Randomised trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain
Randomised trial of acupuncture compared with conventional massage and "sham" laser acupuncture for treatment of chronic neck pain
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DOI：
10.1136/bmj.322.7302.1574
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发表时间：
2001-06-30
影响因子：
105.7
通讯作者：
Schöps, P
中科院分区：
文献类型：
--
作者：
Irnich, D;Behrens, N;Schöps, P
目的比较针灸和传统按摩治疗慢性颈痛的疗效。设计前瞻性，随机，安慰剂对照试验。设置三个门诊部在德国。参与者177例18-85岁的慢性颈痛患者。干预患者被随机分配到五个治疗三周以上的针灸（56），按摩（60）或“假”激光针灸（61）。主要结果测量主要结果测量：治疗后一周与运动有关的最大疼痛（视觉模拟量表），与运动方向无关。次要结局指标：运动范围（3D超声真实的时间运动分析仪）、与sic六个方向运动相关的疼痛（视觉模拟量表）、压痛阈值（压力痛觉计）、自发性疼痛变化、运动相关疼痛、全身主诉（七分量表）和生活质量（SF-36）。在治疗前、治疗期间、治疗后1周和3个月进行评估。结果5次治疗后1周，针刺组与按摩组相比，运动相关性疼痛改善显著（差异24.22（95%可信区间16.5 ~ 31.9），P=0.005），但与假激光组相比，差异无统计学意义（17.28（10.0 ~ 24.6），P=0.33）。在疼痛超过5年的亚组（n=75）和肌筋膜疼痛综合征患者（n=129）中，针灸和按摩或假激光之间的差异更大。针灸组在大多数次要结局指标上的结果最好。结论针刺治疗慢性颈痛短期疗效显著，但5次治疗后远期疗效不明显。
Objectives To compare the efficacy of acupuncture and conventional massage for the treatment of chronic neck pain.Design Prospective, randomised, placebo controlled trial.Setting Three outpatient departments in Germany.Participants 177 patients aged 18-85 years with chronic neck pain.Interventions Patients were randomly allocated to five treatments over three weeks with acupuncture (56), massage (60, or "sham" laser acupuncture (61).Main outcome measures Primary outcome measure: maximum pain related to motion (visual analogue scale) irrespective of direction of movement one week after treatment. Secondary outcome measures: range of motion (3D ultrasound real time motion analyser), pain related to movement in sic six directions (visual analogue scale), pressure pain threshold (pressure algometer), changes of spontaneous pain, motion related pain, global complaints (seven point scale), and quality of life (SF-36). Assessments were performed before, during,and one week and three months after treatment. Patients' beliefs in treatment were assessed.Results One week after five treatments the acupuncture group showed a significantly greater improvement in motion related pain compared with massage (difference 24.22 (95% confidence interval 16.5 to 31.9), P=0.005) but not compared with sham laser (17.28 (10.0 to 24.6), P=0.33). Differences between acupuncture and massage or sham laser were greater in the subgroup who had had pain for longer than five years (n=75) and in patients with myofascial pain syndrome (n=129). The acupuncture group had the best results in most secondary outcome measures. There were no differences in patients' beliefs in treatment.Conclusion Acupuncture is a effective short term treatment for patients with chronic neck pain, but there is only limited evidence for long term effects after five treatments.