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针刺治疗非特异性急性下腰痛的疗效与安全性:一项随机对照多中心试验方案[国际标准随机对照试验编号65814467]

Efficacy and safety of acupuncture for the treatment of non-specific acute low back pain: a randomised controlled multicentre trial protocol [ISRCTN65814467].

作者信息

Vas Jorge, Perea-Milla Emilio, Mendez Camila, Silva Luis Carlos, Herrera Galante Antonia, Aranda Regules Jose Manuel, Martinez Barquin Dulce M, Aguilar Inmaculada, Faus Vicente

机构信息

Unidad de Tratamiento del Dolor, Centro de Salud Dos Hermanas A, Segovia s/n, 41700 Dos Hermanas, Spain.

出版信息

BMC Complement Altern Med. 2006 Apr 21;6:14. doi: 10.1186/1472-6882-6-14.

Abstract

BACKGROUND

Low back pain and its associated incapacitating effects constitute an important healthcare and socioeconomic problem, as well as being one of the main causes of disability among adults of working age. The prevalence of non-specific low back pain is very high among the general population, and 60-70% of adults are believed to have suffered this problem at some time. Nevertheless, few randomised clinical trials have been made of the efficacy and efficiency of acupuncture with respect to acute low back pain. The present study is intended to assess the efficacy of acupuncture for acute low back pain in terms of the improvement reported on the Roland Morris Questionnaire (RMQ) on low back pain incapacity, to estimate the specific and non-specific effects produced by the technique, and to carry out a cost-effectiveness analysis.

METHODS/DESIGN: Randomised four-branch controlled multicentre prospective study made to compare semi-standardised real acupuncture, sham acupuncture (acupuncture at non-specific points), placebo acupuncture and conventional treatment. The patients are blinded to the real, sham and placebo acupuncture treatments. Patients in the sample present symptoms of non specific acute low back pain, with a case history of 2 weeks or less, and will be selected from working-age patients, whether in paid employment or not, referred by General Practitioners from Primary Healthcare Clinics to the four clinics participating in this study. In order to assess the primary and secondary result measures, the patients will be requested to fill in a questionnaire before the randomisation and again at 3, 12 and 48 weeks after starting the treatment. The primary result measure will be the clinical relevant improvement (CRI) at 3 weeks after randomisation. We define CRI as a reduction of 35% or more in the RMQ results.

DISCUSSION

This study is intended to obtain further evidence on the effectiveness of acupuncture on acute low back pain and to isolate the specific and non-specific effects of the treatment.

摘要

背景

腰痛及其相关的致残影响构成了一个重要的医疗保健和社会经济问题,也是工作年龄成年人残疾的主要原因之一。非特异性腰痛在普通人群中的患病率非常高,据信60-70%的成年人在某个时候都曾遭受过这个问题。然而,关于针刺治疗急性腰痛的疗效和效率的随机临床试验很少。本研究旨在根据罗兰·莫里斯腰痛失能问卷(RMQ)报告的改善情况,评估针刺治疗急性腰痛的疗效,估计该技术产生的特异性和非特异性效果,并进行成本效益分析。

方法/设计:随机四组对照多中心前瞻性研究,比较半标准化的真实针刺、假针刺(在非特定穴位针刺)、安慰剂针刺和传统治疗。患者对真实、假和安慰剂针刺治疗不知情。样本中的患者表现出非特异性急性腰痛症状,病史为2周或更短,将从工作年龄的患者中选取,无论是否有带薪工作,由初级医疗保健诊所的全科医生转诊至参与本研究的四家诊所。为了评估主要和次要结果指标,将要求患者在随机分组前以及开始治疗后的3周、12周和48周再次填写问卷。主要结果指标将是随机分组后3周时的临床相关改善(CRI)。我们将CRI定义为RMQ结果降低35%或更多。

讨论

本研究旨在获得关于针刺治疗急性腰痛有效性的进一步证据,并分离出治疗的特异性和非特异性效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb0f/1468427/b8c90ecd716e/1472-6882-6-14-1.jpg

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