Haller Heidemarie, Lauche Romy, Cramer Holger, Rampp Thomas, Saha Felix J, Ostermann Thomas, Dobos Gustav
*Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen ‡Department of Psychology, Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Germany †Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia.
Clin J Pain. 2016 May;32(5):441-9. doi: 10.1097/AJP.0000000000000290.
With growing evidence for the effectiveness of craniosacral therapy (CST) for pain management, the efficacy of CST remains unclear. This study therefore aimed at investigating CST in comparison with sham treatment in chronic nonspecific neck pain patients.
A total of 54 blinded patients were randomized into either 8 weekly units of CST or light-touch sham treatment. Outcomes were assessed before and after treatment (week 8) and again 3 months later (week 20). The primary outcome was the pain intensity on a visual analog scale at week 8; secondary outcomes included pain on movement, pressure pain sensitivity, functional disability, health-related quality of life, well-being, anxiety, depression, stress perception, pain acceptance, body awareness, patients' global impression of improvement, and safety.
In comparison with sham, CST patients reported significant and clinically relevant effects on pain intensity at week 8 (-21 mm group difference; 95% confidence interval, -32.6 to -9.4; P=0.001; d=1.02) and at week 20 (-16.8 mm group difference; 95% confidence interval, -27.5 to -6.1; P=0.003; d=0.88). Minimal clinically important differences in pain intensity at week 20 were reported by 78% within the CST group, whereas 48% even had substantial clinical benefit. Significant between-group differences at week 20 were also found for pain on movement, functional disability, physical quality of life, anxiety and patients' global improvement. Pressure pain sensitivity and body awareness were significantly improved only at week 8. No serious adverse events were reported.
CST was both specifically effective and safe in reducing neck pain intensity and may improve functional disability and the quality of life up to 3 months after intervention.
随着越来越多的证据表明颅骶疗法（CST）在疼痛管理方面的有效性，但其疗效仍不明确。因此，本研究旨在比较CST与假治疗对慢性非特异性颈部疼痛患者的效果。
总共54名不知情的患者被随机分为接受8周的CST治疗组或轻触假治疗组。在治疗前（第8周）和治疗后以及3个月后（第20周）评估结果。主要结果是第8周时视觉模拟量表上的疼痛强度；次要结果包括运动时的疼痛、压痛敏感性、功能障碍、与健康相关的生活质量、幸福感、焦虑、抑郁、压力感知、疼痛接受度、身体意识、患者对改善的总体印象以及安全性。
与假治疗相比，接受CST治疗的患者在第8周时疼痛强度有显著且具有临床意义的改善（组间差异为-21mm；95%置信区间为-32.6至-9.4；P=0.001；d=1.02），在第20周时也有改善（组间差异为-16.8mm；95%置信区间为-27.5至-6.1；P=0.003；d=0.88）。CST组中78%的患者在第20周时报告了疼痛强度的最小临床重要差异，而48%的患者甚至有显著的临床获益。在第20周时，两组在运动时的疼痛、功能障碍、身体生活质量、焦虑和患者总体改善方面也存在显著差异。压痛敏感性和身体意识仅在第8周时有显著改善。未报告严重不良事件。
CST在减轻颈部疼痛强度方面既具有特异性效果又安全，并且可能在干预后长达3个月内改善功能障碍和生活质量。
