Stival Rebecca Saray Marchesini, Cavalheiro Patrícia Rechetello, Stasiak Camila Edith Stachera, Galdino Dayana Talita, Hoekstra Bianca Eliza, Schafranski Marcelo Derbli
Faculdade de Medicina da Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brasil.
Universidade Federal do Paraná, Curitiba, PR, Brasil; Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brasil.
Rev Bras Reumatol. 2014 Nov-Dec;54(6):431-6. doi: 10.1016/j.rbr.2014.06.001. Epub 2014 Sep 23.
To evaluate the efficacy of acupuncture in the treatment of fibromyalgia, considering the immediate response of the visual analogue pain scale (VAS) as its primary outcome.
Randomized, controlled, double-blind study including 36 patients with fibromyalgia (ACR 1990) selected from the outpatient rheumatology clinic, Santa Casa de Misericórdia, Ponta Grossa, PR. Twenty-one patients underwent an acupuncture session, under the principles of the traditional Chinese medicine, and 15 patients underwent a placebo procedure (sham acupuncture). For pain assessment, the subjects completed a Visual Analogue Scale (VAS) before and immediately after the proposed procedure. The mean change in VAS was compared among groups.
The variation between the final and initial VAS values was -4.36±3.23 (P=0.0001) in the treatment group and -1.70±1.55 in the control group (P=0.06). The difference in terms of amplitude of variation of VAS (initial - final VAS) among groups favored the actual procedure (P=0.005). The effect size (ES) for the treatment group was d=1.7, which is considered a large effect. Although small, the statistical power of the sample for these results was very relevant (94.8%).
Acupuncture has proven effective in the immediate pain reduction in patients with fibromyalgia, with a quite significant effect size.
以视觉模拟疼痛量表（VAS）的即时反应作为主要结局指标，评估针刺治疗纤维肌痛的疗效。
采用随机、对照、双盲研究，从巴拉那州蓬塔格罗萨圣卡塔琳娜慈善医院门诊风湿病诊所选取36例符合美国风湿病学会1990年标准的纤维肌痛患者。21例患者按照中医理论接受针刺治疗，15例患者接受安慰剂治疗（假针刺）。为评估疼痛情况，受试者在治疗前及治疗后即刻完成视觉模拟量表（VAS）评分。比较两组VAS评分的平均变化。
治疗组VAS评分最终值与初始值的差值为-4.36±3.23（P=0.0001），对照组为-1.70±1.55（P=0.06）。两组间VAS评分变化幅度（初始VAS评分-最终VAS评分）的差异有利于实际治疗组（P=0.005）。治疗组的效应量（ES）为d=1.7，被认为是大效应。尽管样本量较小，但这些结果的检验效能非常可观（94.8%）。
针刺已被证明能有效减轻纤维肌痛患者的即时疼痛，且效应量相当显著。
