Urits Ivan, Wang Jeffrey Kway, Yancey Kristina, Mousa Mohammad, Jung Jai Won, Berger Amnon A, Shehata Islam Mohammad, Elhassan Amir, Kaye Alan D, Viswanath Omar
Beth Israel Deaconess Medical Center, Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA, USA.
Department of Anesthesiology, LSUHSC School of Medicine, Shreveport, LA, USA.
Curr Pain Headache Rep. 2021 Jan 14;25(1):2. doi: 10.1007/s11916-020-00919-y.
This evidence-based systematic review will focus on the use of acupuncture and its role in the treatment of low back pain to help better guide physicians in their practice. It will cover the background and the burden of low back pain and present the current options for treatment and weigh the evidence that is available to support acupuncture as a treatment modality for low back pain.
Low back pain (LBP), defined as a disorder of the lumbosacral spine and categorized as acute, subacute, or chronic, can be a debilitating condition for many patients. Chronic LBP is more typically defined by its chronicity with pain persisting > 12 weeks in duration. Conventional treatment for chronic LBP includes both pharmacologic and non-pharmacologic options. First-line pharmacologic therapy involves the use of NSAIDs, then SNRI/TCA/skeletal muscle relaxants, and antiepileptics. Surgery is usually not recommended for chronic non-specific LBP patients. According to the 2016 CDC Guidelines for Prescribing Opioids for Chronic Pain and the 2017 American College of Physicians (ACP) clinical practice guidelines for chronic pain, non-pharmacologic interventions, acupuncture can be a first-line treatment for patients suffering from chronic low back pain. Many studies have been done, and most show promising results for acupuncture as an alternative treatment for low back pain. Due to non-standardized methods for acupuncture with many variations, standardization remains a challenge.
本循证系统综述将聚焦于针灸的应用及其在治疗腰痛中的作用，以帮助医生在实践中更好地进行指导。它将涵盖腰痛的背景和负担，介绍当前的治疗选择，并权衡支持针灸作为腰痛治疗方式的现有证据。
腰痛（LBP）被定义为腰骶部脊柱疾病，分为急性、亚急性或慢性，对许多患者来说可能是一种使人衰弱的病症。慢性腰痛更典型地由其慢性特征定义，疼痛持续时间超过12周。慢性腰痛的传统治疗包括药物和非药物选择。一线药物治疗包括使用非甾体抗炎药，然后是5-羟色胺再摄取抑制剂/三环类抗抑郁药/骨骼肌松弛剂和抗癫痫药。通常不建议慢性非特异性腰痛患者进行手术。根据2016年美国疾病控制与预防中心（CDC）慢性疼痛阿片类药物处方指南和2017年美国医师学会（ACP）慢性疼痛临床实践指南，非药物干预措施中，针灸可以作为慢性腰痛患者的一线治疗方法。已经进行了许多研究，大多数研究表明针灸作为腰痛的替代治疗方法有很有前景的结果。由于针灸方法不标准化且存在许多差异，标准化仍然是一个挑战。
