Yuan J, Kerr D, Park J, Liu X H, McDonough S
School of Health Sciences, University of Ulster, Shore Road, Co Antrim BT37 0QB, United Kingdom.
Complement Ther Med. 2008 Oct;16(5):295-304. doi: 10.1016/j.ctim.2008.04.006.
To investigate the difference in acupuncture treatment regimens for low back pain (LBP) among textbooks, clinical studies and clinical practice, and explore reasons for such differences.
A systematic review of textbooks, surveys, clinical studies (randomised controlled trials (RCTs) and case studies) published in English or Chinese, was conducted, plus Chinese expert opinions. Data on detailed acupuncture treatment regimens were extracted.
12 textbooks in English, 31 textbooks in Chinese, 3 surveys in English, no surveys in Chinese, 9 Chinese expert opinions, 25 RCTs in English, 29 RCTs in Chinese, and 38 case studies in English were included. For chronic non-specific LBP, the outstanding differences in regimens found were (irrespective of the approach of acupuncture): (i) clinical studies and surveys (9-11 points) reported the use of many more points per session than Chinese experts (5 points); (ii) two extreme frequencies of treatments were used across all sources (1-2 times/week vs. 5-6 times/week). For acute LBP, the notable differences between RCTs and case studies were: (i) a variety of special points were investigated; (ii) case studies reported the use of many more points per session (10 points) than RCTs in Chinese (2 points); (iii) RCTs in Chinese administrated more treatments (6.5 sessions) than RCTs in English (3.5 sessions) and case studies (3 sessions).
For non-specific LBP, treatment regimens of acupuncture differ by the types of reference sources, in terms of treatment frequency, the points chosen, number of points needled per session, duration and sessions, and co-interventions.
探讨教科书、临床研究及临床实践中腰痛（LBP）针刺治疗方案的差异，并探究造成这些差异的原因。
对以英文或中文发表的教科书、调查、临床研究（随机对照试验（RCT）和病例研究）进行系统评价，并纳入中国专家意见。提取详细针刺治疗方案的数据。
纳入12本英文教科书、31本中文教科书、3项英文调查、无中文调查、9篇中国专家意见、25项英文RCT、29项中文RCT以及38项英文病例研究。对于慢性非特异性腰痛，在治疗方案中发现的显著差异为（无论针刺方法如何）：（i）临床研究和调查（9 - 11个穴位）报告的每次治疗使用的穴位比中国专家（5个穴位）多得多；（ii）所有来源使用了两种极端的治疗频率（每周1 - 2次与每周5 - 6次）。对于急性腰痛，RCT和病例研究之间的显著差异为：（i）研究了多种特殊穴位；（ii）病例研究报告的每次治疗使用的穴位（10个穴位）比中文RCT（2个穴位）多得多；（iii）中文RCT的治疗次数（6.5次）比英文RCT（3.5次）和病例研究（3次）多。
对于非特异性腰痛，针刺治疗方案因参考来源类型而异，在治疗频率、所选穴位、每次针刺的穴位数量、疗程和治疗次数以及联合干预方面均有不同。
