Wu Szu-Ying, Lu Cheng-Nan, Chung Chia-Jung, Kuo Chun-En, Sheen Jer-Ming, Hsueh Tun-Pin, Chen Ching-Chih, Bi Kuo-Wei
Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine.
Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung.
Medicine (Baltimore). 2019 May;98(22):e15937. doi: 10.1097/MD.0000000000015937.
The aim of this study was to compare the short-term and intermediate-term efficacy of acupuncture plus fire needle therapy with that of acupuncture alone in the treatment of lateral epicondylitis (LE).
Thirty-eight patients with LE who had persisted for at least 2 months were enrolled in this prospective, assessor-blinded, randomized controlled pilot trial. Twenty-one patients were randomized to the acupuncture plus fire needle group and 17 to the acupuncture-only group. The primary outcome was the visual analog scale pain score for the previous 24 hours and the secondary outcomes were the maximum grip strength, Patient-rated Forearm Evaluation Questionnaire score, and Medical Outcomes Study 36-Item Short-form Health Survey score. The values at baseline (pretreatment), at the end of treatment, and at 3 months after treatment were used to assess the short-term and intermediate-term effects of treatment. The data were analyzed using the Chi-square test and t test.
Within-group analyses showed better results for acupuncture plus fire needle therapy in the short term and intermediate term. Differences in the severity of pain and secondary outcomes were significant in the intermediate term in the acupuncture group. At the end of treatment, none of the differences in outcome scores were significant, except for maximum grip strength in the affected hand in the acupuncture group. No significant between-group differences in short-term or intermediate-term outcomes were observed.
Acupuncture plus fire needle therapy was effective in the short term in patients seeking improvement of LE. Twelve treatments were effective for relieving pain and improving disability in the intermediate term in patients with chronic LE in both study groups. The findings of the pilot study confirm the feasibility of proceeding to a larger randomized controlled study of the longer-term effects of acupuncture plus fire needle therapy in patients with LE.
本研究旨在比较针刺联合火针疗法与单纯针刺疗法治疗外侧上髁炎（LE）的短期和中期疗效。
本前瞻性、评估者盲法、随机对照试验纳入了38例病程至少2个月的LE患者。21例患者被随机分配至针刺联合火针组，17例患者被随机分配至单纯针刺组。主要结局指标为前24小时的视觉模拟评分疼痛评分，次要结局指标为最大握力、患者自评前臂评估问卷评分和医学结局研究简明健康调查36项评分。使用基线（治疗前）、治疗结束时和治疗后3个月的值来评估治疗的短期和中期效果。采用卡方检验和t检验对数据进行分析。
组内分析显示，针刺联合火针疗法在短期和中期效果更佳。针刺组在中期疼痛严重程度和次要结局指标方面存在显著差异。治疗结束时，除针刺组患侧手的最大握力外，结局评分的差异均无统计学意义。短期和中期结局指标在组间均未观察到显著差异。
针刺联合火针疗法对寻求改善LE的患者在短期内有效。在两个研究组中，12次治疗对缓解慢性LE患者的疼痛和改善功能障碍在中期有效。该初步研究结果证实了对针刺联合火针疗法治疗LE患者的长期效果进行更大规模随机对照研究的可行性。
