Long-Term Effects of Individualized Acupuncture for Chronic Neck Pain : A Randomized Controlled Trial.

IF 19.6 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Annals of Internal Medicine Pub Date : 2024-10-01 Epub Date: 2024-09-03 DOI:10.7326/M23-2425
Ling Zhao, Mingsheng Sun, Zihan Yin, Jin Cui, Ruihui Wang, Laixi Ji, Guoyan Geng, Jiao Chen, Dingjun Cai, Qi Liu, Hui Zheng, Fanrong Liang
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引用次数: 0

Abstract

Background: Long-term effects of individualized acupuncture in persons with chronic neck pain (CNP) remain unknown.

Objective: To evaluate the efficacy and safety of pressure pain, sensory-based individualized acupuncture for relieving CNP.

Design: A 24-week multicenter randomized controlled clinical trial. (ChiCTR1800016371).

Setting: Outpatient settings at 4 clinical centers in China from May 2018 to March 2020.

Participants: 716 participants with CNP.

Intervention: Participants were randomly assigned to a waiting list (WL) group or to 1 of 3 interventions, which consisted of 10 sessions over 4 weeks: higher sensitive acupoints (HSA), lower sensitive acupoints (LSA), and sham acupoints (SA) acupuncture groups.

Measurements: The primary outcome was the change in the visual analogue scale (VAS) score for neck pain (range, 0 to 100) from baseline to 4 weeks, with a difference of 10 points considered the minimum clinically important threshold. The VAS was also assessed every 4 weeks through 24 weeks.

Results: The modified intention-to-treat population included 683 participants. The mean baseline VAS was 50.36, 50.10, 49.24, and 49.16 for HSA, LSA, SA, and WL, respectively. Compared with a mean baseline to week 4 change of -12.16 in the HSA group, the mean changes were -10.19 in the LSA group (net difference [ND], -1.97 [95% CI, -5.03 to 1.09]), -6.11 in the SA group (ND, -6.05 [CI, -9.10 to -3.00]), and -2.24 in the WL group (ND, -9.93 [CI, -12.95 to -6.90]). The intervention effects persisted at 24-week follow-up.

Limitation: Lack of complete blinding and limited generalizability.

Conclusion: Individualized acupuncture interventions using high- or low-sensitivity acupuncture points were more effective in reducing CNP than SA and WL control groups sustained through 24 weeks, but the magnitude of relative improvement did not reach a minimal clinically important difference.

Primary funding source: National Natural Science Foundation of China.

个性化针灸治疗慢性颈痛的长期效果:随机对照试验。
背景:针灸对慢性颈部疼痛(CNP)患者的长期疗效尚不清楚:个体化针灸对慢性颈部疼痛(CNP)患者的长期效果仍然未知:评估基于压痛和感觉的个体化针灸对缓解慢性颈痛的疗效和安全性:设计:为期24周的多中心随机对照临床试验。(ChiCTR1800016371).Setting:2018年5月至2020年3月,中国4个临床中心的门诊环境.参与者:716名CNP参与者:716名CNP患者:参与者被随机分配至等待名单(WL)组或3个干预中的1个,干预包括4周内的10次治疗:较高敏感穴位组(HSA)、较低敏感穴位组(LSA)和假穴位组(SA):主要结果是颈部疼痛视觉模拟量表(VAS)评分(范围从 0 到 100)从基线到 4 周的变化,10 分的差异被认为是最小临床意义阈值。在24周内,每4周对VAS进行一次评估:修改后的意向治疗人群包括 683 名参与者。HSA、LSA、SA 和 WL 的平均基线 VAS 分别为 50.36、50.10、49.24 和 49.16。与 HSA 组从基线到第 4 周的平均变化-12.16 相比,LSA 组的平均变化为-10.19(净差值 [ND],-1.97 [95% CI,-5.03 到 1.09]),SA 组为-6.11(ND,-6.05 [CI,-9.10 到 -3.00]),WL 组为-2.24(ND,-9.93 [CI,-12.95 到 -6.90])。干预效果在24周的随访中持续存在:局限性:缺乏完全盲法,可推广性有限:结论:与SA和WL对照组相比,使用高敏或低敏穴位的个体化针灸干预能更有效地降低CNP,并持续24周,但相对改善的程度未达到最小临床重要差异:国家自然科学基金
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Internal Medicine
Annals of Internal Medicine 医学-医学:内科
CiteScore
23.90
自引率
1.80%
发文量
1136
审稿时长
3-8 weeks
期刊介绍: Established in 1927 by the American College of Physicians (ACP), Annals of Internal Medicine is the premier internal medicine journal. Annals of Internal Medicine’s mission is to promote excellence in medicine, enable physicians and other health care professionals to be well informed members of the medical community and society, advance standards in the conduct and reporting of medical research, and contribute to improving the health of people worldwide. To achieve this mission, the journal publishes a wide variety of original research, review articles, practice guidelines, and commentary relevant to clinical practice, health care delivery, public health, health care policy, medical education, ethics, and research methodology. In addition, the journal publishes personal narratives that convey the feeling and the art of medicine.
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