Su Jiang-tao, Zhou Qing-hui, Li Rui, Zhang Jie, Li Wei-hong, Wang Qiong
Department of TCM, Changhai Hospital Affiliated to The Second Military Medical University, Shanghai 200433, China.
Zhongguo Zhen Jiu. 2010 Aug;30(8):617-22.
To assess the immediate analgesic effect of wrist-ankle acupuncture on acute lumbago and the relationship between the analgesic effect and the expectation of patients.
A randomized, single-blind, sham-controlled trial was designed. Sixty cases of acute lumbago were randomly divided into two groups, 30 cases in each one. In observation group, wrist-ankle acupuncture was adopted to the Lower 5 and Lower 6 bilaterally, no requirement of Deqi (arrival of qi). In control group, sham acupuncture was adopted. The treatment was applied once in either group, with the needles retained for 30 min. The Short-form McGill Pain Questionnaire (SF-MPQ) and the Modified-Modified Schober (MMS) test were used to assess the motion related pain and the situation of spinal flexion in 3 min before treatment and 5 min, 10 min, 15 min, during treatment and 30 min (needle removed), respectively. The Expectation and Treatment Credibility Scale (ETCS) was applied to analyze the relationship between the expectation of patients and the analgesic effect. The adverse reaction was recorded.
There were no statistically significant differences in SF-MPQ, MMS and ETCS before treatment between two groups (all P>0.05). In 5 min after needles insertion, the scores of the items in SF-MPQ in observation group were lower than those in control group (P<0.05, P<0.01). In 10 min after needles insertion, the scores of SF-MPQ in observation group were lower than those in control group and the scores of MMS were higher than those in control group (P<0.05). In 15 min after needles insertion, except the sensory pain rating index, the scores of the rest items in SF-MPQ in observation group were all lower than those in control group (P<0.05, P<0.01). In 30 min (needles removed), the scores of affective pain rating index of SF-MPQ and Visual Analogue Scale (VAS) in observation group were lower than those in control group (P<0.05, P<0.01). The expectation before treatment was negatively correlated with VAS scores in 5 min, 10 min, 15 min and 30 min after needle insertion separately in observation group (P<0.05), while the correlation was not found in control group (P>0.05). No adverse reaction was reported.
Wrist-ankle acupuncture can reduce acute lumbago immediately and significantly. The higher the expectation on the analgesic effect of wrist-ankle acupuncture the patients have, the better the analgesic effect will be. This therapy is highly safe in the treatment.
评估腕踝针治疗急性腰痛的即时镇痛效果以及镇痛效果与患者期望之间的关系。
设计一项随机、单盲、假针刺对照试验。将60例急性腰痛患者随机分为两组,每组30例。观察组双侧腕踝针取双下肢5区、6区,不要求得气。对照组采用假针刺。两组均治疗1次,留针30分钟。分别于治疗前3分钟及治疗中、治疗后5分钟、10分钟、15分钟、30分钟(拔针后)采用简化麦吉尔疼痛问卷(SF-MPQ)和改良改良肖伯试验(MMS)评估运动相关疼痛及脊柱前屈情况。应用期望与治疗可信度量表(ETCS)分析患者期望与镇痛效果之间的关系。记录不良反应。
两组治疗前SF-MPQ、MMS及ETCS评分差异均无统计学意义(均P>0.05)。观察组进针后5分钟,SF-MPQ各条目评分低于对照组(P<0.05,P<0.01)。进针后10分钟,观察组SF-MPQ评分低于对照组,MMS评分高于对照组(P<0.05)。进针后15分钟,观察组除感觉疼痛评分指数外,SF-MPQ其余各条目评分均低于对照组(P<0.05,P<0.01)。治疗后30分钟(拔针后),观察组SF-MPQ情感疼痛评分指数及视觉模拟评分法(VAS)评分低于对照组(P<0.05,P<0.01)。观察组治疗前期望与进针后5分钟、10分钟、15分钟、30分钟VAS评分分别呈负相关(P<0.05),而对照组未发现相关性(P>0.05)。未报告不良反应。
腕踝针能迅速、显著减轻急性腰痛。患者对腕踝针镇痛效果的期望越高,镇痛效果越好。该疗法治疗安全性高。