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日式针灸治疗青少年和年轻女性子宫内膜异位症相关盆腔疼痛:一项随机假针刺对照试验的结果

Japanese-style acupuncture for endometriosis-related pelvic pain in adolescents and young women: results of a randomized sham-controlled trial.

作者信息

Wayne Peter M, Kerr Catherine E, Schnyer Rosa N, Legedza Anna T R, Savetsky-German Jacqueline, Shields Monica H, Buring Julie E, Davis Roger B, Conboy Lisa A, Highfield Ellen, Parton Barbara, Thomas Phaedra, Laufer Marc R

机构信息

Harvard Medical School, Osher Research Center, Boston, Massachusetts 02215, USA.

出版信息

J Pediatr Adolesc Gynecol. 2008 Oct;21(5):247-57. doi: 10.1016/j.jpag.2007.07.008.

Abstract

STUDY OBJECTIVE

To assess feasibility, and collect preliminary data for a subsequent randomized, sham-controlled trial to evaluate Japanese-style acupuncture for reducing chronic pelvic pain and improving health-related quality of life (HRQOL) in adolescents with endometriosis.

DESIGN

Randomized, sham-controlled trial.

SETTINGS

Tertiary-referral hospital.

PARTICIPANTS

Eighteen young women (13-22y) with laparoscopically-diagnosed endometriosis-related chronic pelvic pain.

INTERVENTIONS

A Japanese style of acupuncture and a sham acupuncture control. Sixteen treatments were administered over 8 weeks.

MAIN OUTCOME MEASURES

Protocol feasibility, recruitment numbers, pain not associated with menses or intercourse, and multiple HRQOL instruments including Endometriosis Health Profile, Pediatric Quality of Life, Perceived Stress, and Activity Limitation.

RESULTS

Fourteen participants (out of 18 randomized) completed the study per protocol. Participants in the active acupuncture group (n = 9) experienced an average 4.8 (SD = 2.4) point reduction on a 11 point scale (62%) in pain after 4 weeks, which differed significantly from the control group's (n = 5) average reduction of 1.4 (SD = 2.1) points (P = 0.004). Reduction in pain in the active group persisted through a 6-month assessment; however, after 4 weeks, differences between the active and control group decreased and were not statistically significant. All HRQOL measures indicated greater improvements in the active acupuncture group compared to the control; however, the majority of these trends were not statistically significant. No serious adverse events were reported.

CONCLUSION

Preliminary estimates indicate that Japanese-style acupuncture may be an effective, safe, and well-tolerated adjunct therapy for endometriosis-related pelvic pain in adolescents. A more definitive trial evaluating Japanese-style acupuncture in this population is both feasible and warranted.

摘要

研究目的

评估可行性,并为后续随机、假针刺对照试验收集初步数据,以评价日式针灸对减轻子宫内膜异位症青少年慢性盆腔疼痛及改善健康相关生活质量(HRQOL)的效果。

设计

随机、假针刺对照试验。

地点

三级转诊医院。

参与者

18名经腹腔镜诊断为与子宫内膜异位症相关慢性盆腔疼痛的年轻女性(13 - 22岁)。

干预措施

日式针灸和假针刺对照。在8周内进行16次治疗。

主要观察指标

方案可行性、招募人数、非经期或性交相关疼痛,以及多种HRQOL工具,包括子宫内膜异位症健康概况、儿童生活质量、感知压力和活动受限情况。

结果

18名随机分组参与者中有14名按方案完成了研究。主动针灸组(n = 9)的参与者在4周后,疼痛在11分制量表上平均降低了4.8分(标准差 = 2.4)(62%),与对照组(n = 5)平均降低1.4分(标准差 = 2.1)有显著差异(P = 0.004)。主动组的疼痛减轻在6个月评估时持续存在;然而,4周后,主动组与对照组的差异减小且无统计学意义。所有HRQOL指标均表明主动针灸组比对照组有更大改善;然而,这些趋势大多无统计学意义。未报告严重不良事件。

结论

初步估计表明,日式针灸可能是治疗青少年子宫内膜异位症相关盆腔疼痛的一种有效、安全且耐受性良好的辅助疗法。在该人群中进行更明确的日式针灸试验既可行又有必要。

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