Hansson Ylva, Carlsson Christer, Olsson Elisabeth
The Research and Development Unit, Jamtland County Council, Ostersund, Sweden.
Acupunct Med. 2008 Dec;26(4):214-23. doi: 10.1136/aim.26.4.214.
Periosteal acupuncture has shown promising results in clinical practice. The aim was to compare three patient groups: one with intramuscular acupuncture, one with periosteal acupuncture, and a third information control group, with respect to clinically relevant pain relief, physical functioning and intake of analgesics in patients with chronic musculoskeletal pain in the neck or low back or both. We reported the psychological changes in these patients in a previous issue of this journal.
144 consecutive patients with nociceptive pain for >3 months, aged 18-70 years were alternately allocated to: intramuscular acupuncture (n=59); periosteal acupuncture (n=55); or control group with information only (n=30). All patients were encouraged to stay active. Acupuncture was administered with eight treatments during five weeks, and two optional additional treatments after one month. Pain was estimated with a daily VAS in a pain diary and with an average weekly pain score. Clinically relevant pain relief was defined as at least a 30% decrease from the initial value. Physical functioning was evaluated with Disability Rating Index. All estimations were performed prior to treatment, one week after, and one, three and six months after treatment.
There were no differences between the effects of the two acupuncture methods. There were differences between each of the two acupuncture groups compared with the control group on all test occasions up to one month after treatment with respect to the pain diary and one week after treatment with respect to pain last week (P<0.05). Pain relief as measured by a pain diary was obtained in 29 patients in the intramuscular acupuncture group, 25 in the periosteal acupuncture group, and 5 patients in the control group. Six months after treatment, 46% of the intramuscular acupuncture patients and 45% of the periosteal acupuncture patients had obtained pain relief in terms of the pain diary. The corresponding figure for pain last week was 29% in each group.
Periosteal pecking was no more effective than standard intramuscular acupuncture, but both were more effective than information only.
骨膜针刺疗法在临床实践中已显示出有前景的效果。目的是比较三组患者：一组接受肌肉内针刺治疗，一组接受骨膜针刺治疗，第三组为信息对照组，比较在颈部或下背部或两者均有慢性肌肉骨骼疼痛的患者中，在临床相关的疼痛缓解、身体功能以及镇痛药摄入量方面的差异。我们在本杂志的上一期报道了这些患者的心理变化。
144例年龄在18至70岁之间、伤害性疼痛持续超过3个月的连续患者被交替分配至：肌肉内针刺组（n = 59）；骨膜针刺组（n = 55）；或仅提供信息的对照组（n = 30）。鼓励所有患者保持活动。针刺治疗在五周内进行八次，一个月后有两次可选的额外治疗。通过疼痛日记中的每日视觉模拟评分法（VAS）和每周平均疼痛评分来评估疼痛。临床相关的疼痛缓解定义为比初始值至少降低30%。通过残疾评定指数评估身体功能。所有评估均在治疗前、治疗后一周以及治疗后1、3和6个月进行。
两种针刺方法的效果之间没有差异。在治疗后长达一个月的所有测试场合中，就疼痛日记而言，以及在治疗后一周就上周疼痛而言，两个针刺组中的每一组与对照组相比均存在差异（P<0.05）。肌肉内针刺组有29例患者、骨膜针刺组有25例患者以及对照组有5例患者通过疼痛日记获得了疼痛缓解。治疗六个月后，根据疼痛日记，肌肉内针刺组46%的患者和骨膜针刺组45%的患者获得了疼痛缓解。每组上周疼痛的相应数字为29%。
骨膜啄刺法并不比标准的肌肉内针刺更有效，但两者都比仅提供信息更有效。
