Trinh Kien, Graham Nadine, Gross Anita, Goldsmith Charlie, Wang Ellen, Cameron Ian, Kay Theresa
DeGroote School of Medicine, Office of MD Admissions, McMaster University, Hamilton, Ontario, Canada.
Spine (Phila Pa 1976). 2007 Jan 15;32(2):236-43. doi: 10.1097/01.brs.0000252100.61002.d4.
Systematic review.
To determine the effects of acupuncture for individuals with neck pain.
Neck pain is one of the 3 most frequently reported complaints of the musculoskeletal system. Treatments for neck pain are varied, as are the perceptions of benefits. METHODS.: We searched CENTRAL (2006, issue 1) and MEDLINE, EMBASE, MANTIS, Cumulative Index to Nursing and Allied Health Literature from their beginning to February 2006. We searched reference lists and the acupuncture database TCMLARS in China. Any published trials using randomized (RCT) or quasi-randomized (quasi-RCT) assignment to the intervention groups, either in full text or abstract form, were included.
We found 10 trials that examined acupuncture treatments for chronic neck pain. Overall, methodologic quality had a mean of 2.3 of 5 on the Jadad scale. For chronic mechanical neck disorders, there was moderate evidence that acupuncture was more effective for pain relief than some types of sham controls, measured immediately posttreatment. There was moderate evidence that acupuncture was more effective than inactive, sham treatments measured immediately posttreatment, and at short-term follow-up (pooled standardized mean difference, -0.37; 95% confidence interval, -0.61 to -0.12). There was limited evidence that acupuncture was more effective than massage at short-term follow-up. For chronic neck disorders with radicular symptoms, there was moderate evidence that acupuncture was more effective than a wait-list control at short-term follow-up.
There is moderate evidence that acupuncture relieves pain better than some sham treatments, measured at the end of the treatment. There is moderate evidence that those who received acupuncture reported less pain at short-term follow-up than those on a waiting list. There is also moderate evidence that acupuncture is more effective than inactive treatments for relieving pain posttreatment, and this is maintained at short-term follow-up.
系统评价。
确定针刺疗法对颈部疼痛患者的疗效。
颈部疼痛是肌肉骨骼系统最常报告的三种症状之一。颈部疼痛的治疗方法多种多样，对其疗效的看法也各不相同。
检索CENTRAL（2006年第1期）、MEDLINE、EMBASE、MANTIS以及截至2006年2月的护理及相关健康文献累积索引。检索参考文献列表以及中国的针刺数据库TCMLARS。纳入所有采用随机（RCT）或半随机（quasi-RCT）分组至干预组的已发表试验，全文或摘要形式均可。
我们找到10项研究针刺治疗慢性颈部疼痛的试验。总体而言，根据Jadad量表，方法学质量平均得分为2.3（满分5分）。对于慢性机械性颈部疾病，有中等证据表明，在治疗后即刻测量，针刺疗法在缓解疼痛方面比某些假对照更有效。有中等证据表明，在治疗后即刻及短期随访时，针刺疗法比无活性的假治疗更有效（合并标准化均数差值，-0.37；95%置信区间，-0.61至-0.12）。有有限证据表明，在短期随访时，针刺疗法比按摩更有效。对于伴有神经根症状的慢性颈部疾病，有中等证据表明，在短期随访时，针刺疗法比等待治疗组更有效。
有中等证据表明，在治疗结束时测量，针刺疗法比某些假治疗能更好地缓解疼痛。有中等证据表明，在短期随访时，接受针刺治疗的患者比等待治疗的患者报告的疼痛更少。也有中等证据表明，针刺疗法在治疗后缓解疼痛方面比无活性治疗更有效，且在短期随访时仍保持这一效果。
