Akupunktur Garuda Indonesia dan Perubahan Kadar Asam Urat pada Pasien Gout Artritis
DOI:
https://doi.org/10.25078/jyk.v9i2.7401Kata Kunci:
akupunktur, Akupunktur Garuda Indonesia, gout artritis, kadar asam uratAbstrak
Gout membutuhkan pengendalian urat yang berkelanjutan, sedangkan bukti mengenai perubahan biomarker urat setelah akupunktur masih belum konsisten. Penelitian ini menilai perubahan kadar asam urat darah sebelum dan sesudah tiga sesi Akupunktur Garuda Indonesia (GI) menggunakan desain satu kelompok dengan pengukuran berulang. Data lengkap tersedia pada 24 peserta berusia 20–58 tahun (rerata 35,2±10,3 tahun), terdiri atas 15 perempuan (62,5%) dan 9 laki-laki (37,5%). Ketiga sesi dipisahkan oleh interval 6 hari, dan kadar asam urat diperiksa 30 menit sebelum serta 10 menit sesudah setiap sesi menggunakan EasyTouch® GCU ET-301 pada darah kapiler utuh. Analisis mencakup statistik deskriptif, linear mixed-effects model, uji t berpasangan dengan koreksi Holm, analisis sensitivitas Wilcoxon, dan Cohen’s dz. Rerata pre-post berubah dari 6,16±1,78 menjadi 5,85±1,63 mg/dL pada Sesi 1; 6,19±1,50 menjadi 5,86±1,33 mg/dL pada Sesi 2; dan 6,00±1,60 menjadi 5,73±1,44 mg/dL pada Sesi 3. Penurunan rerata masing-masing sesi adalah 0,304 mg/dL (IK 95% 0,116–0,492), 0,325 mg/dL (IK 95% 0,150–0,500), dan 0,271 mg/dL (IK 95% 0,098–0,444). Model campuran memperkirakan penurunan keseluruhan 0,300 mg/dL (IK 95% 0,204–0,396; p<0,001), tanpa bukti perbedaan efek antar-sesi (p interaksi=0,901). Pada setiap sesi, 19 dari 24 peserta menunjukkan penurunan. Pola ini konsisten secara statistik, tetapi perubahan absolutnya kecil dan hanya mencerminkan perubahan jangka sangat pendek yang dinilai 10 menit pascasesi. Karena penelitian tidak memiliki kelompok kontrol, prosedur rekrutmen tidak terdokumentasi secara rinci, status hidrasi tidak distandardisasi, profil komorbiditas tidak dikumpulkan secara sistematis, dan fungsi ginjal tidak diperiksa, temuan ini bersifat eksploratif dan tidak membuktikan kausalitas maupun pengendalian gout jangka panjang.
Referensi
Agustina, R., & Soemardji, A. A. (2016). Efektivitas akupunktur ‘GI’ terhadap pengobatan stres pada pasien di Klinik Akupunktur Sukamenak dan UPT Layanan Kesehatan Bumi Medika Ganesa ITB. Jurnal Sains dan Kesehatan, 1(5), 251-262. https://doi.org/10.25026/jsk.v1i5.47
Agustina, R., Soemardji, A. A., Fanty, F., & Amalia, L. (2019). Review: Study the role of China acupuncture and ‘GI’ acupuncture as an alternative and complementary therapy in the treatment. Journal of Tropical Pharmacy and Chemistry, 4(6), 311-318. https://doi.org/10.30872/j.trop.pharm.chem.v4i6.196
Ahn, E. Y., & So, M. W. (2025). The pathogenesis of gout. Journal of Rheumatic Diseases, 32(1), 8-16. https://doi.org/10.4078/jrd.2024.0054
Bäumler, P., Zhang, W., Stübinger, T., & Irnich, D. (2021). Acupuncture-related adverse events: Systematic review and meta-analyses of prospective clinical studies. BMJ Open, 11(9), e045961. https://doi.org/10.1136/bmjopen-2020-045961
Dai, K.-S., Tai, D.-Y., Ho, P., Chen, C.-C., Peng, W.-C., Chen, S.-T., ... Mao, S. J. T. (2005). An evaluation of clinical accuracy of the EasyTouch blood uric acid self-monitoring system. Clinical Biochemistry, 38(3), 278-281. https://doi.org/10.1016/j.clinbiochem.2004.11.005
Dalbeth, N., Gosling, A. L., Gaffo, A., & Abhishek, A. (2021). Gout. The Lancet, 397(10287), 1843-1855. https://doi.org/10.1016/S0140-6736(21)00569-9
Dou, B., Li, Y., Ma, J., Xu, Z., Fan, W., Tian, L., ... Lin, X. (2021). Role of neuroimmune crosstalk in mediating the anti-inflammatory and analgesic effects of acupuncture on inflammatory pain. Frontiers in Neuroscience, 15, 695670. https://doi.org/10.3389/fnins.2021.695670
Fan, Y., Zhu, C., Ji, Y., Peng, J., Wang, G., Wan, R., & Liu, W. (2024). Comparison of efficacy of acupuncture-related therapies in treating acute gouty arthritis: A network meta-analysis of randomized controlled trials. Heliyon, 10(7), e28122. https://doi.org/10.1016/j.heliyon.2024.e28122
FitzGerald, J. D., Dalbeth, N., Mikuls, T., Brignardello-Petersen, R., Guyatt, G., Abeles, A. M., ... Neogi, T. (2020). 2020 American College of Rheumatology guideline for the management of gout. Arthritis Care & Research, 72(6), 744-760. https://doi.org/10.1002/acr.24180
