Modellvorhaben Akupunktur - a summary of the ART, ARC and GERAC trials
Modellvorhaben Akupunktur - a summary of the ART, ARC and GERAC trials
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DOI：
10.1136/aim.2008.000281
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发表时间：
2009-03-01
影响因子：
2.5
通讯作者：
Cummings, Mike
中科院分区：
文献类型：
--
作者：
Cummings, Mike
2000年10月，德国联邦医生和健康保险公司委员会建议制定针灸特别示范项目（“Modellvorhaben Akupunktur”），以确定针灸在治疗某些疾病中的循证作用。本文介绍了一个主要的随机对照试验的总结，这些项目的一部分，以及相关的经济分析。总体上，结果表明，针灸是有效的，在实践中的一系列慢性疾病，它似乎可能有可接受的成本效用（至少在（原文如此）35每会话的速度）。假针灸，在治疗背景下，以最小的离点针刺的形式，似乎也是有效的，在偏头痛中与预防性药物没有什么不同，在慢性腰痛中上级基于指南的标准治疗。在接受针灸试验的患者中，对治疗的反应在那些同意随机分配的患者和那些不同意的患者之间没有差异。这表明，务实的针灸在常规护理研究的结果是适用于患者从普通人群谁表示偏好acupunct.In结论，针灸似乎是有效的慢性疾病的范围，它似乎有可接受的成本效益在西方健康经济方面。这些研究项目并没有证实针刺特定穴位是达到令人满意的针灸临床效果所必需的假设。2006年4月，德国卫生当局决定将针灸纳入社会健康保险基金对慢性腰痛和慢性膝关节炎的常规报销范围。
In October 2000 the German Federal Committee of Physicians and Health Insurers recommended that special Model Projects on Acupuncture ("Modellvorhaben Akupunktur'') be developed in order to determine the evidence-based role of acupuncture in the treatment of certain illnesses. This paper presents a summary of the main randomised controlled trials performed as part of these projects, and the associated economic analyses.Overall the results show that acupuncture is effective in practice for a range of chronic conditions, and it seems likely to have acceptable cost utility (at least at a rate of (sic)35 per session). Sham acupuncture, in the form of minimal off-point needling in a therapeutic context, also appears to be effective, being no different to prophylactic medication in migraine, and superior to guideline-based standard care in chronic low back pain.In patients recruited to acupuncture trials, the response to treatment does not differ between those that agree to be randomised and those that do not. This suggests that the results of the pragmatic Acupuncture in Routine Care studies are applicable to patients from the general population who express a preference for acupuncture.In conclusion, acupuncture appears to be effective in a range of chronic conditions and it seems to have acceptable cost-effectiveness in Western health economic terms. These programmes of research do not confirm the hypothesis that needling at specific points is essential to achieve satisfactory clinical effects of acupuncture. Sham acupuncture, in the form of minimal off-point needling in a therapeutic context, is unlikely to be an inactive placebo.In April 2006, the German health authorities decided that acupuncture would be included into routine reimbursement by social health insurance funds for chronic low back pain and chronic osteoarthritis of the knee.