Acupuncture and Tuina College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China.
BMC Complement Altern Med. 2012 Jun 14;12:75. doi: 10.1186/1472-6882-12-75.
To evaluate different types of acupuncture treatment for migraine in China from the perspective of health economics, particularly the comparison between treatment of specific acupoints in Shaoyang meridians and penetrating sham acupoints treatment.
Data were obtained from a multicenter, randomized controlled trial of acupuncture treatment in patients with migraine. Four-hundred eighty migraineurs were randomly assigned to 3 arms of treatment with genuine acupoints and 1 arm of penetrating sham acupoints. The primary outcome measurement was the cost-effectiveness ratio (C/E), expressed as cost per 1 day reduction of headache days from baseline to week 16. Cost-comparison analyses, differences in the migraine-specific quality of life questionnaire (MSQ), and the incremental cost-effectiveness ratio were taken as secondary outcome measurements. In addition, a sensitivity analysis was conducted.
The total cost per patient was ¥1273.2 (95% CI 1171.3-1375.1) in the Shaoyang specific group, ¥1427.7 (95% CI 1311.8-1543.6) in the Shaoyang non-specific group, ¥1490.8 (95% CI 1327.1-1654.6) in the Yangming specific group, and ¥1470.1 (95% CI 1358.8-1581.3) in the sham acupuncture group. The reduced days with migraine were 3.972 ± 2.7, 3.555 ± 2.8, 3.793 ± 3.6, and 2.155 ± 3.7 in these 4 groups (P < 0.05 for each genuine acupoints group vs the sham group), respectively, at week 16. The C/Es of the 4 groups were 320.5, 401.6, 393.1, and 682.2, respectively. Results of the sensitivity analysis were consistent with that of the cost-effectiveness analysis. The Shaoyang specific group significantly improved in all 3 MSQ domains compared with the sham acupuncture group.
Treatment of specific acupoints in Shaoyang meridians is more cost-effective than that of non-acupoints, representing a dramatic improvement in the quality of life of people with migraine and a significant reduction in cost. Compared with the other 3 groups, Shaoyang-specific acupuncture is a relatively cost-effective treatment for migraine prophylaxis in China.
Clinical Trials.gov NCT00599586.
从健康经济学的角度评估中国偏头痛的不同类型的针刺治疗，特别是比较在少阳经上的特定穴位治疗和穿透假穴位治疗。
数据来自于一项多中心、随机对照的针刺治疗偏头痛患者的临床试验。480 例偏头痛患者被随机分为 3 组真穴位治疗和 1 组穿透假穴位治疗。主要结局测量指标为成本效益比（C/E），表示从基线到第 16 周时每天头痛天数减少的成本比。成本比较分析、偏头痛特异性生活质量问卷（MSQ）的差异以及增量成本效益比为次要结局测量指标。此外，还进行了敏感性分析。
少阳特定组每位患者的总费用为 1273.2 元（95%可信区间 1171.3-1375.1），少阳非特定组为 1427.7 元（95%可信区间 1311.8-1543.6），阳明特定组为 1490.8 元（95%可信区间 1327.1-1654.6），假针刺组为 1470.1 元（95%可信区间 1358.8-1581.3）。第 16 周时，4 组偏头痛缓解天数分别为 3.972±2.7、3.555±2.8、3.793±3.6 和 2.155±3.7（各真穴位组与假针组相比 P<0.05）。4 组的 C/E 分别为 320.5、401.6、393.1 和 682.2。敏感性分析结果与成本效益分析结果一致。与假针刺组相比，少阳特定组在所有 3 个 MSQ 领域均有显著改善。
在少阳经上的特定穴位治疗比非穴位治疗更具成本效益，这代表了偏头痛患者生活质量的显著改善和成本的显著降低。与其他 3 组相比，少阳特定穴针刺治疗是中国偏头痛预防治疗的一种相对经济有效的方法。
ClinicalTrials.gov NCT00599586。
