Objective To examine the clinical benefits of acupuncture combined with intra-articular injection of sodium hyaluronate for knee osteoarthritis(KOA)patients.Methods A total of 150 KOA patients were randomized into simple medication and acupuncture plus medication(combined treatment)groups(n=75 in each).For all the patients

intra-articular injection of sodium hyaluronate(2 mL)was performed once a week for 5 weeks

and for patients of the combined treatment group

filiform needles were separately inserted into unilateral or bilateral Zusanli(ST 36)

Liangqiu(ST 34)

Yanglingquan(GB 34)

Yinlingquan(SP 9)

Xiyangguan(GB 33)

Dubi(ST 35)

Neixiyan(EX-LE 4)and Xuehai(SP 10)according to the focus

and manipulated with the uniform reinforcing and reducing technique

followed by retaining the needles for 30 min.The acupuncture treatment was given once every day or every other day

5 weeks in total.The visual analog scale(VAS)was used to assess the pain severity of kneejoint

and the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)employed to assess the 1)pain severity during various positions or movements(20 points)

2)severity of joint stiffness(8 points)

and 3)difficulty in performing daily functional activities(68 points).The therapeutic effect was evaluated according to the decreased level of WOMAC subscale scores and improvement of daily activities.Results After the treatment

the VAS scores of both medication and combined treatment groups were decreased significantly in comparison with their own pre-treatment in each group(P<0.05)

and that of the combined treatment group was significantly lower than that of the medication group(P<0.05).WOMAC and daily activity findings showed that of the two 75 KOA patients in the medication and combined treatment groups

16(21.33%)and 32(42.67%)experienced marked improvement

46(61.33%)and 38(50.67%)were improved

and 13(17.33%)and 5(6.67%)ineffective

with the total effective rates being 82.67% and 93.33%

respectively.The therapeutic effect of the combined treatment group was apparently superior to that of the simple medication group(P<0.05).Conclusion Acupuncture combined with intraarticular injection of sodium hyaluronate is effective in improving KOA patients' pain severity and other symptoms as well as functional activities.