Leibing Eric, Leonhardt Urs, Köster Georg, Goerlitz Anke, Rosenfeldt Joerg André, Hilgers Reinhard, Ramadori Giuliano
Department of Psychosomatics and Psychotherapy, Georg-August-University Goettingen, Goettingen, Germany.
Pain. 2002 Mar;96(1-2):189-96. doi: 10.1016/s0304-3959(01)00444-4.
There is some evidence for the efficacy of acupuncture in chronic low-back pain (LBP), but it remains unclear whether acupuncture is superior to placebo. In a randomized, blinded, placebo-controlled trial, we evaluated the effect of traditional acupuncture in chronic LBP. A total of 131 consecutive out-patients of the Department of Orthopaedics, University Goettingen, Germany, (age=48.1 years, 58.5% female, duration of pain: 9.6 years) with non-radiating LBP for at least 6 months and a normal neurological examination were randomized to one of three groups over 12 weeks. Each group received active physiotherapy over 12 weeks. The control group (n=46) received no further treatment, the acupuncture group (n=40) received 20 sessions of traditional acupuncture and the sham-acupuncture group (n=45) 20 sessions of minimal acupuncture. Changes from baseline to the end of treatment and to 9-month follow-up were assessed in pain intensity and in pain disability, and secondary in psychological distress and in spine flexion, compared by intervention groups. Acupuncture was superior to the control condition (physiotherapy) regarding pain intensity (P=0.000), pain disability (P=0.000), and psychological distress (P=0.020) at the end of treatment. Compared to sham-acupuncture, acupuncture reduced psychological distress (P=0.040) only. At 9-month follow-up, the superiority of acupuncture compared to the control condition became less and acupuncture was not different to sham-acupuncture. We found a significant improvement by traditional acupuncture in chronic LBP compared to routine care (physiotherapy) but not compared to sham-acupuncture. The trial demonstrated a placebo effect of traditional acupuncture in chronic LBP.
有证据表明针灸对慢性下背痛（LBP）有疗效，但针灸是否优于安慰剂仍不清楚。在一项随机、双盲、安慰剂对照试验中，我们评估了传统针灸对慢性LBP的疗效。德国哥廷根大学骨科共有131名连续门诊患者（年龄=48.1岁，女性占58.5%，疼痛持续时间：9.6年），患有非放射性LBP至少6个月且神经学检查正常，在12周内随机分为三组。每组均接受为期12周的积极物理治疗。对照组（n = 46）未接受进一步治疗，针灸组（n = 40）接受20次传统针灸治疗，假针灸组（n = 45）接受20次最小刺激针灸治疗。通过干预组比较，评估从基线到治疗结束以及到9个月随访时疼痛强度、疼痛残疾程度的变化，以及心理困扰和脊柱前屈的次要变化。在治疗结束时，针灸在疼痛强度（P = 0.000）、疼痛残疾程度（P = 0.000）和心理困扰（P = 0.020）方面优于对照条件（物理治疗）。与假针灸相比，针灸仅减轻了心理困扰（P = 0.040）。在9个月随访时，针灸与对照条件相比的优势减弱，且与假针灸无差异。我们发现，与常规护理（物理治疗）相比，传统针灸对慢性LBP有显著改善，但与假针灸相比则没有。该试验证明了传统针灸在慢性LBP中的安慰剂效应。
