Ernst E, Pittler M H
Department of Complementary Medicine, School of Postgraduate Medicine and Health Sciences, University of Exeter, United Kingdom.
J Manipulative Physiol Ther. 1999 Feb;22(2):87-90. doi: 10.1016/s0161-4754(99)70112-0.
Complementary/alternative therapies are used for low back pain more frequently than for any other indication, yet evidence for or against their efficacy is fragmentary. Notwithstanding this void, the high prevalence of such therapies drives their integration into our health care systems. Expert opinions on the use of complementary/alternative therapies for low back pain could therefore be helpful until more data from randomized, controlled trials become available.
A postal questionnaire survey was designed to generate opinion from a systematically identified expert panel on the clinical effectiveness of complementary/alternative therapies for low back pain.
Computerized searches were conducted to systematically identify by objective criteria 50 clinical experts on low back pain. Each panel member received a questionnaire to assess the perceived clinical effectiveness of complementary/alternative therapies for 4 defined categories of low back pain.
For acute uncomplicated low back pain, osteopathy and chiropractic were rated as effective by most experts. For chronic uncomplicated low back pain, most experts considered acupuncture as effective. Experts perceived homeopathy generally as ineffective for any type of low back pain. Clinical experience with herbalism as a treatment for low back pain was insufficient to form an opinion.
Experts' opinion is in favor of the effectiveness of osteopathy and chiropractic for acute uncomplicated low back pain. Acupuncture is judged to be of some value for chronic, uncomplicated low back pain. Homeopathy is perceived as ineffective for any type of low back pain. Insufficient experience with herbalism as a treatment for low back pain prevents firm conclusions.
补充/替代疗法用于治疗腰痛的频率高于其他任何适应症，但支持或反对其疗效的证据并不完整。尽管存在这一空白，但此类疗法的高普及率促使它们融入我们的医疗保健系统。因此，在获得更多来自随机对照试验的数据之前，关于使用补充/替代疗法治疗腰痛的专家意见可能会有所帮助。
设计一项邮寄问卷调查，以收集一个经系统确定的专家小组对补充/替代疗法治疗腰痛的临床有效性的意见。
通过计算机检索，根据客观标准系统地确定了50名腰痛临床专家。每位小组成员都收到一份问卷，以评估补充/替代疗法对4种已定义类型的腰痛的感知临床有效性。
对于急性非复杂性腰痛，大多数专家认为整骨疗法和脊椎按摩疗法有效。对于慢性非复杂性腰痛，大多数专家认为针灸有效。专家们普遍认为顺势疗法对任何类型的腰痛均无效。草药疗法治疗腰痛的临床经验不足，无法形成定论。
专家意见支持整骨疗法和脊椎按摩疗法对急性非复杂性腰痛的有效性。针灸被认为对慢性非复杂性腰痛有一定价值。顺势疗法被认为对任何类型的腰痛均无效。草药疗法治疗腰痛的经验不足，无法得出确切结论。
