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有症状的腰椎滑脱非手术综合干预措施的有效性和安全性:一项随机对照的多国多中心试验方案。

The effectiveness and safety of nonsurgical integrative interventions for symptomatic lumbar spinal spondylolisthesis: A randomized controlled multinational, multicenter trial protocol.

作者信息

Kim Kiok, Youn Yousuk, Lee Sang Ho, Choi Jung Chul, Jung Jae Eun, Kim Jaehong, Qu Wenchun, Eldrige Jason, Kim Tae-Hun

机构信息

Department of Spine Center, Mokhuri Neck and Back Hospital, Seoul Hongik Neurosurgery Hospital, Seongnam, Republic of Korea Department of Physical Medicine and Rehabilitation Department of Anesthesiology, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul, Republic of Korea.

出版信息

Medicine (Baltimore). 2018 May;97(19):e0667. doi: 10.1097/MD.0000000000010667.

Abstract

BACKGROUND

Surgery is generally accepted as the main therapeutic option for symptomatic lumbar spondylolisthesis. However, new nonsurgical therapeutic options need to be explored for this population.

OBJECTIVES

The objective of this study is to assess the effectiveness and safety of a 5-week Mokhuri treatment program compared with conventional nonsurgical treatments for symptomatic lumbar spondylolisthesis.

METHODS

This is a study protocol for a multinational, multicenter clinical randomized controlled trial comparing the effectiveness and safety of 5 weeks of nonsurgical integrative treatments (a Mokhuri treatment program consisting of Chuna, acupuncture, and patient education) with nonsurgical conventional treatments (drugs for pain relief, epidural steroid injections, and physical therapy). Clinical outcomes including visual analogue scale (VAS) scores ranging from 0 to 100 for low back pain and leg pain, EQ-5D scores, Oswestry disability index (ODI) scores, Roland-Morris Disability Questionnaire (RMDQ) scores, Zurich Claudication Questionnaire (ZCQ) scores, walking duration and distance without leg pain, and a 5-minute treadmill test, and the ratio between the actual duration of participation and the originally scheduled duration in each group, the presence of any additional spondylolisthesis treatments, the types of concomitant treatments during the follow-up period, and adverse events (AEs) will be assessed at 7 weeks, 18 weeks, 30 weeks, 54 weeks, and 102 weeks after the end of the treatments.

CONCLUSION AND DISCUSSION

The results of this study will provide clinical evidence on nonsurgical integrative interventions for patients with symptomatic lumbar spondylolisthesis. CLINICAL TRIAL REGISTRY:: clinicaltrials.gov (NCT03107468).

摘要

背景

手术通常被认为是有症状的腰椎滑脱的主要治疗选择。然而,需要为这一人群探索新的非手术治疗选择。

目的

本研究的目的是评估为期5周的 Mokhuri 治疗方案与有症状的腰椎滑脱的传统非手术治疗相比的有效性和安全性。

方法

这是一项多国、多中心临床随机对照试验的研究方案,比较5周非手术综合治疗(由推拿、针灸和患者教育组成的 Mokhuri 治疗方案)与非手术传统治疗(止痛药物、硬膜外类固醇注射和物理治疗)的有效性和安全性。临床结局包括下腰痛和腿痛的视觉模拟量表(VAS)评分(范围为0至100)、EQ-5D评分、Oswestry功能障碍指数(ODI)评分、罗兰-莫里斯残疾问卷(RMDQ)评分、苏黎世间歇性跛行问卷(ZCQ)评分、无腿痛的步行持续时间和距离、5分钟跑步机测试,以及每组实际参与持续时间与原定持续时间的比率、任何额外的腰椎滑脱治疗的存在情况、随访期间伴随治疗的类型以及不良事件(AE),将在治疗结束后的7周、18周、30周、54周和102周进行评估。

结论与讨论

本研究结果将为有症状的腰椎滑脱患者的非手术综合干预提供临床证据。临床试验注册:clinicaltrials.gov(NCT03107468)。

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