Meade T W, Dyer S, Browne W, Frank A O
Epidemiology and Medical Care Unit, Wolfson Institute of Preventive Medicine, Medical College, St Bartholomew's Hospital, London.
BMJ. 1995 Aug 5;311(7001):349-51. doi: 10.1136/bmj.311.7001.349.
To compare the effectiveness over three years of chiropractic and hospital outpatient management for low back pain.
Randomised allocation of patients to chiropractic or hospital outpatient management.
Chiropractic clinics and hospital outpatient departments within reasonable travelling distance of each other in 11 centres.
741 men and women aged 18-64 years with low back pain in whom manipulation was not contraindicated.
Change in total Oswestry questionnaire score and in score for pain and patient satisfaction with allocated treatment.
According to total Oswestry scores improvement in all patients at three years was about 29% more in those treated by chiropractors than in those treated by the hospitals. The beneficial effect of chiropractic on pain was particularly clear. Those treated by chiropractors had more further treatments for back pain after the completion of trial treatment. Among both those initially referred from chiropractors and from hospitals more rated chiropractic helpful at three years than hospital management.
At three years the results confirm the findings of an earlier report that when chiropractic or hospital therapists treat patients with low back pain as they would in day to day practice those treated by chiropractic derive more benefit and long term satisfaction than those treated by hospitals.
比较脊椎按摩疗法与医院门诊治疗对腰痛患者三年的疗效。
将患者随机分配至脊椎按摩疗法组或医院门诊治疗组。
11个中心内彼此距离在合理通勤范围内的脊椎按摩诊所和医院门诊科室。
741名年龄在18 - 64岁之间的腰痛患者，且这些患者均无手法治疗禁忌证。
Oswestry问卷总分的变化、疼痛评分以及患者对所分配治疗的满意度。
根据Oswestry总分，三年时所有患者中，接受脊椎按摩治疗的患者比接受医院治疗的患者改善幅度约高29%。脊椎按摩疗法对疼痛的有益效果尤为明显。在试验治疗结束后，接受脊椎按摩治疗的患者因背痛接受的进一步治疗更多。在最初由脊椎按摩师转诊和医院转诊的患者中，三年时更多患者认为脊椎按摩疗法比医院治疗更有帮助。
三年的结果证实了早期报告的结果，即当脊椎按摩师或医院治疗师按照日常实践方式治疗腰痛患者时，接受脊椎按摩治疗的患者比接受医院治疗的患者获益更多，且长期满意度更高。
