Primary Care Carabanchel Alto, Gerencia Asistencial de Atención Primaria), SERMAS, Madrid, Spain.
Primary Care Becerril de la Sierra, Gerencia Asistencial de Atención Primaria, SERMAS, Madrid, Spain.
Acupunct Med. 2021 Oct;39(5):441-451. doi: 10.1177/0964528420961398. Epub 2020 Dec 6.
Cervical pain is a problem with a high prevalence of ~13% of the population, and is more common in women (16.5%). The most affected age group is 65-74 years. Our aim was to assess the effectiveness of self-applied acupressure for decreasing benign-origin cervical pain, under the supervision of a health professional and in combination with usual treatment, as well as to examine its impact on the patient's self-perceived health condition and their opinion of the technique.
Pragmatic, multicenter, controlled clinical trial randomized by healthcare center. A total of 160 patients with benign-origin cervical pain between 18 and 65 years of age who attended primary care were included from 12 healthcare centers in the autonomous community of Madrid by consecutive sampling, and randomly assigned to a control or intervention group. The main outcome variable was pain intensity measured on a visual analogue scale (VAS) and secondary variables were self-perceived quality of life (EuroQol-5D utility index) and functional ability (neck disability index). An explanative model of generalized estimating equations was built taking into account the lack of independence among observations. The analysis was performed over 6 months.
In total, 150 patients completed the study. Mean age was 45 years (SD: 10.7), 86.7% were women, 86.2% were currently employed, and 57.9% did not perform any physical exercise. Average days experiencing pain was 32.9 (SD: 2.8) and 80% were undergoing previous pharmacological treatment. The quality of life utility index after 3 months was 1.6 points (95% CI: 0.54-2.71) higher in the intervention group. The pain score on the VAS was 0.16 points (95% CI: 0.80-0.48) lower in the intervention group. The health professional explained 10.4% of the reduction in pain observed on the VAS throughout the medical visits.
Acupressure applied in addition to usual practice appeared to improve cervical pain in the long term. The effectiveness of this technique was partially explained by the health professional that trained the participants on technique application.
: NCT01855893.
颈痛是一种发病率较高的问题，约有 13%的人群受到影响，且女性更为常见（16.5%）。最易受影响的年龄组为 65-74 岁。我们的目的是评估自我应用穴位按压对良性起源颈痛的疗效，该方法由卫生专业人员监督，并结合常规治疗，同时评估其对患者自我感知健康状况和对技术的看法的影响。
实用、多中心、对照临床试验，由医疗中心随机分组。通过连续抽样，从马德里自治区的 12 个医疗中心共纳入 160 名年龄在 18-65 岁之间、患有良性起源颈痛的患者，按医疗中心随机分为对照组或干预组。主要结局变量为视觉模拟评分（VAS）上的疼痛强度，次要变量为自我感知的生活质量（EuroQol-5D 效用指数）和功能能力（颈部残疾指数）。建立了广义估计方程的解释模型，以考虑到观察结果之间缺乏独立性。分析在 6 个月内进行。
共有 150 名患者完成了研究。平均年龄为 45 岁（SD：10.7），86.7%为女性，86.2%为在职人员，57.9%没有进行任何体育锻炼。平均疼痛天数为 32.9（SD：2.8），80%正在接受先前的药物治疗。干预组 3 个月后生活质量效用指数提高 1.6 分（95%CI：0.54-2.71）。VAS 上的疼痛评分降低 0.16 分（95%CI：0.80-0.48）。在整个医疗就诊过程中，卫生专业人员解释了 VAS 观察到的疼痛减少的 10.4%。
穴位按压结合常规治疗在长期内似乎可以改善颈痛。该技术的有效性部分可以通过培训参与者应用技术的卫生专业人员来解释。
NCT01855893。
