Balon J, Aker P D, Crowther E R, Danielson C, Cox P G, O'Shaughnessy D, Walker C, Goldsmith C H, Duku E, Sears M R
Division of Graduate Studies and Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.
N Engl J Med. 1998 Oct 8;339(15):1013-20. doi: 10.1056/NEJM199810083391501.
Chiropractic spinal manipulation has been reported to be of benefit in nonmusculoskeletal conditions, including asthma.
We conducted a randomized, controlled trial of chiropractic spinal manipulation for children with mild or moderate asthma. After a three-week base-line evaluation period, 91 children who had continuing symptoms of asthma despite usual medical therapy were randomly assigned to receive either active or simulated chiropractic manipulation for four months. None had previously received chiropractic care. Each subject was treated by 1 of 11 participating chiropractors, selected by the family according to location. The primary outcome measure was the change from base line in the peak expiratory flow, measured in the morning, before the use of a bronchodilator, at two and four months. Except for the treating chiropractor and one investigator (who was not involved in assessing outcomes), all participants remained fully blinded to treatment assignment throughout the study.
Eighty children (38 in the active-treatment group and 42 in the simulated-treatment group) had outcome data that could be evaluated. There were small increases (7 to 12 liters per minute) in peak expiratory flow in the morning and the evening in both treatment groups, with no significant differences between the groups in the degree of change from base line (morning peak expiratory flow, P=0.49 at two months and P=0.82 at four months). Symptoms of asthma and use of 3-agonists decreased and the quality of life increased in both groups, with no significant differences between the groups. There were no significant changes in spirometric measurements or airway responsiveness.
In children with mild or moderate asthma, the addition of chiropractic spinal manipulation to usual medical care provided no benefit.
据报道，整脊脊柱推拿疗法对包括哮喘在内的非肌肉骨骼疾病有益。
我们对患有轻中度哮喘的儿童进行了一项整脊脊柱推拿疗法的随机对照试验。在为期三周的基线评估期后，91名尽管接受了常规药物治疗仍有持续哮喘症状的儿童被随机分配接受为期四个月的主动或模拟整脊推拿治疗。此前均未接受过整脊治疗。每个受试者由11名参与研究的整脊师中的1名进行治疗，由家庭根据地点选择。主要结局指标是在使用支气管扩张剂之前，于两个月和四个月时早晨测量的呼气峰值流速较基线的变化。除治疗整脊师和一名研究人员（不参与评估结局）外，所有参与者在整个研究过程中对治疗分配均保持完全盲态。
80名儿童（主动治疗组38名，模拟治疗组42名）有可评估的结局数据。两个治疗组早晨和晚上的呼气峰值流速均有小幅增加（每分钟7至12升），两组间较基线的变化程度无显著差异（早晨呼气峰值流速，两个月时P = 0.49，四个月时P = 0.82）。两组哮喘症状和β-激动剂的使用均减少，生活质量均提高，组间无显著差异。肺功能测量或气道反应性无显著变化。
对于患有轻中度哮喘的儿童，在常规医疗护理基础上加用整脊脊柱推拿疗法并无益处。
