{"title":"针刺对纤维肌痛患者临床疗效的影响:系统综述和荟萃分析。","authors":"Felipe Araya-Quintanilla, Iván Cuyul-Vásquez, Guillermo Méndez-Rebolledo, Celia Álvarez-Bueno, Mayte Serrat, Héctor Gutiérrez-Espinoza","doi":"10.1177/10538127251344497","DOIUrl":null,"url":null,"abstract":"<p><p>BackgroundAcupuncture, a traditional oriental therapy, is increasingly being adopted globally as a method of complementary intervention for pain relief in patients with fibromyalgia (FM). The aim of this study was to evaluate the effectiveness of acupuncture compared to placebo, pharmacotherapy, or physiotherapy in reducing pain and improving function in patients with FM.MethodsAn electronic search was performed in the MEDLINE, Web of Science, CENTRAL, EMBASE, LILACS, CINAHL, PEDro, and SPORTDiscus databases. The eligibility criteria were systematic reviews of clinical trials that compared acupuncture versus control interventions for pain intensity and other clinical outcomes in women with FM.ResultsA total of 10 systematic reviews met the eligibility criteria for the quantitative synthesis. For pain intensity, the mean difference (MD) was -1.30 cm (95% CI = -1.85 to 0.76, <i>p</i> <i><</i> <i>0.001</i>). For functional status, the MD was -10.18 points (95% CI = -13.56 to -6.79, <i>p</i> <i><</i> <i>0.001</i>). For sleep quality, the MD was 0.46 points 95% CI = -1.85 to 0.76, <i>p</i> <i><</i> <i>0.001</i>). For fatigue, the standard mean difference (SMD) was -0.18 (95% CI = -0.86 to 0.51, <i>p</i> <i>=</i> <i>0.55).</i> For depression, the MD was -6.28 points (95% CI = -9.80 to -2.76, p = 0.0005). Most of the differences were in favor of acupuncture, except for sleep quality.ConclusionCompared to pharmacotherapy and physiotherapy interventions, acupuncture showed statistically significant differences in pain intensity, functional status, and depression symptoms; however, all differences did not reach the minimum threshold to be considered clinically important in patients with FM. The quality of evidence was low to very low according to GRADE ratings.</p>","PeriodicalId":15129,"journal":{"name":"Journal of Back and Musculoskeletal Rehabilitation","volume":" ","pages":"10538127251344497"},"PeriodicalIF":1.4000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of acupuncture on clinical outcomes in patients with fibromyalgia: An overview of systematic reviews and meta-analyses.\",\"authors\":\"Felipe Araya-Quintanilla, Iván Cuyul-Vásquez, Guillermo Méndez-Rebolledo, Celia Álvarez-Bueno, Mayte Serrat, Héctor Gutiérrez-Espinoza\",\"doi\":\"10.1177/10538127251344497\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>BackgroundAcupuncture, a traditional oriental therapy, is increasingly being adopted globally as a method of complementary intervention for pain relief in patients with fibromyalgia (FM). The aim of this study was to evaluate the effectiveness of acupuncture compared to placebo, pharmacotherapy, or physiotherapy in reducing pain and improving function in patients with FM.MethodsAn electronic search was performed in the MEDLINE, Web of Science, CENTRAL, EMBASE, LILACS, CINAHL, PEDro, and SPORTDiscus databases. The eligibility criteria were systematic reviews of clinical trials that compared acupuncture versus control interventions for pain intensity and other clinical outcomes in women with FM.ResultsA total of 10 systematic reviews met the eligibility criteria for the quantitative synthesis. For pain intensity, the mean difference (MD) was -1.30 cm (95% CI = -1.85 to 0.76, <i>p</i> <i><</i> <i>0.001</i>). For functional status, the MD was -10.18 points (95% CI = -13.56 to -6.79, <i>p</i> <i><</i> <i>0.001</i>). For sleep quality, the MD was 0.46 points 95% CI = -1.85 to 0.76, <i>p</i> <i><</i> <i>0.001</i>). For fatigue, the standard mean difference (SMD) was -0.18 (95% CI = -0.86 to 0.51, <i>p</i> <i>=</i> <i>0.55).