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急诊科针灸治疗(ACUITY):一项BraveNet多中心可行性随机对照试验的结果

Acupuncture in the emergency department (ACUITY): Results from a BraveNet multi-center feasibility randomized controlled trial.

作者信息

Dusek Jeffery A, Kallenberg Gene A, Storrow Alan B, Hughes Robert M, Coyne Christopher J, Vago David R, Nielsen Arya, Karasz Alison, Kim Ryung S, Surdam Jessica, Segall Tracy, Faryar Kiran A, Dyer Natalie L, Barton Bruce A, McKee M Diane

机构信息

Department of Medicine, University of California- Irvine, Irvine, CA, USA.

Suan Samueli Integrative Health Institute, University of California- Irvine, Irvine, CA, USA.

出版信息

Integr Med Res. 2024 Dec;13(4):101095. doi: 10.1016/j.imr.2024.101095. Epub 2024 Oct 21.

Abstract

BACKGROUND

Pain plays a significant role in emergency department (ED) visits, however safe and effective nonpharmacologic options are needed. Prior studies of acupuncture in the ED reported pain reduction with minimal side effects, but most were small and single site.

METHODS

We conducted ACUITY, a prospectively designed multi-center feasibility RCT. Our goal was to recruit 165 adults with acute non-emergent pain ≥4 on a 0-10-point scale at three EDs affiliated with BraveNet Practice Based Research Network. At baseline and 45-60 min later (post), participants self-assessed their pain and anxiety using a 0-10 rating scale. The primary feasibility outcome was recruitment of participants, whereas secondary outcomes were retention, and participant/provider acceptability.

RESULTS

From May 3, 2021, to September 24, 2022, 632 eligible individuals were approached and 165 enrolled (165/632: 26.1 %), meeting our recruitment goal. Notably, 42.4 % of enrollees were Black/African American, 42.4 % were White/Caucasian, and 13.9 % were Hispanic/Latino. Participants were randomized to Acupuncture ( = 83) or Usual care ( = 82), of which 151 (91.5 %) and 128 (77.6 %) provided pain and anxiety scores at post-treatment and 1-week respectively. Acupuncture was rated acceptable to participants and providers. Mean pain ratings (pre-to-post) were 7.4 (2.2) to 4.8 (2.8) for acupuncture and 7.1 (2.3) to 6.4 (2.5) for usual care. Mean anxiety ratings (pre-to-post) were 4.5 (3.4) to 2.5 (2.6) for acupuncture and 4.1 (3.4) to 3.5 (3.2) for usual care.

CONCLUSION

Successful completion of ACUITY indicates we have the expertise and preliminary data to conduct a future definitive, multi-center RCT.

TRIAL REGISTRATION CLINICAL TRIALSGOV

NCT04880733.

摘要

背景

疼痛在急诊科就诊中起着重要作用,然而需要安全有效的非药物治疗选择。先前关于急诊科针灸治疗的研究报告称疼痛减轻且副作用最小,但大多数研究规模较小且为单部位研究。

方法

我们开展了ACUITY研究,这是一项前瞻性设计的多中心可行性随机对照试验。我们的目标是在与BraveNet实践基础研究网络相关的三家急诊科招募165名0至10分疼痛评分≥4分的急性非紧急疼痛的成年人。在基线时以及45至60分钟后(治疗后),参与者使用0至10分的评分量表对自己的疼痛和焦虑进行自我评估。主要可行性结果是参与者的招募情况,次要结果是保留率以及参与者/提供者的接受度。

结果

从2021年5月3日至2022年9月24日,共接触了632名符合条件的个体,其中165名被纳入研究(165/632:26.1%),达到了我们的招募目标。值得注意的是,42.4%的入组者为黑人/非裔美国人,42.4%为白人/高加索人,13.9%为西班牙裔/拉丁裔。参与者被随机分为针灸组(n = 83)或常规治疗组(n = 82),其中分别有151名(91.5%)和128名(77.6%)在治疗后和1周时提供了疼痛和焦虑评分。针灸被参与者和提供者评为可接受。针灸组的平均疼痛评分(治疗前至治疗后)从7.4(2.2)降至4.8(2.8),常规治疗组从7.1(2.3)降至6.4(2.5)。针灸组的平均焦虑评分(治疗前至治疗后)从4.5(3.4)降至

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/246c/11617945/74fb0e7b92ea/gr1.jpg

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