What is gouty arthritis?

Gouty arthritis is a form of inflammatory arthritis caused by the build-up of uric acid crystals in a joint. When the body cannot efficiently manage uric acid, tiny crystals can collect in the joint space and surrounding tissues, triggering sudden episodes of intense pain, swelling, warmth, and redness.

Many people describe an acute gout attack as one of the most painful experiences they have ever had. Over time, repeated flare-ups can damage the joints and affect daily activities, sleep, and mood.

Conventional treatments usually include non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, corticosteroids, and long-term urate-lowering therapies. These are important and should not be stopped without guidance from a medical doctor. At the same time, some patients look for additional, non-drug options to help manage pain and support recovery.

Why consider acupuncture for gout?

Acupuncture has been used for centuries in East Asian medicine to help with painful and inflammatory conditions. Modern scientific studies suggest that acupuncture can influence pain pathways, local circulation, and immune responses. For gouty arthritis in particular, several clinical trials and systematic reviews have explored how acupuncture may:

• Reduce the intensity of joint pain during acute attacks
• Shorten the duration of painful episodes
• Improve swelling, warmth, and mobility of the affected joint
• Support better laboratory markers, such as inflammatory indicators
• Cause fewer medication-related side effects when used as a complement

The article “Acupuncture for gouty arthritis: a PRISMA-compliant protocol for a systematic review and meta-analysis of randomized controlled trials” by Lee et al. (2020) outlines how researchers plan to comprehensively evaluate these clinical studies and synthesize the evidence on acupuncture for gouty arthritis.

How is the research being conducted?

The 2020 article by Lee and colleagues is a research protocol. This means it describes in detail how the systematic review and meta-analysis will be carried out, before the actual data analysis is completed. This approach helps improve transparency and reduces bias.

In their protocol, the authors plan to:

• Search multiple international databases for randomized controlled trials of acupuncture for gouty arthritis (in English, Korean, and Chinese).
• Include trials that compare acupuncture with conventional treatment, or acupuncture plus conventional treatment versus conventional treatment alone.
• Focus primarily on pain intensity, and also look at pain relief duration, “total effective rate,” uric acid levels, inflammatory markers, and adverse events.
• Assess the quality of each trial using standard tools for risk of bias.

This protocol builds on earlier systematic reviews (2013, 2016) which suggested that acupuncture may be helpful for gout, but also highlighted problems such as small sample sizes and inconsistent study quality. By updating and refining the evidence, the authors aim to clarify how strong the support for acupuncture really is.

What have previous clinical studies found?

Earlier systematic reviews of acupuncture for gouty arthritis have analyzed dozens of clinical trials. In many of these studies, acupuncture was compared with standard medications alone, or used alongside them. Overall, the results suggest that acupuncture:

• Can reduce pain intensity and improve joint function during acute flare-ups.
• May lower serum uric acid and certain inflammatory markers in some patients.
• May be associated with fewer side effects compared with some drug-only regimens.

At the same time, many of the included trials have limitations, such as small sample sizes, short follow-up periods, or incomplete reporting. Because of this, authors of these reviews recommend interpreting the results cautiously and call for more rigorously designed, larger randomized trials.

What does acupuncture treatment for gouty arthritis look like?

In the clinical literature, different acupuncture methods have been used for gout, including manual acupuncture, electroacupuncture, acupotomy, and fire-needling techniques. Treatment is individualized, but some patterns can be observed across studies:

• Local and adjacent points near the painful joint, sometimes including tender “Ashi” points.
• Channel-regulating points such as ST36, SP6, SP9, GB34, LR3, and LI11, which in traditional Chinese medicine are linked to circulation, dampness, and heat.
• Frequency and duration often range from once daily to several times per week, for one to two weeks in acute attacks.

In practice, a Registered Acupuncturist will assess not only the painful joint but also your overall pattern (sleep, digestion, stress, other health conditions) and then select point combinations and techniques that match your situation and sensitivity.

How might acupuncture help from a biomedical perspective?

Modern research suggests several potential mechanisms for acupuncture in gouty arthritis and other painful inflammatory conditions:

• Modulating pain pathways: Acupuncture can stimulate nerve fibers and influence the way pain signals are processed in the spinal cord and brain. Endogenous opioids and monoamines such as serotonin and norepinephrine are believed to be involved.
• Regulating inflammation: Experimental studies indicate that acupuncture may reduce key inflammatory mediators and modulate immune cell activity.
• Improving microcirculation: By enhancing local blood flow, acupuncture may support the removal of inflammatory by-products and relieve tissue tension.
• Supporting overall balance: In traditional East Asian medicine terms, acupuncture addresses patterns such as “damp-heat,” “phlegm,” or “blood stasis,” which may connect joint symptoms with digestion, metabolism, and lifestyle.

