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Clinical Efficacy of Acupuncture for Knee Osteoarthritis and Associated Changes in Serum Lipidomics: A Prospective Observational Cohort Study.

Journal of pain researchยทFebruary 2026ยทXiaoying Wang, Xiaojie Li, Hui Zhang et al.
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Key Finding

Acupuncture significantly improved pain and function in knee osteoarthritis patients while modulating 218 serum lipid metabolites, with 68 lipids showing reversed trends toward normal levels, suggesting the therapy works through both metabolic restoration and anti-inflammatory mechanisms.

What This Means For You

Researchers in China studied whether acupuncture could help people with knee osteoarthritis, a painful condition where the knee joint gradually deteriorates. They treated 58 patients with knee osteoarthritis using acupuncture at nine specific points on the body, including points around the knee (ST35, EX-LE4, ST36, GB34, SP10, ST34) and other locations like the elbow, ankle, and inner leg. Patients received six acupuncture sessions per week for four weeks, totaling 24 treatments. The study also included 22 healthy people for comparison and analyzed blood samples to understand how acupuncture affects the body's metabolism.

The results were encouraging. After four weeks of treatment, patients experienced significant reductions in both pain levels and improvements in knee function, as measured by standardized questionnaires. Beyond these clinical improvements, researchers discovered that acupuncture changed the levels of specific fats (lipids) in the blood. Before treatment, patients with knee osteoarthritis had abnormal levels of certain lipids compared to healthy people. After acupuncture, many of these lipid levels moved back toward normal ranges.

The researchers identified specific lipid molecules that changed with treatment, including phosphatidylethanolamine (PE), lysophosphatidylcholine (LPC), lysophosphatidylethanolamine (LPE), and triglycerides (TG). These changes suggest that acupuncture may work by reducing inflammation and restoring metabolic balance in the body, not just by providing temporary pain relief. This study adds scientific evidence supporting acupuncture as an effective treatment for knee osteoarthritis, showing measurable improvements in both symptoms and underlying metabolic processes. If you're considering acupuncture for knee osteoarthritis, seek treatment from a licensed acupuncturist trained in traditional point selection.

Clinical Notes for Practitioners

This prospective observational cohort study (n=58 KOA patients, 22 healthy controls) evaluated acupuncture's clinical efficacy and metabolic effects via serum lipidomics using LC-MS/MS. Patients received standardized point prescription (ST35, EX-LE4, ST36, GB34, SP10, ST34, contralateral LI11, KI3, SP6) six sessions weekly for four weeks. Post-treatment, WOMAC and VAS scores decreased significantly (P<0.05). Lipidomics identified 538 differential metabolites between KOA patients and controls, with autophagy and glycerolipid metabolism pathways predominant. Following acupuncture, 218 metabolites changed, including PE (20:1_18:1), LPC (16:0/0:0), and LPE (0:0/18:0), associated with neuroactive ligand-receptor interaction and glycerophospholipid metabolism pathways. Notably, 68 lipids demonstrated reversed trends post-treatment. Key lipid classes affected included phosphatidylethanolamine, lysophosphatidylcholine, lysophosphatidylethanolamine, and triglycerides. Clinical takeaway: Acupuncture provides significant symptomatic relief in KOA while modulating serum lipid metabolism, suggesting dual mechanisms of anti-inflammatory action and metabolic restoration that may explain sustained therapeutic benefits beyond immediate analgesic effects.

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