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评估针刺在中风恢复特定方面的疗效:一项随机、安慰剂对照单盲研究。

Evaluating the efficacy of acupuncture in defined aspects of stroke recovery: a randomised, placebo controlled single blind study.

作者信息

Hopwood V, Lewith G, Prescott P, Campbell M J

机构信息

University of Southampton, Complementary Medicine Research Unit, Primary Medical Care, Aldermoor Health Centre, Aldermoor Close, Southampton, SO16 5ST, UK.

出版信息

J Neurol. 2008 Jun;255(6):858-66. doi: 10.1007/s00415-008-0790-1. Epub 2008 May 13.

Abstract

OBJECTIVE

To investigate the efficacy of acupuncture on stroke recovery compared to an inert placebo.

DESIGN

Placebo-controlled, randomised, clinical trial.

SETTING

Post-stroke rehabilitation wards in five NHS hospitals in the UK.

SUBJECTS

Patients between 4 and 10 days after their first stroke.

INTERVENTIONS AND OUTCOME MEASURES

The patients received 12 acupuncture or placebo treatments over four weeks. Acupuncture with electrical stimulation was compared with mock TENS, and assessments continued for 12 months after entry. Primary outcome was the Barthel Index (BI). Secondary outcomes were muscle power, Motricity Index (MI), mood, Nottingham Health Profile (NHP) and treatment credibility.

RESULTS

92 patients completed data sets. Data were analysed using both t tests and a structural equation based on longitudinal analysis of both BI and MI, using generalised estimating equations with an exchangeable correlation structure. While both acupuncture and placebo (mock TENS) appeared to have had an equal effect on stroke recovery, there is no significant difference between the two interventions at 12 (p = 0.737, 95 % CI -2.00 to 2.81) and 52 weeks (p = 0.371, 95 % CI -3.48 to 1.32). An apparently accelerated improvement in the MI scores in the acupuncture group at 3 weeks (p = 0.009, 95 % CI 1.55 to 10.77) is interesting.

CONCLUSIONS

Acupuncture did not demonstrate specific efficacy over placebo and both groups did as well as normally expected with this condition.

摘要

目的

与惰性安慰剂相比,研究针刺对中风恢复的疗效。

设计

安慰剂对照、随机临床试验。

地点

英国五家国民保健服务医院的中风后康复病房。

研究对象

首次中风后4至10天的患者。

干预措施及结果测量

患者在四周内接受12次针刺或安慰剂治疗。将电刺激针刺与模拟经皮神经电刺激(TENS)进行比较,入组后评估持续12个月。主要结局指标是巴氏指数(BI)。次要结局指标是肌肉力量、运动指数(MI)、情绪、诺丁汉健康概况(NHP)和治疗可信度。

结果

92例患者完成数据集。使用t检验和基于BI和MI纵向分析的结构方程进行数据分析,采用具有可交换相关结构的广义估计方程。虽然针刺和安慰剂(模拟TENS)对中风恢复似乎有相同的效果,但在12周(p = 0.737,95%CI -2.00至2.81)和52周时,两种干预措施之间无显著差异(p = 0.371,95%CI -3.48至1.32)。针刺组在3周时MI评分明显加速改善(p = 0.009,95%CI 1.55至10.77),这一结果很有趣。

结论

针刺未显示出优于安慰剂的特定疗效,两组在此病症中的表现与正常预期相同。

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