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针刺在慢性血友病疼痛管理中的应用。

Use of acupuncture in the management of chronic haemophilia pain.

机构信息

Henry Ford Health System, Hemophilia and Thrombosis Treatment Center, Detroit, MI, USA.

出版信息

Haemophilia. 2012 Jul;18(4):613-7. doi: 10.1111/j.1365-2516.2012.02766.x. Epub 2012 Mar 8.

Abstract

Persons with haemophilia experience persistent pain resulting in chronic arthritic symptoms. The older person with haemophilia who did not benefit from primary prophylaxis are particularly at risk for persistent pain in multiple target joints as a result of repeated joint bleeding with delayed treatment received. The National Pain Study, Ref. [11] identified over 700 persons with haemophilia who rated daily persistent pain as 4.22/10 (SD ± 2.05) using a visual analogue scale. The study suggests that persons are continually seeking additional resources to relieve pain. This study seeks to identify: (i) effects of acupuncture use for persons with haemophilia who experience persistent joint pain as a result of repeated haemarthrosis and (ii) document no reported increased bleeding risk as a result of acupuncture use. End points include the subjects reported perception of reduction in pain via the 10-point visual analogue pain scale and bleeding. Nine subjects participated in the study, some who received a factor replacement to 15% correction and others who did not receive factor prior to any acupuncture sessions totaling 14 acupuncture treatments. No one of the subjects experienced bleeding or bruising. Six of the nine subjects reported an improvement in pain scores by at least 50%. Seven of the nine quality of life (QOL) domains within the QOL SF-36 questionnaire improved, suggesting a perception by subjects of improvement. This study suggests that acupuncture therapy can be a safe additional modality for pain management therapies in persons with haemophilia, although larger randomized studies are needed for further validation.

摘要

患有血友病的人会经历持续的疼痛,导致慢性关节炎症状。未从初级预防中受益的老年血友病患者由于反复关节出血和延迟治疗,特别容易在多个目标关节中出现持续疼痛。国家疼痛研究,参考文献[11]确定了超过 700 名血友病患者,他们使用视觉模拟量表将每日持续疼痛评为 4.22/10(SD ± 2.05)。该研究表明,人们一直在寻求额外的资源来缓解疼痛。本研究旨在确定:(i)针灸治疗因反复关节内出血而导致持续性关节疼痛的血友病患者的效果,以及(ii)记录针灸治疗不会增加出血风险。终点包括通过 10 分视觉模拟疼痛量表和出血报告,受试者报告的疼痛减轻程度。9 名受试者参与了这项研究,一些人接受了 15%的因子替代治疗,而另一些人在接受任何针灸治疗前没有接受因子治疗,共接受了 14 次针灸治疗。没有一名受试者出现出血或瘀伤。9 名受试者中有 6 名报告疼痛评分至少改善了 50%。9 名受试者中有 7 名在生活质量(QOL)SF-36 问卷的 7 个领域中改善,这表明受试者感知到了改善。本研究表明,针灸疗法可以成为血友病患者疼痛管理治疗的一种安全的附加疗法,尽管需要更大规模的随机研究来进一步验证。

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