節炎的症狀沒 有明顯療效，甚至對某些參數有不利的影響。
依實驗組內 VAS 數據證實電針治療的確有止痛效果，但使用本 評估法時須考慮受試者心理因素影響，PIK 數據除了證實電針治療的 止痛效果外，也說明本法在退化較輕微的關節評估能力較為敏感。
參考文獻
[1] Craik R, Oatis C. Gait Analysis - Theory and Application, Mosby - year Book, Inc., New York, 1995, pp. 248
[2] Ronald P, Grelsamer S. The Columbia Prebyterian Osteoarthritis Handbook, A Simon & Schuster Macmillan Company, New York, 1996, pp.
[3] Cailliet R. Knee Pain and Disability, Info Access & Distribution Pte Ltd, Singapore, 1993, pp. 190-197
[4] Kindynis P, Haller J, Kang H, Resnick D, Sartoris D, Trudell D, Tyson R.
Osteophytosis of the knee: anatomic, radiologic, and pathologic investigation.
Radiology 1990; 174: 841-846
[5] Berg W. Pathophysiology of osteoarthritis. Joint Bone Spine 2000; 67: 555-556 [6] Wu J, Epstein M. Joint contact mechanics in early stage of osteoarthritis.
Medical Engineering & Physics 2000; 22: 1-12
[7] Goldberg V, Colyer R. Osteoarthritis of the knee., Moskowitz R, Goldberg V, Mankin H. Saunders, London, 1992, pp.
[8] Fishkin Z, Ritter C, Ziv I. Change in human knee ligament stiffness secondary to osteoarthritis. Journal of Orthopaedic Research 2002; 20: 204-207
[9] Malfait A, Liu R, Ijiri K, Komiya S, Tortorella M. Inhibition of ADAM-TS4 and ADAM-TS5 prevents aggrecan degradation in osteoarthritic cartilage. Journal of Biological Chemistry 2002; 277: 22201-22208
[10] Chevalier X. Upregulation of enzymatic activity by interleukin-1 in osteoarthritis. Biomedicine & Pharmacotherapy 1997; 51: 58-62
[11] Sakkas L. Role of T cells in the pathogenesis of osteoarthritis.[comment].
Arthritis & Rheumatism 2002; 46: 3112-3113
[12] Hawley D. Pain,disability,and pain/disability relationships in severe rheumatic disorders. A study of 1522 patients. J Rheumatol 1991; 18: 1552-1557
[13] Bill H, McCarberg K. Osteoarthritis- How to manage pain and improve patient function. Geriatrics 2001; 56: 14-24
[14] Perry J. Gait ANALYSIS. Normal and Pathological Function., SLACK, Thorofare, NJ, 1992, pp. 10
[15] Grelsamer R, Suzanne L. The Columbia Prebyterian Osteoarthritis Handbook, A Simon & Schuster Macmillan Company, New York, 1996, pp. 1-20
[16] Altman R. Overview of osteoarthritis. American Journal of Medicine 1987; 83:
65-69
[17] Creamer P. Osteoarthritis. Lancet 1997; 350: 503-509
[18] Altman R, Moskowitz R, Schnitzer T. Recommendations for the medical
43: 1905-1915
[19] Lawrence R, Arnett F, Deyo R, Felson D, Giannini E. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in United States.
Arthritis & Rheumatism 1998; 41: 778-799
[20] Brandt K, Block J, Michalski J, Moreland L, Caldwell J, Lavin P. Efficacy and safety of intraarticular sodium hyaluronate in knee osteoarthritis. Clinical Orthopaedics and Related Research 2001; 1: 130-143
[21] Mazzuca S, Katz B, Chambers M, Byrd D, Hanna M. Effects of self-care education on the health status of inner-city patients with osteoarthritis of the knee. Arthritis & Rheumatism 1997; 40: 1466-1474
[22] Felson D. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis & Rheumatism 1998; 41: 1343-1355
[23] Felson D, Zhang Y, Hannan M, Naimark A, Weissman B, Aliabadi P, Levy D.
