Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
Am J Chin Med. 2013;41(1):1-19. doi: 10.1142/S0192415X13500018.
Chronic low back pain is one of the most common reasons that people seek medical treatment, and the consequent disability creates a great financial burden on individuals and society. The etiology of chronic low back pain is not clear, which means it is often refractory to treatment. Acupuncture has been reported to be effective in providing symptomatic relief of chronic low back pain. However, it is not known whether the effects of acupuncture are due to the needling itself or nonspecific effects arising from the manipulation. To determine the effectiveness of acupuncture therapy, a meta-analysis was performed to compare acupuncture with sham acupuncture and other treatments. Overall, 2678 patients were identified from thirteen randomized controlled trials. The meta-analysis was performed by a random model (Cohen's test), using the I-square test for heterogeneity and Begg's test to assess for publication bias. Clinical outcomes were evaluated by pain intensity, disability, spinal flexion, and quality of life. Compared with no treatment, acupuncture achieved better outcomes in terms of pain relief, disability recovery and better quality of life, but these effects were not observed when compared to sham acupuncture. Acupuncture achieved better outcomes when compared with other treatments. No publication bias was detected. Acupuncture is an effective treatment for chronic low back pain, but this effect is likely to be produced by the nonspecific effects of manipulation.
慢性下背痛是人们寻求医疗的最常见原因之一，由此导致的残疾给个人和社会带来了巨大的经济负担。慢性下背痛的病因尚不清楚，这意味着它通常对治疗有抗性。有报道称针灸对慢性下背痛的症状缓解有效。然而，尚不清楚针灸的效果是由于针刺本身还是由于操作引起的非特异性效应。为了确定针灸疗法的有效性，进行了荟萃分析，以比较针灸与假针灸和其他治疗方法。总体而言，从 13 项随机对照试验中确定了 2678 名患者。荟萃分析采用随机模型（Cohen 检验）进行，使用 I 平方检验进行异质性检验和 Begg 检验评估发表偏倚。临床结果通过疼痛强度、残疾、脊柱弯曲和生活质量来评估。与不治疗相比，针灸在缓解疼痛、恢复残疾和提高生活质量方面有更好的效果，但与假针灸相比，没有观察到这些效果。与其他治疗方法相比，针灸的效果更好。未发现发表偏倚。针灸是治疗慢性下背痛的有效方法，但这种效果可能是由操作的非特异性效应产生的。
