Fleckenstein Johannes, Lill Christian, Lüdtke Rainer, Gleditsch Jochen, Rasp Gerd, Irnich Dominik
Multidisciplinary Pain Center, Department of Anesthesiology, University of Munich, Pettenkoferstr 8A, 80336 München, Germany.
Clin J Pain. 2009 Sep;25(7):624-31. doi: 10.1097/AJP.0b013e3181a49e35.
One out of 4 patients visiting a general practitioner reports of a sore throat associated with pain on swallowing. This study was established to examine the immediate pain alleviating effect of a single point acupuncture treatment applied to the large intestine meridian of patients with sore throat.
Sixty patients with acute tonsillitis and pharyngitis were enrolled in this randomized placebo-controlled trial. They either received acupuncture, or sham laser acupuncture, directed to the large intestine meridian section between acupuncture points LI 8 and LI 10. The main outcome measure was the change of pain intensity on swallowing a sip of water evaluated by a visual analog scale 15 minutes after treatment. A credibility assessment regarding the respective treatment was performed.
The pain intensity for the acupuncture group before and immediately after therapy was 5.6+/-2.8 and 3.0+/-3.0, and for the sham group 5.6+/-2.5 and 3.8+/-2.5, respectively. Despite the articulation of a more pronounced improvement among the acupuncture group, there was no significant difference between groups (Delta=0.9, confidence interval: -0.2-2.0; P=0.12; analysis of covariance). Patients' satisfaction was high in both treatment groups. The study was prematurely terminated due to a subsequent lack of suitable patients.
A single acupuncture treatment applied to a selected area of the large intestine meridian was no more effective in the alleviation of pain associated with clinical sore throat than sham laser acupuncture applied to the same area. Hence, clinically relevant improvement could be achieved. Pain alleviation might partly be due to the intense palpation of the large intestine meridian. The benefit of a comprehensive acupuncture treatment protocol in this condition should be subject to further trials.
每4名看全科医生的患者中就有1人报告有咽喉疼痛且吞咽时疼痛。本研究旨在检验对咽喉疼痛患者大肠经进行单点针刺治疗的即时止痛效果。
60例急性扁桃体炎和咽炎患者纳入了这项随机安慰剂对照试验。他们分别接受针对大肠经位于穴位手三里(LI 10)和上廉(LI 8)之间部位的针刺治疗或假激光针刺治疗。主要结局指标是治疗15分钟后通过视觉模拟量表评估的吞咽一小口水时疼痛强度的变化。对相应治疗进行了可信度评估。
针刺组治疗前和治疗后的疼痛强度分别为5.6±2.8和3.0±3.0,假针刺组分别为5.6±2.5和3.8±2.5。尽管针刺组的改善更为明显,但两组之间无显著差异(差值=0.9,置信区间:-0.2至2.0;P=0.12;协方差分析)。两个治疗组患者的满意度都很高。由于随后缺乏合适的患者,该研究提前终止。
对大肠经选定区域进行单次针刺治疗在缓解临床咽喉疼痛方面并不比在同一区域进行假激光针刺更有效。因此,可以实现临床相关的改善。疼痛缓解可能部分归因于对大肠经的强烈触诊。在这种情况下,全面针刺治疗方案的益处应通过进一步试验来验证。