The incidence and national history of knee osteoarthritis in the elderly. Arthritis
& Rheumatism 1995; 38: 1500-1505
[24] Felson, D., Naimark, A., Anderson, J., Kazis, L., Castelli, W. and Meenan, R., The prevalence of knee osteoarthritis in the elderly. Arthritis & Rheumatism 1987; 30: 914-918
[25] March L. Economics of osteoarthritis: a global perspective. Occupational health and Industrial medicine 1998; 38: 154
[26] Fiechtner J, Brodeur R. Manual and manipulation techniques for rheumatic disease. Medical Clinics of North America 2002; 86: 91-103
[27] Simons D, Mense S. Understanding and measurement of muscle tone as related to clinical muscle pain. Pain 1998; 75: 1-17
[28] Egbert A. Postoperative pain management in the frail elderly. Clinics in Geriatric Medicine 1996; 12: 583-599
[29] DiNubile N. Exercise for Osteoarthritis. The Physician and Sports Medicine 1997; 25:
[30] Melzack R, W. P., Pain mechanisms:a new theory. Science 1965; 150: 971-977 [31] Conference, N. Osteoarthritis:New Insights. part2: treatment approach. Annals
of internal medicine 2000; 133: 726-737
[32] Caldwell J, Davis J, Offenberg H, Marker H, Roth S, Yuan W, Eliot L, Babul L, Pharm D, Lynch P. Efficacy and safety of a once-daily morphine formulation in chronic, moderate-to-severe osteoarthritis pain: results from a randomized, placebo-controlled, double-blind trial and an open-label extension trial. Journal of pain and symptom management 2002; 23: 278-291
[33] Langman M. Ulcer complication and nonsteroidal anti- inflammatory drugs.
[34] Ray W, Hall K, Daugherty K, Griffin M. Non-steroidal anti- inflammatory drugs and risk of serious coronary heart disease: an observational cohort study. The Lancet 2002; 359: 118-123
[35] Vane J. Mechanism of action of aspirin- like drugs. Seminars in Arthritis &
Rheumatism. 1997; 26: 2-10
[36] Schnitzer T. Cyclooxygenase-2-specific inhibitors:are they safe? The American Journal of Medicine 2001; 110: 46s-49s
[37] Emery P. Cyclooxygenase-2: a major therapeutic advance? The American Journal of Medicine 2001; 110: 42s-45s
[38] Mukherjee D, Topol E. Risk of cardiovascular events associated with selective COX-2 inhibitors. JAMA 2001; 286: 954-959
[39] Bassleer C, Franchimont P. Stimulation of proteoglycan production by glucosamine sulfate in chondrocytes isolated from human osteoarthritic articular cartilage in vitro. Osteoarthritis Cartilage 1998; 6: 427-434
[40] Uebelhart D. Effects of hyaluronic acid on cartilage degeneration. Current Opinion in Rheumatology. 1999; 11: 427-435
[41] Hurley M. Quadriceps weakness in osteoarthritis. Current Opinion in Rheumatology. 1998; 10: 246-250
[42] Perrot S, Menkes C. Nonpharmacological approaches to pain in osteoarthritis.
Drugs 1996; 52: 21-26
[43] Slemenda C, Heilman D, Mazzuca S, Braunstein E, Katz B, Wolinsky F.
Quadriceps weakness and osteoarthritis of the Knee. Annals of internal medicine 1997; 127: 97-104
[44] Fries J,Carey C, McShane D. Patient education in arthritis: randomized controlled trial of a mail-delivered program. J Rheumatol 1997; 24: 1378-1383 [45] Marshall K. Intra-articular hyaluronan therapy. Current Opinion in
Rheumatology. 2000; 12: 468-474
[46] Rao J, Mihaliak K, Kroenke K, Bradley J, Tierney W, Weinberger M. Use of complementary therapy for arthritis among patients of rheumatologists. Annals of internal medicine 1999; 131: 409-416
[47] Astin J. Why patients use alternative medicine: results of a national study.
Journal of the American Medical Association 1998; 279: 1548-1553 [48] 黃帝內經素問校釋，人民衛生出版社，北京 1995：pp. 557, [49] 黃帝內經素問校釋，人民衛生出版社，北京 1995：pp. 149 [50] 黃帝內經素問校釋，人民衛生出版社，北京 1995：pp. 704, 213
[51] 東漢•張仲景：傷寒雜病論，中醫整合研究小組，台北 1986：pp. 281.
