Effects of Electroacupuncture on Opioid Consumption in Patients with Chronic Musculoskeletal Pain: A Multicenter Randomized Controlled Trial
Effects of Electroacupuncture on Opioid Consumption in Patients with Chronic Musculoskeletal Pain: A Multicenter Randomized Controlled Trial
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DOI：
10.1093/pm/pny113
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发表时间：
2019-02-01
期刊：
影响因子：
3.1
通讯作者：
Xue, Charlie Chang Li
中科院分区：
文献类型：
--
作者：
Zheng, Zhen;Gibson, Stephen;Xue, Charlie Chang Li
目的评价电针治疗慢性肌肉骨骼疼痛患者减少阿片类药物使用的有效性和安全性。设计随机、参与者盲法、三臂试验，随机抽取3家疼痛诊所的受试者，随机抽取108名服用阿片类药物的成人慢性疼痛患者作为研究对象。受试者被随机分为电针组(N=48)、假电针组(N=29)和单纯教育组(N=31)，接受相关治疗12周。最后一组在三个月的随访中接受电针治疗。结果两组治疗期末阿片类药物用量分别减少20.5%(P<；0.05)和13.7%(P<；0.01)，教育组减少4.5%，但两组间差异无统计学意义。所有三组的疼痛强度都没有随着时间的推移而改变。在非阿片类止痛药的剂量、疼痛强度、功能和阿片类药物相关不良事件方面，两组之间没有差异。在随访中，教育组在电针一个疗程后阿片类药物减少了47%。结论慢性疼痛患者减少阿片类药物的使用是安全的。由于样本量较小，我们不能确定电针是否在教育之外还有额外的好处。这种非药物疗法可能是一种有希望的辅助手段，有助于愿意减少阿片类药物的患者减少阿片类药物的使用。
Objectives To evaluate the efficacy and safety of electroacupuncture in reducing opioid consumption in patients with chronic musculoskeletal pain.Design A randomized, participant-assessor-blinded, three-arm trial.Setting Participants from three pain clinics and from the public.Subjects One hundred and eight adults with chronic pain who were taking opioids.Methods All participants received pain and medication management education. Participants were randomly allocated to electroacupuncture (N = 48), sham electroacupuncture (N = 29), or education alone (N = 31) to receive relevant treatment for 12 weeks. The last group received electroacupuncture during the three-month follow-up. Analysis of covariance and paired t tested were used.Results Opioid dosage, that is, the primary outcome measure, was reduced by 20.5% (P < 0.05) and 13.7% (P < 0.01) in the two acupuncture groups and by 4.5% in the education group at the end of the treatment phase, but without any group difference. Intensity of pain of all three groups did not change over time. No group differences were found in dosage of nonopioid analgesics, pain intensity, function, and opioid-related adverse events. During follow-up, the education group had a 47% reduction of opioids after a course of electroacupuncture. Adverse events to electroacupuncture were minor.Conclusion It is safe to reduce opioid medication use in patients with chronic pain. Due to the small sample size, we could not confirm if electroacupuncture offers extra benefit in addition to education. This nondrug therapy could be a promising adjunct to facilitate opioid tapering in patients who are willing to reduce opioids.