Chengdu Military General Hospital, Chengdu, Sichuan, PR China.
J Altern Complement Med. 2012 Feb;18(2):130-6. doi: 10.1089/acm.2010.0779.
Acupuncture has long been employed for the treatment of chronic low back pain (CLBP). However, very few studies have characterized the effectiveness of the different acupuncture modes for CLBP.
In total, 187 patients with CLBP participated in this study. Eligible patients were randomized to Hegu acupuncture, Standard acupuncture, or Usual Care groups. Eighteen (18) treatments were provided over 7 weeks. Back-related dysfunction and symptom severity were assessed by the Roland-Morris Disability Questionnaire (RMDQ) and the Visual Analogue Scale (VAS), which were collected at baseline and at 8 and 48 weeks after beginning the treatment. Repeated-measures analysis of variance (ANOVA) was employed for factorial analyses.
Significant differences were found between follow-up and the baseline scores (p<0.05). The Hegu acupuncture group had higher RMDQ scores (8 weeks, 5.3 versus 2.1; 48 weeks, 5.7 versus 3.3; p<0.001 for both) and VAS scores (8 weeks, 1.5 versus 0.5; 48 weeks, 2.6 versus 1.6; p<0.001 for both) compared with the usual care group. The standardized acupuncture group also had higher RMDQ scores (8 weeks, 4.2 versus 2.1; 48 weeks, 4.6 versus 3.3, p<0.001 for both) and VAS scores (8 weeks, 1.3 versus 0.5; 48 weeks, 2.4 versus 1.6, p<0.001 for both) compared with the Usual Care group. The Hegu group had higher RMDQ scores (8 weeks, p<0.05; 48 weeks, p<0.001) and VAS scores (48 weeks, p<0.05) compared with the standardized group. There was a significant difference between the Hegu and standardized acupuncture groups in repeated-measures ANOVA (p<0.05). Across the three testing points, significant differences were found in the RMDQ and VAS scores between the usual care group and both treatment groups (p<0.001).
Both acupuncture modes have beneficial and persistent effectiveness against CLBP compared with the usual care group; Hegu acupuncture is significantly more effective than standardized acupuncture, especially in the long term.
针灸长期以来一直被用于治疗慢性下腰痛（CLBP）。然而，很少有研究描述 CLBP 不同针灸模式的有效性。
共有 187 名 CLBP 患者参与了这项研究。符合条件的患者被随机分配到合谷穴针灸、标准针灸或常规护理组。7 周内共进行 18 次治疗。采用 Roland-Morris 残疾问卷（RMDQ）和视觉模拟量表（VAS）评估与背部相关的功能障碍和症状严重程度，在治疗开始后 8 周和 48 周时收集。采用重复测量方差（ANOVA）进行析因分析。
随访与基线评分之间存在显著差异（p<0.05）。与常规护理组相比，合谷穴针灸组的 RMDQ 评分（8 周，5.3 比 2.1；48 周，5.7 比 3.3；p<0.001）和 VAS 评分（8 周，1.5 比 0.5；48 周，2.6 比 1.6；p<0.001）更高。标准针灸组的 RMDQ 评分（8 周，4.2 比 2.1；48 周，4.6 比 3.3；p<0.001）和 VAS 评分（8 周，1.3 比 0.5；48 周，2.4 比 1.6；p<0.001）也高于常规护理组。与标准组相比，合谷组的 RMDQ 评分（8 周，p<0.05；48 周，p<0.001）和 VAS 评分（48 周，p<0.05）更高。在重复测量方差分析中，合谷组和标准组之间存在显著差异（p<0.05）。在三个测试点中，常规护理组与两组治疗组之间的 RMDQ 和 VAS 评分均有显著差异（p<0.001）。
与常规护理组相比，两种针灸模式对 CLBP 均具有有益且持久的疗效；与标准针灸相比，合谷针灸在长期疗效方面更显著。
