Department of Health Sciences and Children's Dentistry, School of Dentistry of Piracicaba, University of Campinas (FOP/Unicamp), Campinas, Brazil.
Department of Medical Clinic, School of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil.
Haemophilia. 2020 Nov;26(6):e315-e322. doi: 10.1111/hae.14151. Epub 2020 Sep 30.
Chronic pain is common in individuals with severe and moderate haemophilia who did not receive prophylaxis during childhood.
To verify the effectiveness of acupuncture in reducing intensity in chronic pain, changes in quality of life, joint function and impact on treatment satisfaction of haemophilia patients.
Single-blinded randomized clinical trial with 28 participants divided into two groups: Acupuncture (G1) treated with traditional unilateral acupuncture (side of greatest referred pain) and Control (G2) treated with transcutaneous electrical nerve stimulation (TENS), with electrodes on the joint of most intense pain. Both groups had a 20-minute session per week, total of 05 consecutive sessions. Before starting treatment, participants underwent sociodemographic assessment, physical assessment (HJHS), quality of life questionnaire (Haem-a-Qol) and treatment expectation (Likert scale). After the end of the fifth session, Haem-a-Qol, HJHS and degree of satisfaction (Likert) were performed. The assessment of pain intensity using the visual analogue scale (VAS) was performed before the beginning and after the end of all sessions in both groups. Statistical analysis was performed using ANOVA, Bonferroni, t test and chi-square test (P < .05).
There was a statistical difference within and between groups G1 and G2 in reduction of VAS. In Haem-a-Qol, the groups showed similarity in quality of life. Both groups had high expectations for treatment. G1 presented a better degree of treatment satisfaction than G2. Total HJHS showed no difference within and between groups.
Acupuncture was effective in reducing pain intensity in haemophilia patients with chronic joint disease when compared to TENS.
在儿童时期未接受预防治疗的重度和中度血友病患者中，慢性疼痛较为常见。
验证针刺在减轻慢性疼痛强度、改善生活质量、关节功能以及提高血友病患者治疗满意度方面的有效性。
采用单盲随机临床试验，将 28 名参与者分为两组：针刺组（G1）接受传统单侧针刺（疼痛最严重侧），对照组（G2）接受经皮神经电刺激（TENS）治疗，电极置于疼痛最严重的关节。两组均每周进行 20 分钟的治疗，共进行 05 次连续治疗。在开始治疗前，参与者接受社会人口学评估、体格检查（HJHS）、生活质量问卷（Haem-a-Qol）和治疗期望（Likert 量表）评估。在第五次治疗结束后，对 Haem-a-Qol、HJHS 和满意度（Likert）进行评估。在两组治疗前后均使用视觉模拟量表（VAS）评估疼痛强度。统计分析采用方差分析、Bonferroni 检验、t 检验和卡方检验（P<.05）。
G1 和 G2 两组内和两组间 VAS 均有统计学差异。在 Haem-a-Qol 方面，两组的生活质量相似。两组对治疗均有较高的期望。G1 组的治疗满意度优于 G2 组。总 HJHS 在组内和组间均无差异。
与 TENS 相比，针刺在减轻慢性关节疾病血友病患者的疼痛强度方面更为有效。
