Reinstein Adam S, Erickson Lauren O, Griffin Kristen H, Rivard Rachael L, Kapsner Christopher E, Finch Michael D, Dusek Jeffery A
Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota, USA.
Emergency Department, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
Pain Med. 2017 Jan 30;18(1):169-178. doi: 10.1093/pm/pnv114.
To evaluate acceptability and clinical outcomes of acupuncture on patient-reported pain and anxiety in an emergency department (ED).
Observational, retrospective pilot study.
Abbott Northwestern Hospital ED, Minneapolis, MN.
Retrospective data was used to identify patients receiving acupuncture in addition to standard medical care in the ED between 11/1/13 and 12/31/14. Feasibility was measured by quantifying the utilization of acupuncture in a novel setting and performing limited tests of its efficacy. Patient-reported pain and anxiety scores were collected by the acupuncturist using an 11-point (0-10) numeric rating scale before (pre) and immediately after (post) acupuncture. Efficacy outcomes were change in pain and anxiety scores.
During the study period, 436 patients were referred for acupuncture, 279 of whom were approached by the acupuncturist during their ED visit. Consent for acupuncture was obtained from 89% (248/279). A total of 182 patients, who had a pre-pain score >0 and non-missing anxiety scores, were included in analyses. Of the 52% (94/182) who did not have analgesics before or during the acupuncture session, the average decrease of 2.37 points (95% CI: 1.92, 2.83) was not different (p > 0.05) than the mean decrease of 2.68 points for those receiving analgesics (95% CI 2.21, 3.15). The average pre-anxiety score was 4.73 points (SD = 3.43) and the mean decrease was 2.27 points (95% CI: 1.89, 2.66).
Results from this observational trial indicate that acupuncture was acceptable and effective for pain and anxiety reduction, in conjunction with standard medical care. These results will inform future randomized trials.
评估针刺疗法对急诊科患者自述疼痛和焦虑的可接受性及临床疗效。
观察性回顾性试点研究。
明尼苏达州明尼阿波利斯市雅培西北医院急诊科。
采用回顾性数据，确定在2013年11月1日至2014年12月31日期间，在急诊科接受标准医疗护理的同时还接受针刺治疗的患者。通过量化针刺疗法在新环境中的使用情况并对其疗效进行有限测试来衡量可行性。针灸师在针刺前（针刺前）和针刺后立即（针刺后）使用11分制（0 - 10）数字评分量表收集患者自述的疼痛和焦虑评分。疗效结果为疼痛和焦虑评分的变化。
在研究期间，436名患者被转诊接受针刺治疗，其中279名患者在急诊科就诊时被针灸师接触。89%（248/279）的患者获得了针刺治疗的同意。共有182名患者纳入分析，这些患者针刺前疼痛评分>0且焦虑评分无缺失。在针刺过程中或针刺前未使用镇痛药的患者中，52%（94/182）的患者平均疼痛评分下降2.37分（95%可信区间：1.92, 2.83），与接受镇痛药治疗的患者平均下降2.68分（95%可信区间2.21, 3.15）相比，差异无统计学意义（p > 0.05）。焦虑评分的平均针刺前评分为4.73分（标准差 = 3.43），平均下降2.27分（95%可信区间：1.89, 2.66）。
该观察性试验结果表明，针刺疗法结合标准医疗护理对减轻疼痛和焦虑是可接受且有效的。这些结果将为未来的随机试验提供参考。