</i> For depression, the MD was -6.28 points (95% CI = -9.80 to -2.76, p = 0.0005). Most of the differences were in favor of acupuncture, except for sleep quality.ConclusionCompared to pharmacotherapy and physiotherapy interventions, acupuncture showed statistically significant differences in pain intensity, functional status, and depression symptoms; however, all differences did not reach the minimum threshold to be considered clinically important in patients with FM. The quality of evidence was low to very low according to GRADE ratings.</p>\",\"PeriodicalId\":15129,\"journal\":{\"name\":\"Journal of Back and Musculoskeletal Rehabilitation\",\"volume\":\" \",\"pages\":\"10538127251344497\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-05-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Back and Musculoskeletal Rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/10538127251344497\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Back and Musculoskeletal Rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10538127251344497","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
背景:针灸作为一种传统的东方疗法,在全球范围内越来越多地被采用为纤维肌痛(FM)患者疼痛缓解的辅助干预方法。本研究的目的是评估针灸与安慰剂、药物治疗或物理治疗相比,在减轻疼痛和改善FM患者功能方面的有效性。方法在MEDLINE、Web of Science、CENTRAL、EMBASE、LILACS、CINAHL、PEDro、SPORTDiscus等数据库中进行电子检索。入选标准是对临床试验的系统评价,这些临床试验比较了针灸与对照干预对FM女性疼痛强度和其他临床结果的影响。结果共有10篇系统评价符合定量综合的合格标准。对于疼痛强度,平均差异(MD)为-1.30 cm (95% CI = -1.85至0.76,p 0.001)。对于功能状态,MD为-10.18点(95% CI = -13.56至-6.79,p 0.001)。对于睡眠质量,MD为0.46点(95% CI = -1.85至0.76,p 0.001)。对于疲劳,标准均差(SMD)为-0.18 (95% CI = -0.86至0.51,p = 0.55)。抑郁症的MD为-6.28点(95% CI = -9.80 ~ -2.76, p = 0.0005)。除了睡眠质量外,大多数差异都有利于针灸。结论与药物治疗和物理治疗干预相比,针刺在疼痛强度、功能状态和抑郁症状方面具有统计学差异;然而,在FM患者中,所有的差异都没有达到被认为具有临床重要性的最小阈值。根据GRADE评分,证据质量为低至极低。
Effectiveness of acupuncture on clinical outcomes in patients with fibromyalgia: An overview of systematic reviews and meta-analyses.
BackgroundAcupuncture, a traditional oriental therapy, is increasingly being adopted globally as a method of complementary intervention for pain relief in patients with fibromyalgia (FM). The aim of this study was to evaluate the effectiveness of acupuncture compared to placebo, pharmacotherapy, or physiotherapy in reducing pain and improving function in patients with FM.MethodsAn electronic search was performed in the MEDLINE, Web of Science, CENTRAL, EMBASE, LILACS, CINAHL, PEDro, and SPORTDiscus databases. The eligibility criteria were systematic reviews of clinical trials that compared acupuncture versus control interventions for pain intensity and other clinical outcomes in women with FM.ResultsA total of 10 systematic reviews met the eligibility criteria for the quantitative synthesis. For pain intensity, the mean difference (MD) was -1.30 cm (95% CI = -1.85 to 0.76, p<0.001). For functional status, the MD was -10.18 points (95% CI = -13.56 to -6.79, p<0.001). For sleep quality, the MD was 0.46 points 95% CI = -1.85 to 0.76, p<0.001). For fatigue, the standard mean difference (SMD) was -0.18 (95% CI = -0.86 to 0.51, p=0.55). For depression, the MD was -6.28 points (95% CI = -9.80 to -2.76, p = 0.0005). Most of the differences were in favor of acupuncture, except for sleep quality.ConclusionCompared to pharmacotherapy and physiotherapy interventions, acupuncture showed statistically significant differences in pain intensity, functional status, and depression symptoms; however, all differences did not reach the minimum threshold to be considered clinically important in patients with FM. The quality of evidence was low to very low according to GRADE ratings.
期刊介绍:
The Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty.
In each issue clinicians can find information which they can use in their patient setting the very next day.