GBD 2021 Gout Collaborators. (2024). Global, regional, and national burden of gout, 1990-2020, and projections to 2050: A systematic analysis of the Global Burden of Disease Study 2021. The Lancet Rheumatology, 6(8), e507-e517. https://doi.org/10.1016/S2665-9913(24)00117-6
Goo, B., Lee, G., Cho, F. Y., Lee, D. M., & Park, Y. C. (2023). Acupuncture for gouty arthritis: A systematic review and meta-analysis of randomized controlled trials. European Journal of Integrative Medicine, 61, 102265. https://doi.org/10.1016/j.eujim.2023.102265
Hao, S. H., Ye, L. Y., & Yang, C. (2023). The landscape of pathophysiology guided therapeutic strategies for gout treatment. Expert Opinion on Pharmacotherapy, 24(18), 1993-2003. https://doi.org/10.1080/14656566.2023.2291073
Huang, Y., Meng, J., Sun, B., Xiang, T., Zhou, X., Xu, B., ... Zhang, S. (2017). Acupuncture for serum uric acid in patients with asymptomatic hyperuricemia: A randomized, double-blind, placebo-controlled trial. International Journal of Cardiology, 232, 227-232. https://doi.org/10.1016/j.ijcard.2017.01.016
Hwang, J. H., Song, A., & Song, H. S. (2022). Systematic review and meta-analysis of efficacy and safety of fire needling and warm needling on acute gout. Journal of Pharmacopuncture, 25(4), 301-316. https://doi.org/10.3831/KPI.2022.25.4.301
Kim, S. H., Shin, J., Son, H.-E., & Kang, D.-H. (2026). Role of urate transporters in the kidneys and intestine in uric acid homeostasis. Kidney Research and Clinical Practice, 45(3), 296-313. https://doi.org/10.23876/j.krcp.24.321
Leask, M. P., Crișan, T. O., Ji, A., Matsuo, H., Köttgen, A., & Merriman, T. R. (2024). The pathogenesis of gout: Molecular insights from genetic, epigenomic and transcriptomic studies. Nature Reviews Rheumatology, 20(8), 510-523. https://doi.org/10.1038/s41584-024-01137-1
Li, N., Guo, Y., Gong, Y., Zhang, Y., Fan, W., Yao, K., ... Lyu, Z. (2021). The anti-inflammatory actions and mechanisms of acupuncture from acupoint to target organs via neuro-immune regulation. Journal of Inflammation Research, 14, 7191-7224. https://doi.org/10.2147/JIR.S341581
Lin, J., Liu, J., O’Fee, A., Pandey, C., Benna-Doyle, S., Maunder, A., ... Ee, C. (2024). The effectiveness and safety of lifestyle medicine and integrative therapies in inflammatory arthritis: An umbrella review using a hierarchical evidence gathering approach. Frontiers in Medicine, 11, 1357914. https://doi.org/10.3389/fmed.2024.1357914
Liu, S., Wang, Z., Su, Y., Qi, L., Yang, W., Fu, M., ... Ma, Q. (2021). A neuroanatomical basis for electroacupuncture to drive the vagal-adrenal axis. Nature, 598, 641-645. https://doi.org/10.1038/s41586-021-04001-4
MacPherson, H., Altman, D. G., Hammerschlag, R., Li, Y., Wu, T., White, A., & Moher, D. (2010). Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): Extending the CONSORT statement. Acupuncture in Medicine, 28(2), 83-93. https://doi.org/10.1136/aim.2009.001370
National Institute for Health and Care Excellence. (2022). Gout: Diagnosis and management (NG219). https://www.nice.org.uk/guidance/ng219
Ni, Z., Xiao, Q., Xia, Z., Kuang, K., Yin, B., & Peng, D. (2024). Electroacupuncture for acute gouty arthritis: A systematic review and meta-analysis of randomized controlled trials. Frontiers in Immunology, 14, 1295154. https://doi.org/10.3389/fimmu.2023.1295154
Son, C.-N., Stewart, S., Su, I., Mihov, B., Gamble, G., & Dalbeth, N. (2021). Global patterns of treat-to-serum urate target care for gout: Systematic review and meta-analysis. Seminars in Arthritis and Rheumatism, 51(4), 677-684. https://doi.org/10.1016/j.semarthrit.2021.04.011
Wang, Y.-R., Liu, C.-Z., Cong, Y., Xi, Y.-W., Xu, Y.-Y., Li, B., ... Shi, G.-X. (2025). Acupuncture as an adjunctive therapy to etoricoxib for patients with acute gouty arthritis: Protocol for a multicenter randomized controlled trial. Journal of Pain Research, 18, 2889-2900. https://doi.org/10.2147/JPR.S523657
Wei, H., Liu, B., Yin, C., Zeng, D., Nie, H., Li, Y., ... Liu, B. (2023). Electroacupuncture improves gout arthritis pain via attenuating ROS-mediated NLRP3 inflammasome overactivation. Chinese Medicine, 18(1), 86. https://doi.org/10.1186/s13020-023-00800-1
Yu, L.-L., Li, C.-N., Fang, M.-Y., Ma, Y., Wang, B., Lin, F.-P., ... Wang, Y. (2023). Evaluating the effectiveness and safety of acupuncture on serum uric acid in asymptomatic hyperuricemia population: A randomized controlled clinical trial study protocol. Frontiers in Endocrinology, 14, 1218546. https://doi.org/10.3389/fendo.2023.1218546
