Meng C F, Wang D, Ngeow J, Lao L, Peterson M, Paget S
Department of Rheumatology, Hospital for Special Surgery, New York, NY 10021, USA.
Rheumatology (Oxford). 2003 Dec;42(12):1508-17. doi: 10.1093/rheumatology/keg405. Epub 2003 Jul 30.
To determine if acupuncture is an effective, safe adjunctive treatment to standard therapy for chronic low back pain (LBP) in older patients.
The inclusion criteria for subjects were: (i) LBP > or =12 weeks and (ii) age > or =60 yr; the exclusion criteria were (i) spinal tumour, infection or fracture and (ii) associated neurological symptoms. The subjects were randomized to two groups. The control group of subjects continued their usual care as directed by their physicians, i.e. NSAIDs, muscle relaxants, paracetamol and back exercises. Subjects in the acupuncture group in addition received biweekly acupuncture with electrical stimulation for 5 weeks. Outcome was measured by the modified Roland Disability Questionnaire (RDQ) at weeks 0, 2, 6 and 9. The primary outcome measure was change in RDQ score between weeks 0 and 6.
Fifty-five patients were enrolled, with eight drop-outs. Twenty-four subjects were randomized to the acupuncture group and 23 were randomized to the control group. Acupuncture subjects had a significant decrease in RDQ score of 4.1 +/- 3.9 at week 6, compared with a mean decrease of 0.7 +/- 2.8 in the control group (P = 0.001). This effect was maintained for up to 4 weeks after treatment at week 9, with a decrease in RDQ of 3.5 +/- 4.4 from baseline, compared with 0.43 +/- 2.7 in the control group (P = 0.007). The mean global transition score was higher in the acupuncture group, 3.7 +/- 1.2, indicating greater improvement, compared with the score in the control group, 2.5 +/- 0.9 (P < 0.001). Fewer acupuncture subjects had medication-related side-effects compared with the control group.
Acupuncture is an effective, safe adjunctive treatment for chronic LBP in older patients.
确定针灸对于老年慢性下腰痛（LBP）患者而言，是否为标准治疗的一种有效且安全的辅助治疗方法。
受试者的纳入标准为：（i）下腰痛≥12周且（ii）年龄≥60岁；排除标准为（i）脊柱肿瘤、感染或骨折以及（ii）相关神经症状。受试者被随机分为两组。对照组受试者按照医生指示继续其常规治疗，即使用非甾体抗炎药、肌肉松弛剂、对乙酰氨基酚及进行背部锻炼。针灸组受试者另外接受为期5周的每周两次的电针治疗。在第0、2、6和9周通过改良罗兰残疾问卷（RDQ）测量结果。主要结局指标为第0周和第6周之间RDQ评分的变化。
共纳入55例患者，8例退出。24例受试者被随机分配至针灸组，23例被随机分配至对照组。针灸组受试者在第6周时RDQ评分显著降低4.1±3.9，而对照组平均降低0.7±2.8（P = 0.001）。在第9周治疗后长达4周内该效果得以维持，与对照组相比，针灸组RDQ较基线降低3.5±4.4，而对照组为0.43±2.7（P = 0.007）。针灸组的平均总体改善评分更高，为3.7±1.2，表明改善程度大于对照组，对照组评分为2.5±0.9（P < 0.001）。与对照组相比，针灸组出现药物相关副作用的受试者更少。
针灸是老年慢性下腰痛患者一种有效且安全的辅助治疗方法。