Safety, limitations, and how to use this information

In the clinical studies reviewed so far, acupuncture has generally been well tolerated. The most common side effects are minor and temporary, such as slight bruising or local soreness at the needle site. Serious complications are rare when treatment is provided by a trained and licensed practitioner.

At the same time, it is important to emphasize that acupuncture does not replace medical care for gout. Because gout is closely tied to uric acid metabolism and may affect the kidneys, heart, and other systems, you should:

• Work with your family doctor or specialist to manage medications and monitor blood tests.
• Use acupuncture as a complementary therapy for pain relief, recovery, and quality of life.
• Discuss any sudden or severe symptoms with a medical doctor promptly.

The protocol by Lee et al. and earlier systematic reviews are valuable steps toward clarifying the evidence. As more high-quality trials are completed, we will have a clearer picture of exactly how acupuncture fits into the overall management of gouty arthritis.

How Jade Health Acupuncture approaches gouty arthritis

In our clinic, acupuncture for gouty arthritis is provided in a calm, individualized setting. Treatment plans are designed to support both the painful joint and your overall balance, and can be coordinated with your existing medical care. If you have questions about whether acupuncture may be suitable for your situation, you are welcome to discuss this during a consultation.

References (English)

1. Lee G, Cho FY, Goo B, Park YC. Acupuncture for gouty arthritis: A PRISMA-compliant protocol for a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2020;99(49):e23527. PMCID: PMC7717824.
2. Lu WW, Zhang JM, Lv ZT, Chen AM. Update on the clinical effect of acupuncture therapy in patients with gouty arthritis: systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine. 2016;2016:9451670.

什麼是「痛風性關節炎」？

痛風性關節炎是由於體內尿酸代謝失衡，單鈉尿酸結晶沉積在關節腔與周邊組織， 所引起的一種發炎性關節炎。當結晶刺激關節時，就會突然出現劇烈疼痛、 紅腫、發熱與觸痛。

很多患者形容，急性痛風發作的疼痛強度幾乎難以忍受。若發作反覆出現， 也可能造成關節結構受損，影響走路、穿鞋、睡眠與情緒。

現代醫學的治療主要包括非類固醇消炎止痛藥（NSAIDs）、秋水仙素、 類固醇，以及長期降尿酸藥物等。這些治療非常重要，不應自行停藥。 同時，也有不少患者希望在醫師治療之外，多一個 溫和、非藥物的輔助選項，協助舒緩疼痛、促進恢復， 這時就會想到針灸。

為什麼會有人考慮以針灸輔助治療痛風？

在東亞傳統醫學裡，針灸長期被用來處理疼痛性與發炎性問題。 現代研究也發現，針灸可以調節疼痛傳導、局部血流與免疫反應。 對於痛風性關節炎，已有多篇臨床試驗與系統性回顧報告指出， 針灸可能有助於：

• 降低急性發作時的關節疼痛強度
• 縮短疼痛與紅腫持續的時間
• 改善關節活動度與日常功能
• 調整部分發炎指標與尿酸相關檢驗值
• 在與藥物併用時，可能減少部分藥物副作用的困擾

由 Lee 等人於 2020 年發表的 「Acupuncture for gouty arthritis」 一文， 是一篇針對痛風性關節炎針灸治療的 系統性回顧與統合分析（meta-analysis）研究計畫書（protocol）。 也就是說，作者在正式分析數據之前，就先公開他們的搜尋、納入與分析方法， 以提高透明度與研究品質。

這項研究計畫是如何設計的？

這篇文章本身並不是單一臨床試驗，而是說明研究團隊將如何 系統性整理所有相關臨床試驗。作者計畫：

• 在多個國際與亞洲資料庫中，搜尋以英語、韓語與中文發表的隨機對照試驗。
• 納入「針灸 VS. 傳統治療」或「針灸＋傳統治療 VS. 單純傳統治療」的研究。
• 以疼痛強度為主要結果，並觀察疼痛緩解時間、總有效率、血中尿酸、 發炎指標與不良反應等。
• 使用國際公認的工具評估各篇試驗的偏差風險與方法學品質。

在此之前，2013 年與 2016 年已經有兩篇系統性回顧指出， 針灸對痛風性關節炎呈現正向效果，但受限於樣本數不大、 研究品質不一致等問題，結論仍需謹慎解讀。 Lee 等人的研究計畫，正是希望在此基礎上， 更完整地更新與整合新的臨床證據。

