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一项针对慢性阻塞性肺疾病(COPD)患者的针刺随机安慰剂对照试验:COPD针刺试验(CAT)。

A randomized, placebo-controlled trial of acupuncture in patients with chronic obstructive pulmonary disease (COPD): the COPD-acupuncture trial (CAT).

作者信息

Suzuki Masao, Muro Shigeo, Ando Yuki, Omori Takashi, Shiota Tetsuhiro, Endo Kazuo, Sato Susumu, Aihara Kensaku, Matsumoto Masataka, Suzuki Shinko, Itotani Ryo, Ishitoko Manabu, Hara Yoshikazu, Takemura Masaya, Ueda Tetsuya, Kagioka Hitoshi, Hirabayashi Masataka, Fukui Motonari, Mishima Michiaki

机构信息

Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Japan.

出版信息

Arch Intern Med. 2012 Jun 11;172(11):878-86. doi: 10.1001/archinternmed.2012.1233.

Abstract

BACKGROUND

Dyspnea on exertion (DOE) is a major symptom of chronic obstructive pulmonary disease (COPD) and is difficult to control. This study was performed to determine whether acupuncture is superior to placebo needling in improving DOE in patients with COPD who are receiving standard medication.

METHODS

Sixty-eight of 111 patients from the Kansai region of Japan who were diagnosed as having COPD and were receiving standard medication participated in a randomized, parallel-group, placebo-controlled trial (July 1, 2006, through March 31, 2009) in which the patients, evaluators, and statistician were unaware of the random allocation. Participants were randomly assigned to traditional acupuncture (real acupuncture group, n=34) or placebo needling (placebo acupuncture group, n=34). Both groups received real or placebo needling at the same acupoints once a week for 12 weeks. The primary end point was the modified Borg scale score evaluated immediately after the 6-minute walk test. Measurements were obtained at baseline and after 12 weeks of treatment.

RESULT

After 12 weeks, the Borg scale score after the 6-minute walk test was significantly better in the real acupuncture group compared with the placebo acupuncture group (mean [SD] difference from baseline by analysis of covariance, -3.6 [1.9] vs 0.4 [1.2]; mean difference between groups by analysis of covariance, -3.58; 95% CI, -4.27 to -2.90). Patients with COPD who received real acupuncture also experienced improvement in the 6-minute walk distance during exercise, indicating better exercise tolerance and reduced DOE.

CONCLUSION

This study clearly demonstrates that acupuncture is a useful adjunctive therapy in reducing DOE in patients with COPD.

TRIAL REGISTRATION

umin.ac.jp/ctr Identifier: UMIN000001277.

摘要

背景

运动性呼吸困难(DOE)是慢性阻塞性肺疾病(COPD)的主要症状,且难以控制。本研究旨在确定在接受标准药物治疗的COPD患者中,针刺疗法在改善DOE方面是否优于假针刺疗法。

方法

来自日本关西地区的111名被诊断为患有COPD且正在接受标准药物治疗的患者中,有68名参加了一项随机、平行组、安慰剂对照试验(2006年7月1日至2009年3月31日),患者、评估者和统计学家均不知随机分配情况。参与者被随机分配至传统针刺组(真针刺组,n = 34)或假针刺组(假针刺疗法组,n = 34)。两组均在相同穴位接受真针刺或假针刺,每周1次,共12周。主要终点是6分钟步行试验后立即评估的改良Borg量表评分。在基线和治疗12周后进行测量。

结果

12周后,真针刺组6分钟步行试验后的Borg量表评分显著优于假针刺疗法组(协方差分析得出的与基线相比的平均[标准差]差值,-3.6 [1.9] 对比 0.4 [1.2];协方差分析得出的组间平均差值,-3.58;95% CI,-4.27至-2.90)。接受真针刺的COPD患者在运动期间的6分钟步行距离也有所改善,表明运动耐量更好且DOE减轻。

结论

本研究清楚地表明,针刺疗法是减轻COPD患者DOE的一种有用的辅助治疗方法。

试验注册

umin.ac.jp/ctr 标识符:UMIN000001277

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