[52] 東漢•華陀：華陀中藏經，自由出版社，台北 1998：pp. 27-28.
59-60.
[57] Deyle G, Matekel R, Ryder M, Garber M, Allison S. Effective ness of manual physical therapy and exercise in osteoarthritis of the knee: a randomized, controlled trial. Annals of internal medicine 2000; 132: 173-181
[58] 清•吳謙：醫宗金鑑，中國中醫藥出版社，北京 1995：pp. 1005-1006.
[68] O'Connor J, Bensky D. A Summary of Research Concerning the Effects of Acupuncture. American Journal of Chinese Medicine 1975; 3: 377-394
[69] Lin, J. A Concept in Analgesic Mechanisms of Acupuncture. Chinese Medical Journal 1996; 109: 185-188
[70] Ezzo J, Berman B, Hadhazy V, Jadad A, Lao L, Singh B. Is acupuncture effective for the treatment of chronic pain? A systematic review. Pain 2000; 86:
217-225
[71] Fisher M, Behr A, Reumont J. Acupuncture- a therapeutic concept in the treatment of painful conditions and functional disorders. Report on 971 cases.
Acupuncture & Electro-therapeutics Research 1984; 9: 11-29
acupuncture in patients with osteoarthritis pain: a placebo controlled study.
American Journal of Chinese Medicine 1991; XIX: 95-100
[73] Christensen B, Iuhl I, Vilbek H, Bulow H, Dreijer N, Rasmussen H. cupuncture treatment of severe knee osteoarthritis: a long-term study. Acta Anaesthesiol Scand 1992; 36: 519-525
[74] Berman B, Singh B, Lao L, Langenberg P, Li H, Hadhazy V, Bareta J, Hochberg M. A randomized trial of acupuncture as an adjunctive therapy in osteoarthritis of the knee. Rheumatology 1999; 38: 346-354
[75] Gaw A, Chang L, Shaw L. Efficacy of acupuncture on osteoarthritic pain. The new england journal of medicine 1975; 293: 375-378
[76] Ezzo J, Hadhazy V, Birch S, Lao L, Kaplan G, Hochberg M, Berman B.
Acupuncture for osteoarthritis of the knee. Arthritis & Rheumatism 2001; 44:
819-825
[77] Ulett G, Han S, Han J. Electroacupuncture: mechanisms and clinical application.
Biological Psychiatry 1998; 44: 129-138
[78] Wong A, Leong C, Su T, Yu S, Tsai W, Chen C. Clinical trial of acupuncture for patients with spinal cord injuries. American Journal of Physical Medicine &
Rehabilitation 2003; 82: 21-27
[79] Wong A, Su T, Tang F, Cheng P, Liaw M. Clinical trial of electrical acupuncture on hemiplegic stroke patients. American Journal of Physical Medicine & Rehabilitation 1999; 78: 117-122
[80] Man P, Chen C. Mechanism of acupuncture anesthesia. The two-gate control theory. Disease of the nervous system 1972; 33: 730-735
[81] Hughes J. Isolation of an endogenous compound from the brain with pharmacological properties similar to morphine. Brain research 1975; 88:
295-308
[82] Ying C, Ping P. Correlation of pain threshold and level of ?endorphin- like immunoreactive substance in human CSF during electroacupuncture analgesia.
Acta Physiol Sin. 1984; 36: 183-187
[83] Zhu J, He X, Cao X. Changes of releases of P-endorphin- like immunoreactive substance and noradrenaline in rabbit's preoptic area during acupunctureanalgesia. Acta Physiol Sin. 1990; 42: 188-193
[84] Cheng R, Pomeranz B. Electroacupuncture anaigesia could be mediated by at least two pain-relieving mechanisms; endorphin and nonendorphin system. Life science 1979; 25: 1957-1962
[85] Bing Z, Bars D. Acupuncture and diffuse noxious inhibitory control:
Naloxone-reversible depression of activities of trigeminal convergent neurons.
