Patients and methods: This study conducted between January 2023 to June 2023, 108 KOA patients (48 males and 60 females; mean age: 61.0±6.8 years; range 43 to 79 years) were randomly divided into the control group and research group. Both groups received basic treatment, including adequate rest and exercise, and oral celecoxib capsules. The research group performed acupuncture operations on the inner knee eye (EX-LE4), outer knee eye (EX-LE5), Yanglingquan (GB34), and Zusanli (ST36). In the control group, three nonacupuncture points were determined for sham acupuncture. The level of Michel Lequesne index of severity for osteoarthritis score, Visual Analog Scale, Lysholm Knee Score Scale, erythrocyte sedimentation rate, C-reactive protein, interleukin (IL)-1β, IL-6, transforming growth factor-beta (TGF-β), insulin-like growth factor-1 (IGF-1), fibroblast growth factor-2 (FGF-2), and p38 mitogen-activated protein kinase (p38 MAPK) were compared before and after treatment.

Results: The reduction of inflammatory markers in the research group was greater than that in the control group after treatment. The levels of cytokines TGF-β, IGF-1, and FGF-2 were significantly increased after treatment, and the levels in the research group were higher than those in the control group during the same period. In addition, p38 MAPK messenger ribonucleic acid (mRNA) was significantly downregulated after treatment, and the level in the research group was lower than that in the control group during the same period.

Conclusion: Acupuncture combined with basic treatment can effectively promote the relief of symptoms and the improvement of knee joint function and effectively inhibit the expression of the p38 MAPK signaling pathway. Keywords : Acupuncture, inflammation, knee osteoarthritis, p38 MAPK signaling pathway