Tuina Department, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China.
School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
JAMA Netw Open. 2022 Dec 1;5(12):e2246538. doi: 10.1001/jamanetworkopen.2022.46538.
IMPORTANCE: Both tuina therapy and yijinjing exercise were beneficial to patients with nonspecific chronic neck pain, but the evidence for this combination is limited. OBJECTIVE: To investigate the effectiveness of tuina therapy combined with yijinjing exercise compared with tuina therapy alone for patients with nonspecific chronic neck pain. DESIGN, SETTING, AND PARTICIPANTS: A 12-week, open-label, analyst-blinded randomized clinical trial (8-week intervention plus 4-week observational follow-up) was conducted from September 7, 2020, to October 25, 2021. A total of 102 participants with nonspecific chronic neck pain were recruited, and data were analyzed from December 10, 2021, to March 26, 2022. INTERVENTIONS: Participants in the tuina group or tuina combined with yijinjing group received 3 sessions of tuina therapy per week for 8 weeks, for a total of 24 sessions. Participants in the tuina combined with yijinjing group practiced yijinjing 3 times a week for 8 weeks, including an instructor-guided exercise at the hospital and 2 self-practice exercises at home. MAIN OUTCOMES AND MEASURES: The primary outcome was change in visual analog scale (VAS) score from baseline to week 8. Secondary outcomes included Neck Disability Index scores, Self-rating Anxiety Scale scores, tissue hardness, and active range of motion. RESULTS: This randomized clinical trial recruited 102 patients (mean [SD] age, 36.5 [4.9] years; 69 [67.6%] female) who were randomized to 2 groups. All 102 patients (100%) completed all the outcome measurements. The mean difference in VAS scores from baseline at week 8 for the tuina combined with yijinjing group was -5.4 (95% CI, -5.8 to -5.1). At week 8, the difference in VAS score was -1.2 (95% CI, -1.6 to -0.8; P < .001) between the tuina group and the tuina combined with yijinjing group. The effectiveness of tuina combined with yijinjing in treating nonspecific chronic neck pain remained at the 12-week follow-up. CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, for patients with nonspecific chronic neck pain, tuina combined with yijinjing was more effective than tuina therapy alone in terms of pain, functional recovery, and anxiety at week 8, and effectiveness remained at week 12. A combination of tuina and yijinjing should be considered in the management of nonspecific chronic neck pain. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2000036805.
重要性：推拿疗法和易筋经锻炼对非特异性慢性颈痛患者均有益，但两者联合的证据有限。 目的：探究推拿疗法联合易筋经锻炼与单纯推拿疗法相比，对非特异性慢性颈痛患者的疗效。 设计、地点和参与者：这是一项为期 12 周、开放标签、分析员设盲的随机临床试验（8 周干预加 4 周观察随访），于 2020 年 9 月 7 日至 2021 年 10 月 25 日进行。共招募了 102 名非特异性慢性颈痛患者，数据于 2021 年 12 月 10 日至 2022 年 3 月 26 日进行分析。 干预：推拿组或推拿联合易筋经组的患者每周接受 3 次推拿治疗，共 8 周，共 24 次。推拿联合易筋经组的患者每周进行 3 次易筋经锻炼，包括在医院接受指导员指导的锻炼和在家进行 2 次自我练习。 主要结局和测量指标：主要结局为从基线到第 8 周视觉模拟量表（VAS）评分的变化。次要结局包括颈部残疾指数评分、焦虑自评量表评分、组织硬度和主动活动范围。 结果：这项随机临床试验共纳入 102 例患者（平均[标准差]年龄为 36.5[4.9]岁；69[67.6%]例女性），随机分为 2 组。所有 102 例患者（100%）均完成了所有结局测量。从基线到第 8 周，推拿联合易筋经组的 VAS 评分平均差值为-5.4（95%CI，-5.8 至-5.1）。第 8 周时，推拿组和推拿联合易筋经组的 VAS 评分差值为-1.2（95%CI，-1.6 至-0.8；P<0.001）。推拿联合易筋经治疗非特异性慢性颈痛的疗效在 12 周随访时仍存在。 结论和相关性：在这项随机临床试验中，对于非特异性慢性颈痛患者，与单纯推拿疗法相比，推拿联合易筋经在第 8 周时疼痛、功能恢复和焦虑方面更有效，在第 12 周时疗效仍保持。在非特异性慢性颈痛的管理中，应考虑推拿联合易筋经。 试验注册：中国临床试验注册中心：ChiCTR2000036805。
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