自然疗法治疗慢性下腰痛：一项随机试验。
Naturopathic care for chronic low back pain: a randomized trial.
机构信息
Division of Clinical Epidemiology, Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada.
出版信息
PLoS One. 2007 Sep 19;2(9):e919. doi: 10.1371/journal.pone.0000919.
OBJECTIVE
Chronic low back pain represents a substantial cost to employers through benefits coverage and days missed due to incapacity. We sought to explore the effectiveness of Naturopathic care on chronic low back pain.
METHODS
This study was a randomized clinical trial. We randomized 75 postal employees with low back pain of longer than six weeks duration to receive Naturopathic care (n = 39) or standardized physiotherapy (n = 36) over a period of 12 weeks. The study was conducted in clinics on-site in postal outlets. Participants in the Naturopathic care group received dietary counseling, deep breathing relaxation techniques and acupuncture. The control intervention received education and instruction on physiotherapy exercises using an approved education booklet. We measured low back pain using the Oswestry disability questionnaire as the primary outcome measure, and quality of life using the SF-36 in addition to low back range of motion, weight loss, and Body Mass Index as secondary outcomes.
RESULTS
Sixty-nine participants (92%) completed eight weeks or greater of the trial. Participants in the Naturopathic care group reported significantly lower back pain (-6.89, 95% CI. -9.23 to -3.54, p = <0.0001) as measured by the Oswestry questionnaire. Quality of life was also significantly improved in the group receiving Naturopathic care in all domains except for vitality. Differences for the aggregate physical component of the SF-36 was 8.47 (95% CI, 5.05 to 11.87, p = <0.0001) and for the aggregate mental component was 7.0 (95% CI, 2.25 to 11.75, p = 0.0045). All secondary outcomes were also significantly improved in the group receiving Naturopathic care: spinal flexion (p<0.0001), weight-loss (p = 0.0052) and Body Mass Index (-0.52, 95% CI, -0.96 to -0.08, p = 0.01).
CONCLUSIONS
Naturopathic care provided significantly greater improvement than physiotherapy advice for patients with chronic low back pain.
TRIAL REGISTRATION
Controlled-Trials.com ISRCTN41920953.
目的
慢性下腰痛给雇主带来了大量的福利支出和因丧失工作能力而导致的缺勤损失。本研究旨在探讨顺势疗法对慢性下腰痛的疗效。
方法
本研究为一项随机临床试验。我们将 75 名患有慢性下腰痛（持续时间超过 6 周）的邮政员工随机分为接受顺势疗法治疗组（n=39）或标准化物理治疗组（n=36），治疗周期为 12 周。研究在邮政网点的诊所进行。接受顺势疗法治疗组的患者接受饮食咨询、深呼吸放松技术和针灸治疗。对照组则接受经批准的教育手册中的物理治疗运动教育和指导。我们使用 Oswestry 残疾问卷作为主要结局指标来衡量下腰痛，并用 SF-36 评估生活质量，此外还评估了下腰痛活动范围、体重减轻和体重指数等次要结局。
结果
69 名参与者（92%）完成了 8 周或更长时间的试验。接受顺势疗法治疗组的患者报告下腰痛明显减轻（-6.89，95%置信区间-9.23 至-3.54，p<0.0001），Oswestry 问卷的测量结果更低。接受顺势疗法治疗组的患者在除活力外的所有领域的生活质量也显著提高。SF-36 综合身体成分的差异为 8.47（95%置信区间，5.05 至 11.87，p<0.0001），综合心理成分的差异为 7.0（95%置信区间，2.25 至 11.75，p=0.0045）。接受顺势疗法治疗组的所有次要结局也均显著改善：脊柱前屈（p<0.0001）、体重减轻（p=0.0052）和体重指数（-0.52，95%置信区间-0.96 至-0.08，p=0.01）。
结论
与物理治疗建议相比，顺势疗法为慢性下腰痛患者提供了更显著的改善。
试验注册
controlled-trials.com ISRCTN41920953。
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