Joos Stefanie, Brinkhaus Benno, Maluche Christa, Maupai Nathalie, Kohnen Ralf, Kraehmer Nils, Hahn Eckhart G, Schuppan Detlef
Department of Medicine I-Gastroenterology, Research Group for Alternative Medicine, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany.
Digestion. 2004;69(3):131-9. doi: 10.1159/000078151. Epub 2004 Apr 26.
Acupuncture has traditionally been used in the treatment of inflammatory bowel disease in China and is increasingly being applied in Western countries. The purpose of this study was to investigate the efficacy of acupuncture in the treatment of active Crohn's disease (CD).
A prospective, randomized, controlled, single-blind clinical trial was carried out to analyze the change in the CD activity index (CDAI) after treatment as a main outcome measure, and the changes in quality of life and general well-being, serum markers of inflammation (alpha(1)-acid glycoprotein, C-reactive protein) as secondary outcome measures. 51 patients with mild to moderately active CD were treated in a single center for complementary medicine by three trained acupuncturists and randomly assigned to receive either traditional acupuncture (TCM group, n = 27) or control treatment at non-acupuncture points (control group, n = 24). Patients were treated in 10 sessions over a period of 4 weeks and followed up for 12 weeks.
In the TCM group the CDAI decreased from 250 +/- 51 to 163 +/- 56 points as compared with a mean decrease from 220 +/- 42 to 181 +/- 46 points in the control group (TCM vs. control group: p = 0.003). In both groups these changes were associated with improvements in general well-being and quality of life. With regard to general well-being, traditional acupuncture was superior to control treatment (p = 0.045). alpha(1)-acid glycoprotein concentration fell significantly only in the TCM group (p = 0.046).
Apart from a marked placebo effect, traditional acupuncture offers an additional therapeutic benefit in patients with mild to moderately active CD.
在中国,针灸传统上一直用于治疗炎症性肠病,并且在西方国家的应用也日益增多。本研究的目的是调查针灸治疗活动期克罗恩病(CD)的疗效。
开展一项前瞻性、随机、对照、单盲临床试验,以分析治疗后克罗恩病活动指数(CDAI)的变化作为主要结局指标,生活质量和总体幸福感的变化、炎症血清标志物(α1-酸性糖蛋白、C反应蛋白)作为次要结局指标。51例轻至中度活动期CD患者在一个单一中心由三名经过培训的针灸师进行补充医学治疗,并随机分配接受传统针灸治疗(中医组,n = 27)或非穴位对照治疗(对照组,n = 24)。患者在4周内接受10次治疗,并随访12周。
中医组CDAI从250±51降至163±56分,而对照组平均从220±42降至181±46分(中医组与对照组比较:p = 0.003)。两组的这些变化均与总体幸福感和生活质量的改善相关。在总体幸福感方面,传统针灸优于对照治疗(p = 0.045)。仅中医组α1-酸性糖蛋白浓度显著下降(p = 0.046)。
除了显著的安慰剂效应外,传统针灸对轻至中度活动期CD患者还具有额外的治疗益处。