[86] He L, Dong W, Wang M. Effects of ion trophoretic etorphin and naloxone, and electroacupuncture on nociceptive responses from thalamic neurones in rabbits.
Pain 1991; 44: 89-95
[87] Chen X, Han J. Analgesia induced by electroacupuncture of different frequencies is mediated by different types of opioid receptors: Another cross-tolerance study. Behavioural brain research 1992; 47: 143-149
[88] Sun S, Han J. High and low frequency electroacupuncture analgesia are mediated by different types of opioid receptors at spinal level: A cross-tolerance study. Acta Physiologica Sinica. 1989; 41: 416-420
[89] Basbaum A, Field H. Endogenous pain control mechanisms: Review and hypothesis. Annals of Neurology 1978; 4: 451-462
[90] Wigdor S, Wilcox G. Centrol and systemic morphine- induced antinociception in mice: contribution of descending serotonergic and noradrenergic pathways.
Journal of Pharmacology Expert. Ther. 1987; 242: 90-95
[91] Shen J. Research on the neurophysiological mechanisms of acupuncture: review of selected studies and methodological issues. Journal of Alternative &
Complementary Medicine. 2001; 7: S121-127
[92] 褚建平：合谷刺治療膝骨性關節炎 15 例。中國針灸 1998; 11: 675-676. 2001; 21(11): 687-688.
[99] 張悅、王澎：半導體激光照射治療膝關節骨性骨關節炎療效觀察。中國針 灸 2001; 21(6): 339-340.
[100] 于璟玲：針灸及中藥離子導入治療膝關節骨性骨關節炎的療效觀察。中國 自然醫學雜誌 2000; 2(3): 155-157.
[101] Marcus N. Comprehensiveness, uniformity and standardization in the evaluation of patients with complaints of pain. Journal of Back and Musculoskeletal Rehabilitation 1997; 8: 89-93
[102] Dowd G. . Anterior knee pain. The Knee 1996; 3: 98-99
Cooke T, Greenwald R, Hochberg M, Howell D, Kaplan D, Koopman W, Longley S, Mankin H, Mcshane D, Medsger T, Meenan R, Mikkelsen W, Moskowitz R, Murphy W, Rothschild B, Segal M, Sokoloff L, Wolfe F.
Development of criteria for the classification and reporting of osteoarthritis.
Arthritis & Rheumatism 1986; 29: 1039-1049
[104] Altman R, Fries J, Bloch D, Carstens J , Cooke T, Genant D, Gofton P, Groth H, Mcshane D, Murphy W, Sharp J, Spitz P, Williams C, Wolfe F.
Radiographic assessment of progression in osteoarthritis. Arthritis and Rheumatism 1987; 30: 1214-1225
[105] Menkes C. Radiographic criteria for classification of osteoarthritis. Journal of Rheumatology - Supplement 1991; 27: 13-15
[106] Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K, Brown C, Cooke T, Daniel W, Gray R. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hand. Arthritis & Rheumatism 1990; 33: 1601-1610
[107] Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K, Brown C, Cooke T, Daniel W, Feldman D. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip.[comment]. Arthritis & Rheumatism 1991; 34: 505-514
[108] Briggs M, Closs J. A descriptive study of the use of visual analogue scales and verbal rating scales for the assessment of postoperative pain in orthopedic patients. Journal of Pain & Symptom Management 1999; 18: 438-446
[109] Rosier E, Iadarola M, Coghill R. Reproducibility of pain measurement and pain perception. Pain 2002; 98: 205-216
[110] Langley G, Sheeppeard H. Problems associated with pain measurement in arthritis: comparison of visual analogue and verbal rating scale. Clinical &
Experimental Rheumatology 1984; 2: 231-234
[111] Williams A, Davies H, Chadury Y. Simple pain rating scale hide complex idiosyncratic meanings. Pain 2000; 85: 457-463
[112] Jamison R, Gracely R, Raymond S, Levine J, Marino B, Herrmann T, Daly M, Fram D, Katz N. Comparative study of electronic vs. paper VAS ratings: a randomized, crossover trial using healthy volunteers. Pain 2002; 99: 341-347 [113] Collins S, Moore R, McQuay H. The visual analogue pain intensity scale:
what is moderate pain in millimetres? Pain 1997; 72: 95-97
[114] Jensen M. Handbook of pain assessment., Turk D. Guilford, New York, 1992, pp. 135-151
