Acupuncture as a disease modifying therapy for the treatment in remission stage of neuromyelitis optics spectrum disorders

INTERVENTION: Participants are randomised to one of two groups using a computerised random number table. Intervention group: Participants are treated with oral azathioprine at a dose of 2mg/Kg‐D for three months in addition to receiving manual acupuncture three times a week, two weeks a month. Accupoints used include: Jiaji acupoints: back to the first thoracic lumbar spine to the fifth lumbar spine on both sides, after the middle of the midline beside 0.5 inches, one side of the 17 points, a total of 34 points on both sides Hand and foot twelve acupoints: ShangWan, ZhongWan, XiaWan, TianShu, GuanYuan, NeiGuan, ZuSanLi Add acupuncture points according to the accompanying symptoms: Decreasing of visual acuity : CuanZhu , JingMing, fengchi , QiuHou, GuangMing Dysphagia : LianQuan , FengChi , WanGu, YiFeng Urinary disorders : ShuiDao, Cilia, Zhongji Dysphoria: Tianshu, Zhongwan, Qihai Control group: Participants are treated with oral azathioprine at a dose of 2mg/Kg‐D for three months only. Participants in both groups are followed up after three months, six months and one year. CONDITION: Neuromyelitis optics spectrum disorders of remitting stage ; Nervous System Diseases ; Neuromyelitis optics spectrum disorders of remitting stage PRIMARY OUTCOME: Disability is measured using the Expanded disability scale score at baseline, 3, 6 and 12 months. SECONDARY OUTCOME: 1. AQP4‐IgG level is measured using cell transfection method at baseline and 3 months; 2. Annual relapse rate is measured using computer formula at baseline, 3, 6 and 12 months INCLUSION CRITERIA: 1. Diagnosis of neuromyelitis optics spectrum disorders in accordance with NMOSDs diagnostic criteria established by the international panel for NMO diagnosis (IPND) in 2015. 2. In remission stage (no acute progress, no corticosteroid therapy or immunoglobulin therapy, plasma exchange, stable condition without relapse signs) 3. Age of 18‐75 years old 4. EDSS score less than 5 5. No other treatment with immunosuppressive drugs within 6 months or no other immunosuppressive drugs other than azathioprine 6. Provision of informed consent