Witt Claudia M, Pach Daniel, Brinkhaus Benno, Wruck Katja, Tag Brigitte, Mank Sigrid, Willich Stefan N
Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany.
Forsch Komplementmed. 2009 Apr;16(2):91-7. doi: 10.1159/000209315. Epub 2009 Apr 9.
To evaluate the safety of acupuncture in a large number of patients receiving conventional health care and, based on these results, to develop a new medical consent form for acupuncture.
The prospective observational study included patients who received acupuncture treatment for chronic osteoarthritis pain of the knee or hip, low back pain, neck pain or headache, allergic rhinitis, asthma, or dysmenorrhoea. After treatment, all patients documented adverse events associated with acupuncture (defined as adverse effects). Patients who reported a need for treatment due to an adverse effect completed an additional standardised questionnaire on the most important adverse effect. Based on this data and considering ethical and legal aspects a new consent form was developed.
A total of 229,230 patients received on average 10.2 +/- 3.0 acupuncture treatments. Altogether, 19,726 patients (8.6%) reported experiencing at least one adverse effect and 4,963 (2.2%) reported one which required treatment. Common adverse effects were bleedings or haematoma (6.1% of patients, 58% of all adverse effects), pain (1.7%) and vegetative symptoms (0.7%). Two patients experienced a pneumothorax (one needed hospital treatment, the other observation only). The longest duration of a side effect was 180 days (nerve lesion of the lower limb). The resulting medical consent form consists of five modules: Introduction to acupuncture and moxibustion, Risks of acupuncture treatment, Conditions which can increase the risk, Doctor's statement, and Consent.
Acupuncture provided by physicians is a relatively safe treatment and the proposed consent form could support both patients and professionals in the process of obtaining informed consent.
评估大量接受常规医疗保健的患者接受针灸治疗的安全性,并基于这些结果制定一种新的针灸医疗同意书。
这项前瞻性观察性研究纳入了因膝关节或髋关节慢性骨关节炎疼痛、腰痛、颈部疼痛或头痛、过敏性鼻炎、哮喘或痛经而接受针灸治疗的患者。治疗后,所有患者记录与针灸相关的不良事件(定义为不良反应)。因不良反应而报告需要治疗的患者完成了一份关于最重要不良反应的额外标准化问卷。基于这些数据并考虑伦理和法律方面,制定了一份新的同意书。
共有229,230名患者平均接受了10.2±3.0次针灸治疗。总共19,726名患者(8.6%)报告至少经历了一种不良反应,4,963名患者(2.2%)报告了一种需要治疗的不良反应。常见的不良反应包括出血或血肿(占患者的6.1%,占所有不良反应的58%)、疼痛(1.7%)和植物神经症状(0.7%)。两名患者发生了气胸(一名需要住院治疗,另一名仅需观察)。副作用的最长持续时间为180天(下肢神经损伤)。由此产生的医疗同意书由五个模块组成:针灸和艾灸介绍、针灸治疗风险、可能增加风险的情况、医生声明和同意。
医生提供的针灸治疗是一种相对安全的治疗方法,所提议的同意书可为患者和专业人员在获得知情同意的过程中提供支持。