psychometric properties and clinical utility. Journal of Be havioral Medicine 1988; 11: 71-82
[116] Notcutt W, Morgan R. Introducing patient-controlled analgesia for postoperative pain control into a district general hospital. Anaesthesia 1990;
45: 401-406
[117] Briggs M, Closs J. A descriptive study of the use of visual analogue scales and verbal rating scales for the assessment of postoperative pain in orthopedic patients. Journal of Pain & Symptom Management 1999; 18: 438-446
[118] Penny K, Purves A, Smith B, Chambers W, Smith W. Relationship between the chronic pain grade and measures of physical, social and psychological well-being. Pain 1999; 79: 275-279
[119] Melzack R. The McGill pain questionnire: major properties and scoring methods. Pain 1975; 1: 227-299
[120] Melzack R, Torgerson W. On the language of pain. Anaesthesiology 1971; 34:
50-59
[121] Wilkie D, Savedra M, Holzemer W. Use of the McGill pain questionnaire to measure pain: a meta-analysis. Nurs Res 1990; 39: 36-41
[122] Escalante A, Lichtenstein M, Rios N, Hazuda H. Measuring chronic rheumatic pain in Maxican Americans: cross-cultural adaptation of the McGill pain questionnaire. J Clin Epidemiol 1996; 49: 1389-1399
[123] Masedo A, Esteve R. Some empirical evidence regarding the validity of the spanish version of the McGill pain questionnaire. Pain 2000; 85: 451-456
[124] Parker R, Holtmann B, White P. Patient-controlled analgesia dose a concurrent opioid infusion improve pain management after surgery? Journal of the American Medical Association 1991; 226: 1947-1952
[125] Wilkie D, Judge M, Berry D, Zo ng S, Gilespie R. Usability of a computerized PAINReportIt in the general public with pain and people with cancer pain.
Journal of pain and symptom management 2003; 25: 213-224
[126] Weiner D, Pieper C, McConnell E, Martinez S, Keefe F. Pain measurement in elders with chronic low back pain: traditional and alternative approaches. Pain 1996; 67: 461-467
[127] Keefe F, Block A. Development of an observation method for assessing pain behavior in chronic low back pain patients. Behav. Ther. 1982; 13: 363-375
[128] Keefe F, Caldwell D, Queen K, Gil K, Martinez S, Crisson J, Ogden W, Nunley J. Osteoarthritis knee pain: a behavioral analysis. Pain 1987; 28:
309-321
[129] Lewis B, Bellomo R, Lewis D, Cumming G. A clinical procedure for
[130] Bellamy N, Buchanan W, Goldsmith C, Campbell J, Stitt L. Validation study of WOMAC: a health status instrument for measuring clinically- important patient-relevant outcomes following total hip or knee arthroplasty in osteoarthritis. Journal of Orthopaedic Rheumatology 1988; 1: 95-108
[131] Bellamy N, Kean W, Buchanan W, Gerecz-Simon E, Campbell J. Double blind randomized controlled trial of sodium meclofenamate(Meclomen) and Diclofenac sodium(Voltaren): post validation reapplication of the WOMAC osteoarthritis index. The journal of Rheumatology 1992; 19: 153-159
[132] Bellamy N, Buchanan W, Goldsmith C, Campbell J, Stitt L. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. The journal of Rheumatology 1988; 15:
1833-1840
[133] Barr S, Bellamy N, Buchanan W, Chalmers A, Ford P, Kean W, Kraag G, Gerecz-Simon E, Campbell J. A comparative study of signal versus aggregate methods of outcome measurement based on the WOMAC osteoarthritis index.
The journal of Rheumatology 1994; 21: 2106-2112
[134] Jinks C, Jordan K, Croft P. Measuring the population impact of knee pain and disability with the Western Ontario and McMaster Universities osteoarthritis index. Pain 2002; 100: 55-64
[135] Wolfe F. Determinants of WOMAC function, pain and stiffness scores:
evidence for the role of low back pain, symptom counts, fatigue and depression in osteoarthr itis, rheumatoid arthritis and fibromyalgia.
