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一项关于针灸治疗儿童持续性变应性鼻炎的双盲、随机、安慰剂对照试验。

A double-blind, randomized, placebo-controlled trial of acupuncture for the treatment of childhood persistent allergic rhinitis.

作者信息

Ng Daniel K, Chow Pok-yu, Ming Shun-pei, Hong Siu-hung, Lau Sunny, Tse Debbie, Kwong Wilson K, Wong Mui-fong, Wong Wilfred H, Fu Yu-ming, Kwok Ka-li, Li Handong, Ho Jackson C

机构信息

Department of Paediatrics, Kwong Wah Hospital, 25 Waterloo Rd, Kowloon, SAR, Hong Kong.

出版信息

Pediatrics. 2004 Nov;114(5):1242-7. doi: 10.1542/peds.2004-0744.

Abstract

OBJECTIVE

To compare active acupuncture with sham acupuncture for the treatment of persistent allergic rhinitis among children.

METHODS

Subjects with persistent allergic rhinitis were recruited from the pediatric outpatient clinic. They were randomized to receive either active acupuncture or sham acupuncture. Main outcome measures included daily rhinitis scores, symptom-free days, visual analog scale scores for immediate effects of acupuncture, daily relief medication scores, blood eosinophil counts, serum IgE levels, nasal eosinophil counts, patients' and parents' preferences for treatment modalities, and adverse effects.

RESULTS

Eighty-five patients were recruited from the pediatric outpatient clinic at Kwong Wah Hospital, in Hong Kong. Thirteen patients withdrew before randomization; 35 patients (mean age: 11.7 +/- 3.2 years) were randomized to receive active acupuncture for 8 weeks, and 37 patients (mean age: 11 +/- 3.8 years) were randomized to receive sham acupuncture for 8 weeks. Acupuncture was performed twice per week for both groups. Both the assessing pediatricians and the patients were blinded. There were significantly lower daily rhinitis scores and more symptom-free days for the group receiving active acupuncture, during both the treatment and follow-up periods. The visual analog scale scores for immediate improvement after acupuncture were also significantly better for the active acupuncture group. There was no significant difference in the following outcome measures between the active and sham acupuncture groups: daily relief medication scores, blood eosinophil counts, serum IgE levels, and nasal eosinophil counts, except for the IgE levels before and 2 months after acupuncture in the sham acupuncture group. No severe adverse effects were encountered. Numbness, headache, and dizziness were found in both the active and sham acupuncture groups, with no difference in incidence, and the effects were self-limiting.

CONCLUSIONS

This study showed that active acupuncture was more effective than sham acupuncture in decreasing the symptom scores for persistent allergic rhinitis and increasing the symptom-free days. No serious adverse effect was identified. A large-scale study is required to confirm the safety of acupuncture for children.

摘要

目的

比较主动针刺与假针刺治疗儿童持续性变应性鼻炎的疗效。

方法

从儿科门诊招募持续性变应性鼻炎患者。将他们随机分为接受主动针刺或假针刺治疗。主要观察指标包括每日鼻炎评分、无症状天数、针刺即刻效应的视觉模拟量表评分、每日缓解药物评分、血液嗜酸性粒细胞计数、血清IgE水平、鼻嗜酸性粒细胞计数、患者及家长对治疗方式的偏好以及不良反应。

结果

从香港广华医院儿科门诊招募了85例患者。13例患者在随机分组前退出;35例患者(平均年龄:11.7±3.2岁)被随机分配接受主动针刺治疗8周,37例患者(平均年龄:11±3.8岁)被随机分配接受假针刺治疗8周。两组均每周进行2次针刺。评估的儿科医生和患者均不知情。在治疗期和随访期,接受主动针刺治疗的组每日鼻炎评分显著更低,无症状天数更多。主动针刺组针刺后即刻改善的视觉模拟量表评分也显著更好。主动针刺组与假针刺组在以下观察指标上无显著差异:每日缓解药物评分、血液嗜酸性粒细胞计数、血清IgE水平和鼻嗜酸性粒细胞计数,但假针刺组针刺前和针刺后2个月的IgE水平除外。未出现严重不良反应。主动针刺组和假针刺组均出现麻木、头痛和头晕,发生率无差异,且症状为自限性。

结论

本研究表明,主动针刺在降低持续性变应性鼻炎症状评分和增加无症状天数方面比假针刺更有效。未发现严重不良反应。需要进行大规模研究以证实针刺对儿童的安全性。

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