Lathia Amanda Tiffany, Jung S M, Chen Lan X
Department of Internal Medicine, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224, Philadelphia, PA, USA.
J Altern Complement Med. 2009 Jun;15(6):613-8. doi: 10.1089/acm.2008.0272.
The aim of this study was to evaluate the efficacy of acupuncture as a treatment for chronic shoulder pain and to compare the efficacy of individualized acupuncture to fixed, standard point acupuncture treatment.
The study was a single-blind randomized, controlled trial.
SETTINGS/LOCATION: The study was conducted in an outpatient rheumatology clinic at the VA Medical Center of Philadelphia.
The participants were adults with shoulder pain for at least 8 weeks with a diagnosis of osteoarthritis or rotator cuff tendonitis and a total Shoulder Pain and Disability Index (SPADI) score of > or =30.
Thirty-one (31) subjects were randomized to one of three treatment groups: individualized acupuncture points according to the approaches of Traditional Chinese Medicine; fixed, standard acupuncture points conventionally used for shoulder pain; and sham nonpenetrating acupuncture. Subjects received 12 treatments over 6 weeks and were reassessed using the SPADI at the end of the 6 weeks.
The primary outcome evaluated was the mean change in total SPADI score in each group from baseline to 6 weeks.
After 6 weeks of treatment, the mean total SPADI score improved in all three groups, but the change was clinically significant (> or =10 points) only in groups 1 and 2 (-20.3 and -20.4, respectively, versus -6.5 in group 3). The treatment effects of groups 1 and 2 compared to the sham acupuncture group were -13.8 (95% confidence interval: -2.2 to -25.4, p < 0.015) and -13.9 (-2.0 to -25.8, p < 0.013), respectively. There was no difference between the individualized acupuncture and standardized acupuncture treatments.
Acupuncture may be an effective treatment for chronic shoulder pain. There may be no difference in efficacy between individualized and standardized acupuncture treatment. This suggests that the use of standard points may make treatment easier for patient care and for further research studies.
本研究旨在评估针刺治疗慢性肩痛的疗效，并比较个体化针刺与固定标准穴位针刺治疗的疗效。
本研究为单盲随机对照试验。
研究在费城退伍军人医疗中心的门诊风湿病诊所进行。
参与者为患有肩痛至少8周、诊断为骨关节炎或肩袖肌腱炎且总肩痛与功能障碍指数（SPADI）评分≥30的成年人。
31名受试者被随机分为三个治疗组之一：根据中医方法选取个体化穴位；用于肩痛的固定标准穴位；假非穿透性针刺。受试者在6周内接受12次治疗，并在6周结束时使用SPADI进行重新评估。
评估的主要结果是每组从基线到6周时总SPADI评分的平均变化。
治疗6周后，三组的总SPADI平均评分均有所改善，但仅第1组和第2组的变化具有临床意义（≥10分）（分别为-20.3和-20.4，而第3组为-6.5）。与假针刺组相比，第1组和第2组的治疗效果分别为-13.8（95%置信区间：-2.2至-25.4，p<0.015）和-13.9（-2.0至-25.8，p<0.013）。个体化针刺与标准化针刺治疗之间无差异。
针刺可能是治疗慢性肩痛的有效方法。个体化针刺与标准化针刺治疗的疗效可能无差异。这表明使用标准穴位可能使治疗更便于患者护理和进一步研究。