以往臨床研究大致看到什麼結果？

先前的系統性回顧分析了數十篇有關痛風性關節炎的針灸臨床試驗。 在許多試驗中，研究者將針灸與常規藥物比較，或將針灸與藥物併用。 整體而言，這些研究多半顯示：

• 針灸可以幫助減少疼痛強度，提升急性期關節活動度。
• 在部分研究中，患者的血中尿酸值與某些發炎指標也有所改善。
• 以不良反應來看，針灸組通常比藥物單獨治療組更為溫和、安全。

不過，由於許多試驗存在樣本數偏小、追蹤時間短、 報告內容不完整等限制，作者們也提醒， 雖然結果傾向支持針灸，但仍需要更高品質、 大規模的隨機對照試驗來確認療效。

臨床上常見的針灸治療方式與選穴思路

在文獻中，治療痛風的針灸方式相當多樣， 包括傳統針刺、电針、刀針與火針等。雖然每位患者的治療方案會量身調整， 但可以看到一些共同的設計方向：

• 局部與鄰近穴位：在痛風關節周圍尋找壓痛點（阿是穴）， 搭配附近經絡的經穴。
• 調和氣血與「濕熱」的經穴：例如足三里、三陰交、 陰陵泉、陽陵泉、太衝、曲池等，在傳統醫學理論中與 「運化水濕、清熱、活血」有關。
• 治療頻率與療程：急性期常見為每天一次， 或每週數次，持續一至兩週，視發作情況調整。

在實際臨床上，合格的針灸師除了評估疼痛的關節， 也會一起考量睡眠、消化、生活壓力與既有慢性病等， 再依照個體體質、耐受度與就診頻率來調整針灸方式與選穴。

從現代醫學角度看，針灸可能如何影響痛風？

目前的實驗與臨床研究指出，針灸在處理痛風性關節炎與其他疼痛、 發炎性疾病時，可能涉及下列機制：

• 調節疼痛傳導：針刺可刺激周邊神經末梢， 影響脊髓與中樞神經對疼痛訊號的處理，並促進體內啡肽、 血清素與正腎上腺素等物質的釋放。
• 調節發炎反應：實驗研究顯示， 針灸可能降低部分發炎細胞激素與免疫細胞活性， 有助於減緩關節局部的「火勢」。
• 改善微循環：透過改善局部血流， 針灸可能促進代謝產物與發炎物質的清除，緩解壓力與腫脹。
• 全身調整：在中醫理論中， 痛風常被歸為「濕熱、痰濁、瘀血」等體質與飲食、壓力相關。 針灸透過經絡系統調整整體狀態，而不只是針對單一關節。

安全性、限制與你可以如何運用這些資訊

目前臨床文獻中，針灸大多被認為是安全性良好的治療方式。 最常見的不良反應是短暫的針刺酸脹感、輕微瘀青或局部痠軟， 通常在短時間內便會消退。由合格、受訓完備的針灸師操作時， 嚴重併發症相當少見。

不過，必須強調的是，針灸 不是 取代醫療的唯一治療方式。 由於痛風與尿酸代謝、腎臟與心血管健康息息相關，你仍然需要：

• 按照家庭醫師或專科醫師的建議，規律追蹤血液檢查與使用藥物。
• 將針灸視為輔助療法，用來協助減輕疼痛、改善生活品質與恢復速度。
• 若出現突發嚴重症狀（例如高燒、劇痛、疑似感染或全身不適）， 應優先聯繫西醫尋求急性醫療處置。

Lee 等人的研究計畫以及過去的統合分析， 為「針灸治療痛風性關節炎」提供了重要的學術基礎。 隨著更多高品質臨床試驗完成，我們也會對針灸在痛風整體照護中 所扮演的角色，有愈來愈清楚的認識。

Jade Health Acupuncture 對痛風性關節炎的照護方向

在本診所，痛風相關的針灸治療會以 平靜、細緻與個別化 為核心。 我們會同時關注急性發作時的疼痛與腫脹，也會評估飲食、 睡眠、壓力與其他慢性疾病，並與你的家庭醫師或專科醫師合作。 若你想了解針灸是否適合自己的痛風情況， 歡迎在諮詢時與我們討論。

參考文獻（中文說明）

1. Lee G, Cho FY, Goo B, Park YC. Acupuncture for gouty arthritis: A PRISMA-compliant protocol for a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2020;99(49):e23527. PMCID: PMC7717824.
2. Lu WW, Zhang JM, Lv ZT, Chen AM. Update on the clinical effect of acupuncture therapy in patients with gouty arthritis: systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine. 2016;2016:9451670.