Acupuncture versus classic placebo medication
inflammation, KOA knee pain, knee pain, KOA
INFLAMMATION
This study found that acupuncture treatment had a better therapeutic effect than placebo medication in knee pain relief for KOA patients. The neuroimaging results showed that the AG exhibited increased vlPAG rs‐FC with the bilateral DLPFC and the right angular compared with the PB group. The acupuncture effect has long been considered a magic placebo in western countries. Although several studies indicate that acupuncture is not a placebo,Studies have shown that endogenous opioid and non‐opioid mechanisms (e.g., dopamine and endocannabinoids) may mediate placebo analgesia.This research had the following drawbacks: (1) each group's sample size was relatively small, preventing us from comparing clinical outcome variations across the different groups; (2) the inflammation and pain‐related variables in the knee joint were not observed and investigated, preventing a comprehensive analysis of acupuncture and celecoxib mechanism for KOA knee pain; (3) the course of acupuncture and celecoxib treatment for KOA patients was relatively too short, which might have influenced the clinical and neuroimaging results; (4) there may have been a risk of bias between the two concurrent trials in this study; (5) neither KOA patients in the celecoxib nor placebo groups received nocebo‐related psychological assessments in this study, which might have a potential impact on the clinical and fMRI results in this study; (6) this study only observed DPMS from the perspective of resting‐state functional connectivity in KOA knee pain patients, and structural connectivity as a topic worth studying in the future; and (7) the fMRI data with cardiac‐gating was not obtained