Rheumatology 1999; 38: 355-361
[136] Keele S, Davidson M, Hayes A. Sequential representation and the neural basis of motor skills., Piek J. Human Kinetics, Champaign,IL, 1998, pp. 3-28
[137] Benedetti M, Catani F, Leardini A, Pignotti E, Giannini S. Data management in gait analysis for clinical applications. Clinical Biomechanics 1998; 13:
204-215
[138] Ernst E. Acupuncture as a symptomatic treatment of osteoarthritis. A systematic review. Scandinavian Journal of Rheumatology 1997; 26: 444-447 [139] Gupta S, Francis J, Tillu A, Sattirajah A, Sizer J. The effect of pre-emptive
acupuncture treatment on analgesi requirements after day-case knee arthroscopy. Anaesthesia 1999; 54: 1204-1219
[140] Smith L, Weiss E, Lehmkuhl L. Brunnstrom's Clinical Kinesiology, F. A.
Davis company, Philadelphia, 1996, pp. 404-406
[141] Hasan SS, R. D., Szurkus DC, Ashmead DH, Peterson SW, Shiavi RG,
during upright stance. Part 1: methods. Gait posture 1996; 4: 1-10
[142] Chao E, Laughman R, Schneider E, Stauffer R. Normative data of knee joint motion and ground reaction forces in adult level walkng. Journal of Biomechanics 1983; 16: 219-233
[143] 民國•黃維三：針灸科學，國立編譯館，台北 1995：pp. 366.
[144] 中國中醫研究院針灸研究所：標準針灸穴位圖冊，青島出版社，青島 1997：pp. 130.
[145] 民國•林昭庚：新針灸大成，中國醫藥學院針灸研究中心，台中 1996：
pp. 657-658.
[146] 民國•黃維三：針灸科學，國立編譯館，台北 1995：pp. 279.
[147] 中國中醫研究院針灸研究所：標準針灸穴位圖冊，青島出版社，青島 1997：pp. 140.
[148] 民國•李世珍：常用腧穴臨床發揮，人民衛生出版社，北京 1993：pp.
[156] Whittle M. Musculoskeletal application of three-dimensional analysis., Allord, P., Strokes, I. and Blanchi, J., Human Kinetics, Champaign, IL, 1995, pp.
295-309
[157] Rose G. . Clinical gait asessment: a personal view. Journal of Medical Engineering & Technology 1983; 7: 273-279
[158] Kernozek T, LaMott E. Comparisons of plantar pressures between the elderly and young adults. Gait and posture 1995; 3: 143-148
[159] Wu G, Chiang J. The effects of surface compliance on foot pressure in stance.
Gait and posture 1996; 4: 122-129
[160] Berman B, Singh B, Lao L, Langenberg P, Li H, Hadhazy V, Bareta J, Hochberg M. A randomized trial of acupuncture as an adjunctive therapy in
[161] Cheng R, Pomeranz B. Electroacupuncture anaigesia could be mediated by at least two pain-relieving mechanisms; endorphin and nonendorphin system.
Life Science 1979; 25: 1957-1962
[162] Christensen B, Iuhl I, Vilbek H, Bulow H, Dreijer N, Rasmussen H.
Acupuncture treatment of severe knee osteoarthritis: a long-term study. Acta Anaesthesiologica Scandinavica 1992; 36: 519-525
[163] Tillu A, Tillu S, Vowler S. Effect of acupuncture on knee functio n in advancedosteoarthritis of the knee: a prospective,non-randomised controlled study. Acupuncture in Medicine 2002; 20: 19-21
[164] Ezzo J, Hadhazy V, Birch S, Lao L, Kaplan G., Hochberg M, Berman B.
Acupuncture for osteoarthritis of the knee. Arthritis & Rheumatism 2001; 44:
819-825
[165] 李蘭敏、張立夫、楊會道：電針治療中老年骨性關節炎 165 例。針灸臨
[165] 李蘭敏、張立夫、楊會道：電針治療中老年骨性關節炎 165 例。針灸臨