ReviewJournal of pain research2026
Effects of Warm-Needling Acupuncture Plus Tuina on Inflammatory and Cartilage Biomarkers in Knee Osteoarthritis: A Systematic Review and Meta-Analysis.
Review in Journal of pain research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Knee osteoarthritis (KOA) involves cartilage degeneration and synovial inflammation. Warm-needling acupuncture (WNA) plus Tuina is used clinically, but its systemic and local anti-inflammatory effects, as well as its potential benefits in modulating cartilage metabolism, lack robust evidence. Objective: To systematically evaluate WNA plus Tuina's effects on inflammatory cytokines and cartilage biomarkers in KOA. Methods: We searched 8 databases (PubMed, Embase, Web of Science, Cochrane, CNKI, Wanfang, VIP, SinoMed) to March 2026 for RCTs comparing WNA plus Tuina against single or conventional therapies. Outcomes included IL-1/IL-1β, TNF-α, IL-6, CRP, IL-17, and MMP-3. We used the Cochrane RoB 2.0 tool and GRADE system. Results: A total of 19 RCTs were included. Meta-analysis revealed that compared with the control group, WNA combined with Tuina was associated with reduced systemic inflammation levels, including serum CRP (standardized mean difference [SMD] -2.58, 95% confidence interval [CI] [-4.49, -0.67]), IL-1/IL-1β (SMD -1.73, 95% CI [-3.00, -0.47]), IL-6 (SMD -2.19, 95% CI [-3.38, -0.99]), TNF-α (SMD -1.63, 95% CI [-2.92, -0.34]), and IL-17 (SMD -2.06, 95% CI [-3.49, -0.62]). Within the local joint microenvironment, the combined therapy also showed a greater decrease in synovial fluid IL-1/IL-1β (SMD -0.93) and TNF-α (SMD -1.60). Furthermore, the serum level of MMP-3, a cartilage degradation marker, appeared to be downregulated (SMD -2.77, 95% CI [-3.22, -2.31]). Sensitivity analyses confirmed the robustness of these results. GRADE assessment indicated that the certainty of the evidence ranged from very low to low. Conclusion: WNA combined with Tuina shows potential in reducing local and systemic inflammatory markers in KOA patients and may offer potential benefits in modulating cartilage metabolism. However, limited by the low certainty of current evidence, these findings should be interpreted with caution, and future validation through high-quality, large-scale RCTs is still required.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.