Characteristics of acupuncture treatment associated with outcome: an individual patient meta-analysis of 17,922 patients with chronic pain in randomised controlled trials.
Characteristics of acupuncture treatment associated with outcome: an individual patient meta-analysis of 17,922 patients with chronic pain in randomised controlled trials.
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与结果相关的针灸治疗的特征：在随机对照试验中，单个患者对17,922例慢性疼痛患者的荟萃分析。
DOI：
10.1371/journal.pone.0077438
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Acupuncture Trialists' Collaboration
中科院分区：
文献类型：
--
作者：
MacPherson H;Maschino AC;Lewith G;Foster NE;Witt CM;Vickers AJ;Acupuncture Trialists' Collaboration
最近的证据表明，针灸对慢性疼痛有效。然而，我们不知道针灸或针灸师的特征是否与更好或更差的结果相关。由针灸试验者合作组织开发的现有数据集包括29项针灸治疗慢性疼痛的试验，涉及17，922名患者的个人数据。关于针灸特征的现有数据包括针灸风格、穴位处方、针的位置、电刺激和艾灸的使用、疗程的数量、频率和持续时间、使用的针数和针灸师的经验。我们使用随机效应荟萃回归来测试每个特征对疼痛的主效应估计的影响。如果有足够的患者水平数据，我们进行了患者水平分析。当比较针灸与假手术对照组时，几乎没有证据表明针灸对疼痛的影响受到任何评估的针灸特征的影响，包括针灸的风格，针的数量或位置，会议的数量，频率或持续时间，患者与医生的互动以及针灸师的经验。当比较针灸与非针灸对照时，几乎没有证据表明这些特征改变了针灸的效果，除了当使用更多的针时观察到更好的疼痛结果（p=0.010），并且从涉及五个试验的子集的患者水平分析中，当提供更多的针灸治疗时（p<0.001）。几乎没有证据表明针灸或针灸师的不同特征会改变治疗对疼痛结局的影响。当比较针灸与非针灸对照时，增加针数和更多的疗程似乎与更好的结果相关，这表明剂量很重要。潜在的混杂因素包括对照组和试验间样本量的差异。评估与不同针灸特征相关的结果的潜在微小差异的试验可能需要大样本量。
Recent evidence shows that acupuncture is effective for chronic pain. However we do not know whether there are characteristics of acupuncture or acupuncturists that are associated with better or worse outcomes. An existing dataset, developed by the Acupuncture Trialists’ Collaboration, included 29 trials of acupuncture for chronic pain with individual data involving 17,922 patients. The available data on characteristics of acupuncture included style of acupuncture, point prescription, location of needles, use of electrical stimulation and moxibustion, number, frequency and duration of sessions, number of needles used and acupuncturist experience. We used random-effects meta-regression to test the effect of each characteristic on the main effect estimate of pain. Where sufficient patient-level data were available, we conducted patient-level analyses. When comparing acupuncture to sham controls, there was little evidence that the effects of acupuncture on pain were modified by any of the acupuncture characteristics evaluated, including style of acupuncture, the number or placement of needles, the number, frequency or duration of sessions, patient-practitioner interactions and the experience of the acupuncturist. When comparing acupuncture to non-acupuncture controls, there was little evidence that these characteristics modified the effect of acupuncture, except better pain outcomes were observed when more needles were used (p=0.010) and, from patient level analysis involving a sub-set of five trials, when a higher number of acupuncture treatment sessions were provided (p<0.001). There was little evidence that different characteristics of acupuncture or acupuncturists modified the effect of treatment on pain outcomes. Increased number of needles and more sessions appear to be associated with better outcomes when comparing acupuncture to non-acupuncture controls, suggesting that dose is important. Potential confounders include differences in control group and sample size between trials. Trials to evaluate potentially small differences in outcome associated with different acupuncture characteristics are likely to require large sample sizes.
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影响因子：
--
作者：
Vickers, Andrew J.;Cronin, Angel M.;Maschino, Alexandra C.;Lewith, George;MacPherson, Hugh;Foster, Nadine E.;Sherman, Karen J.;Witt, Claudia M.;Linde, Klaus
通讯作者：
Linde, Klaus
影响因子：
2.9
作者：
Hopton AK;Curnoe S;Kanaan M;Macpherson H
通讯作者：
Macpherson H
影响因子：
3.6
作者：
Lewis, Martyn;Morley, Stephen;Main, Chris J.
通讯作者：
Main, Chris J.
影响因子：
3.6
作者：
Hughes, J. G.;Goldbart, J.;Knowles, K.
通讯作者：
Knowles, K.
影响因子：
105.7
作者：
Foster, Nadine E.;Thomas, Elaine;Hay, Elaine M.
通讯作者：
Hay, Elaine M.