OBJECTIVE: To analysis the mechanism, method and effect of Chinese herbs, massage and acupuncture for treating knee osteoarthritis. DATA SOURCES: We researched the Medline database in English from January 1986 to March 2006 and CNKI full text database as well as Chinese outstanding papers for doctors and masters in Chinese from January 2000 to March 2006 for related articles with the terms of 'knee osteoarthritis, Chinese herbs, massage, acupuncture'. STUDY SELECTION: The articles including controls and treatment group were selected to look up the full texts, and the non-randomized studies were excluded. Inclusion criteria: (1) randomized controlled research; (2) experimental or clinical study involving parallel control group; (3) knee osteoarthritis group, treated with Chinese herbs, massage and acupuncture. Exclusion criteria: repetitive study. DATA EXTRACTION: Totally 276 randomized or non-randomized articles were collected on treatments of Chinese herbs, massage and acupuncture for knee osteoarthritis, and 23 experimental or clinical studies met the inclusion criteria. Among the 253 deleted articles, 231 ones were non-randomized studies or duplicated articles, and 22 ones were reviews. DATA SYNTHESIS: There were 440 experimental animals and 410 patients involved in 23 trials, which confirmed that Chinese herbs could protect cartilage function, prevent the degeneration of articular cartilage; reduce the intraosseous pressure, improve microcirculation of bone; inhibit oxygen-derived free radical injury, increase the activity of superoxide dismutase (SOD), and restrain nitrogen monoxide; inhibit synovitis, decrease serum hyaluronic acid (HA) and regulate the level of abnormal cell factor; accommodate sex hormone, etc. Chinese herbs, massage and acupuncture were effective for treating knee osteoarthritis. CONCLUSION: It is evident that Chinese herbs, massage and acupuncture are effective for knee osteoarthritis. Both or more combined therapy may enhance the clinical effects.

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