手法和电针治疗慢性非特异性腰痛的疗效：一项随机对照试验

WTW

Abstract

Background: Low back pain is a common condition that can be effectively treated by acupuncture. However, several treatment point prescriptions and further electrical needle stimulation (i.e., local acupoints, distal acupoints, and sensitized acupoints) may be used. There is an implicit yet unexplored assumption about the evidence on manual and electrical stimulation techniques.

Objective: The present study aims to identify effectiveness of electroacupuncture (EA) and manual acupuncture (MA) on pain and disability in patients with chronic nonspecific low back.

Methods: This study is a randomized controlled clinical trial. Sixty-six patients between 20 and 60 years of age with non-specific chronic low back pain experiencing low back pain lasting for at least the previous three months and ≥3 points on a 10 numerical analogic scale. Patients diagnosed with chronic LBP were assigned to receive either 12 sessions of MA or EA. The primary outcomes measurements were pain intensity on Numeric Rating Scale and disability by Roland Morris Disability Questionnaire.

Results: The participants reported improvements post-treatment to pain intensity and disability respectively; however, no differences between groups were observed. Regarding the secondary outcomes, we observed a between-group difference only for kinesiophobia in favor of the manual acupuncture group (difference = -4.1 points, 95% CI = -7.0 to -1.1). The results were maintained after 3 months of follow-up.

Conclusion: The study provides evidence that EA is not superior to MA treatment. Both therapies had similar efficacy in reducing pain and disability for chronic nonspecific low back pain.

Keywords: Acupuncture and Rehabilitation; Electroacupuncture; Low Back Pain.

背景：腰痛是一种常见的病症，针灸可以有效治疗。然而，可以使用几种治疗穴位处方和进一步的电针刺激（即局部穴位、远端穴位和致敏穴位）。关于人工和电刺激技术的证据，有一个隐含但未经探索的假设。目的：本研究旨在确定电针（EA）和手法针（MA）治疗慢性非特异性下腰痛患者疼痛和残疾的有效性。方法：本研究为随机对照临床试验。66名年龄在20岁至60岁之间的非特异性慢性腰痛患者经历了至少持续前三个月的腰痛，并且在10个数字模拟量表上≥3分。被诊断为慢性LBP的患者被分配接受12次MA或EA治疗。主要结果测量是数字评定量表上的疼痛强度和Roland Morris残疾问卷上的残疾。结果：参与者报告了治疗后疼痛强度和残疾的改善情况；然而，各组之间没有观察到差异。关于次要结果，我们观察到仅运动恐惧症的组间差异有利于手法针灸组（差异=-4.1分，95%CI=-7.0至-1.1）。随访3个月后，结果得以维持。结论：本研究提供了电针治疗并不优于MA治疗的证据。两种疗法在减轻慢性非特异性腰痛的疼痛和致残方面具有相似的疗效。关键词：针灸与康复；电针；腰痛。