Peninsula Medical School, N32 ITTC Building, Tamar Science Park, Plymouth PL6 8BX, UK.
Acupunct Med. 2009 Jun;27(2):70-2. doi: 10.1136/aim.2009.000810.
A new guideline on the care and management of osteoarthritis has recently been published by the National Institute for Health and Clinical Excellence, and makes wide-ranging and authoritative recommendations. The guideline states that there is insufficient evidence to recommend acupuncture. There appears to be three areas where the guidelines may have not used the available evidence in the most appropriate manner. First, data on the long-term effectiveness of acupuncture may have been misinterpreted. Second, the specific rejection of electroacupuncture indicates a restricted understanding of acupuncture as a treatment, and is based on a cost-effectiveness analysis which may not be ideal. Third, the cost-effectiveness calculations used comparisons with sham acupuncture ("placebo") when comparison with standard care would have been more appropriate. The guideline may therefore lead some patients with osteoarthritis to miss out on a treatment that may be effective for them.
最近，国家卫生与临床优化研究所发布了一份关于骨关节炎护理和管理的新指南，其中提出了广泛而权威的建议。该指南指出，没有足够的证据推荐使用针灸。该指南可能有三个方面没有以最合适的方式使用现有证据。首先，针灸长期疗效的数据可能被误解了。其次，明确拒绝电针表明对针灸作为一种治疗方法的理解有限，这是基于成本效益分析，可能并不理想。第三，使用与假针灸（“安慰剂”）的成本效益计算进行比较，而与标准护理进行比较会更合适。因此，该指南可能导致一些骨关节炎患者错失可能对他们有效的治疗方法。
