Wang Shu-Ming, Kain Zeev N, White Paul F
Center for Advancement of Perioperative Health, Department of Anesthesiology, Yale School of Medicine, 333 Cedar St., New Haven, CT 06510, USA.
Anesth Analg. 2008 Feb;106(2):611-21, table of contents. doi: 10.1213/ane.0b013e318160644d.
Acupuncture and related percutaneous neuromodulation therapies can be used to treat patients with both acute and chronic pain. In this review, we critically examined peer-reviewed clinical studies evaluating the analgesic properties of acupuncture modalities.
Using Ovid and published medical databases, we examined prospective, randomized, sham-controlled clinical investigations involving the use of acupuncture and related forms of acustimulation for the management of pain. Case reports, case series, and cohort studies were not included in this analysis.
Peer-reviewed literature suggests that acupuncture and other forms of acustimulation are effective in the short-term management of low back pain, neck pain, and osteoarthritis involving the knee. However, the literature also suggests that short-term treatment with acupuncture does not result in long-term benefits. Data regarding the efficacy of acupuncture for dental pain, colonoscopy pain, and intraoperative analgesia are inconclusive. Studies describing the use of acupuncture during labor suggest that it may be useful during the early stages, but not throughout the entire course of labor. Finally, the effects of acupuncture on postoperative pain are inconclusive and are dependent on the timing of the intervention and the patient's level of consciousness.
Current data regarding the clinical efficacy of acupuncture and related techniques suggest that the benefits are short-lasting. There remains a need for well designed, sham-controlled clinical trials to evaluate the effect of these modalities on clinically relevant outcome measures such as resumption of daily normal activities when used in the management of acute and chronic pain syndromes.
针灸及相关经皮神经调节疗法可用于治疗急慢性疼痛患者。在本综述中，我们严格审查了评估针灸疗法镇痛特性的同行评议临床研究。
我们使用Ovid及已发表的医学数据库，审查了涉及使用针灸及相关电刺激形式治疗疼痛的前瞻性、随机、假对照临床研究。本分析未纳入病例报告、病例系列和队列研究。
同行评议文献表明，针灸及其他形式的电刺激在短期治疗下背痛、颈痛和膝骨关节炎方面有效。然而，文献也表明，针灸短期治疗不会带来长期益处。关于针灸治疗牙痛、结肠镜检查疼痛和术中镇痛效果的数据尚无定论。描述分娩期间使用针灸的研究表明，它可能在分娩早期有用，但并非在整个分娩过程中都有用。最后，针灸对术后疼痛的影响尚无定论，且取决于干预时机和患者的意识水平。
目前关于针灸及相关技术临床疗效的数据表明，其益处是短暂的。仍需要设计良好的假对照临床试验，以评估这些疗法在用于治疗急慢性疼痛综合征时，对恢复日常正常活动等临床相关结局指标的影响。
