Prady Stephanie L, Thomas Kate, Esmonde Lisa, Crouch Simon, MacPherson Hugh
Department of Health Sciences, University of York, UK.
Acupunct Med. 2007 Dec;25(4):121-9. doi: 10.1136/aim.25.4.121.
There is growing evidence about the effectiveness of acupuncture in the short term treatment of chronic low back pain but little is known about long term outcomes. To address this question we followed up participants of a past randomised controlled trial of acupuncture to assess outcomes after 5.5 to 7 years.
A postal questionnaire assessing pain, quality of life, disability, experience with back pain and healthcare resource use was sent to all 239 participants of the York Acupuncture for Back Pain trial.
Response to the survey was low at 43.9%. Pain measured by the SF-36 Bodily Pain dimension was maintained in the acupuncture group since the last follow up 3.5 to 5 years previously. The usual care group had improved over the intervening years and there was now no evidence of a difference between the groups (difference -0.4 points, 95% confidence interval -10.1 to 9.7). The results were unchanged on sensitivity analysis using multiple imputation. In both groups back pain had not completely resolved and worry about back health was moderate. Physiotherapy and acupuncture were used at similar rates for continuing treatment.
We theorise that exposure to a short course of acupuncture speeds natural recovery from a back pain episode, but improvements plateau after two years. Acupuncture is often accessed privately for long term management of back pain but is rarely available within the health service. While our study methods were robust, the low response rate means that our findings should be interpreted with caution.
越来越多的证据表明针灸在慢性下背痛的短期治疗中有效，但对其长期疗效却知之甚少。为解决这一问题，我们对过去一项针灸随机对照试验的参与者进行了随访，以评估5.5至7年后的疗效。
向约克背部疼痛针灸试验的所有239名参与者发送了一份邮政调查问卷，评估疼痛、生活质量、残疾情况、背痛经历和医疗资源使用情况。
调查回复率较低，为43.9%。自3.5至5年前的上次随访以来，针灸组通过SF-36身体疼痛维度测量的疼痛情况保持稳定。在这期间，常规护理组有所改善，现在两组之间没有差异的证据（差异-0.4分，95%置信区间-10.1至9.7）。使用多重填补法进行敏感性分析时，结果不变。两组的背痛均未完全缓解，对背部健康的担忧程度为中等。继续治疗时，物理治疗和针灸的使用率相似。
我们推测，接受短期针灸治疗可加速背痛发作后的自然恢复，但两年后改善趋于平稳。针灸通常通过私人途径用于背痛的长期管理，但在医疗服务体系中很少提供。虽然我们的研究方法很可靠，但低回复率意味着我们的研究结果应谨慎解读。
