针刺治疗肩痛长期疗效的随机试验
Randomised trial of long term effect of acupuncture for shoulder pain.
作者信息
Guerra de Hoyos Juan Antonio, Martín Maria Del Carmen Andrés, Leon Elena Bassas Y Baena de, Lopez Miguel Vigára, López Teresa Molina, Morilla Francisco Antonio Verdugo, Moreno Maria José González
机构信息
Andalusia Public Health Service, C/La Maria 26, DP 41008 Sevilla, Spain C/Avda Eduardo Dato no. 54 3° B DP 41005, Sevilla, Spain Analysis Department, Riotinto Hospital, Andalucia Public Health Service, Huelva, Spain C/Pastor y Landero 23-25, 2° A. DP 41001 Sevilla, Spain Andalusia Public Health Service, Distrito Sanitario Este-Sur, Calle Greco s\n, Sevilla, Spain Andalusia Public Health Service, Sevilla Primary Health Care Pharmacist, C/Greco s\n, Sevilla, Spain C/Cardenal Rodrigo de Castro n°5, 1° Puerta 5, DP 41005, Seville, Spain Nursing and Physiotherapy Department, Health Sciences School, Sevilla University, Avda Sanchez Pizjuan s/n 41009 Sevilla, Spain.
出版信息
Pain. 2004 Dec;112(3):289-298. doi: 10.1016/j.pain.2004.08.030.
The objective of the study is to compare the efficacy of electro-acupuncture with placebo-acupuncture for the treatment of shoulder pain. This study comprised of a prospective, randomized, placebo controlled trial, with independent evaluator set in a Public primary care clinic in Spain. The participants are patients aged from 25 to 83 years with shoulder pain. Patients were randomly allocated to two treatments over eight weeks, with electro-acupuncture or skin non-penetrating placebo-acupuncture, both able to take diclofenac if needed for intense pain. Primary outcome measure was the difference between groups in pain intensity (visual analogue scale-VAS). Secondary outcomes were differences between groups in pain intensity measured by Lattinen index, in range of motion (goniometer), functional ability (SPADI), quality of life (COOP-WONCA charts), NSAIDS intake, credibility (Borkoveck and Nau scale) and global satisfaction (10 points analogue scale). Assessments were performed before, during and three and six months after treatment. At six month follow-up after treatment the acupuncture group showed a significantly greater improvement in pain intensity compared with the control group [VAS mean difference 2.0 (95% CI 1.2-2.9)]. The acupuncture group had consistently better results in every secondary outcome measure than the control group. Acupuncture is an effective long-term treatment for patients with shoulder pain (from soft tissues lesions) in a primary care setting.
本研究的目的是比较电针与假针刺治疗肩痛的疗效。本研究为前瞻性、随机、安慰剂对照试验,由西班牙一家公立初级保健诊所的独立评估员进行。参与者为年龄在25至83岁之间的肩痛患者。患者在八周内被随机分配接受两种治疗,即电针或皮肤非穿透性假针刺,若疼痛剧烈,两者均可服用双氯芬酸。主要结局指标是两组之间疼痛强度的差异(视觉模拟量表-VAS)。次要结局指标包括两组之间用拉蒂宁指数测量的疼痛强度差异、活动范围(测角计)、功能能力(SPADI)、生活质量(COOP-WONCA图表)、非甾体抗炎药摄入量、可信度(博尔科韦克和瑙量表)和总体满意度(10分模拟量表)。在治疗前、治疗期间以及治疗后三个月和六个月进行评估。在治疗后六个月的随访中,针刺组与对照组相比,疼痛强度有显著更大的改善[VAS平均差异2.0(95%CI 1.2-2.9)]。针刺组在每个次要结局指标上的结果始终优于对照组。在初级保健环境中,针刺是治疗肩痛(源于软组织损伤)患者的一种有效的长期治疗方法。