Vas J, Ortega C, Olmo V, Perez-Fernandez F, Hernandez L, Medina I, Seminario J M, Herrera A, Luna F, Perea-Milla E, Mendez C, Madrazo F, Jimenez C, Ruiz M A, Aguilar I
Pain Treatment Unit, Healthcare Centre Doña Mercedes, Calle Segovia s/n, 41700 Dos Hermanas, Spain.
Rheumatology (Oxford). 2008 Jun;47(6):887-93. doi: 10.1093/rheumatology/ken040. Epub 2008 Apr 10.
Evaluate the efficacy of acupuncture associated with physiotherapy for patients with painful shoulder.
In a multicentre controlled randomized study, participants were recruited with a clinical diagnosis of unilateral subacromial syndrome from six rehabilitation medicine departments belonging to the Public Health System in two Spanish regions. All participants received 15 sessions of physiotherapy during the 3 weeks that the treatment lasted and were randomized to additionally receive, once a week, acupuncture or mock TENS (transcutaneous electrical nerve stimulation). The primary outcome measure was the change in the Constant-Murley Score (CMS) for functional assessment of the shoulder, at 4 weeks after randomization. This study is registered as an International Standard Randomized Controlled Trial, number ISRCTN28687220.
A total of 425 patients were recruited. The mean score (s.d.) on the CMS had increased by 16.6 (15.6) points among the acupuncture group, compared with 10.6 (13.5) points in the control group, and the mean difference between the two groups was statistically significant (6.0 points; 95% CI 3.2, 8.8 points; P < 0.001). By the end of the treatment, 53% of the patients in the acupuncture group had decreased their consumption of analgesics, compared with a corresponding 30% among the control group (P < 0.001).
Single-point acupuncture in association with physiotherapy improves shoulder function and alleviates pain, compared with physiotherapy as the sole treatment. This improvement is accompanied by a reduction in the consumption of analgesic medicaments.
评估针灸联合物理治疗对肩部疼痛患者的疗效。
在一项多中心对照随机研究中，从西班牙两个地区公共卫生系统所属的六个康复医学科室招募临床诊断为单侧肩峰下综合征的参与者。所有参与者在为期3周的治疗期间接受15次物理治疗，并被随机分组，额外每周接受一次针灸或模拟经皮电刺激神经疗法（TENS）。主要结局指标是随机分组后4周时用于评估肩部功能的Constant-Murley评分（CMS）的变化。本研究已注册为国际标准随机对照试验，编号为ISRCTN28687220。
共招募了425名患者。针灸组CMS的平均评分（标准差）增加了16.6（15.6）分，而对照组为10.6（13.5）分，两组间的平均差异具有统计学意义（6.0分；95%可信区间3.2, 8.8分；P < 0.001）。治疗结束时，针灸组53%的患者减少了镇痛药的用量，而对照组相应比例为30%（P < 0.001）。
与单纯物理治疗相比，单点针灸联合物理治疗可改善肩部功能并减轻疼痛。这种改善伴随着镇痛药用量的减少。
