Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden.
Acupunct Med. 2011 Jun;29(2):108-15. doi: 10.1136/aim.2010.003269. Epub 2011 Apr 6.
The study sought to explore the possibility of using acupuncture and massage therapy for relieving neuropathic pain following spinal cord injury (SCI).
30 individuals with SCI and neuropathic pain were assigned to treatment of either massage or acupuncture, with 15 individuals in each group. Both groups received treatment twice weekly for 6 weeks. Treatments were evaluated at the end of treatment and 2 months later (follow-up).
Data were analysed on an intention-to-treat basis. Within the groups, ratings of present pain, general pain, pain unpleasantness and coping improved significantly at the end of treatment after acupuncture compared to baseline values, and following massage therapy ratings of pain interference on the Multidimensional Pain Inventory improved. At follow-up no significant improvements were seen. Between-group differences were seen regarding ratings of worst pain intensity at the end of treatment, and regarding pain unpleasantness and coping with pain at follow-up, both in favour of acupuncture. At the end of treatment, eight of the 15 individuals receiving acupuncture and nine receiving massage reported an improvement on the Patient Global Impression of Change Scale, and at follow-up six patients in the acupuncture group and one patient in the massage group still reported a favourable effect from the treatment. Few side effects were reported and neither dropout from the study did this due to adverse events.
Neuropathic pain following SCI is often only partially responsive to most interventions. Results from this study indicate, however, that both acupuncture and massage therapy may relieve SCI neuropathic pain. For this reason, larger randomised controlled trials are warranted for assessing the long-term effects of these treatments.
本研究旨在探讨针灸和按摩疗法缓解脊髓损伤后神经性疼痛的可能性。
30 名脊髓损伤伴神经性疼痛的患者被分配至按摩或针灸治疗组,每组 15 人。两组患者均每周接受两次治疗,共 6 周。在治疗结束时和 2 个月后(随访)对治疗进行评估。
对意向治疗进行数据分析。在组内,与基线值相比,针刺治疗后治疗结束时的当前疼痛、总体疼痛、疼痛不适和应对评分显著改善,而按摩治疗后多维疼痛量表的疼痛干扰评分也有所改善。随访时未见显著改善。在治疗结束时,针刺组的 15 名患者中有 8 名和按摩组的 9 名患者的最差疼痛强度评分存在组间差异,在随访时的疼痛不适和应对疼痛方面也存在组间差异,均有利于针刺组。治疗结束时,接受针刺治疗的 15 名患者中有 8 名和接受按摩治疗的 15 名患者中有 9 名报告了患者整体变化量表的改善,随访时针刺组仍有 6 名患者和按摩组有 1 名患者报告治疗效果良好。报告的副作用很少,也没有因不良反应而退出研究的患者。
脊髓损伤后的神经性疼痛通常对大多数干预措施仅有部分反应。然而,本研究结果表明,针灸和按摩疗法均可缓解脊髓损伤后的神经性疼痛。因此,有必要进行更大规模的随机对照试验来评估这些治疗方法的长期效果。