确定适当的针灸剂量对临床试验研究至关重要。

Sheng Ma
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引用次数: 4

摘要

重要性最近的一些临床试验表明,与假针灸和不针灸相比,针灸对治疗慢性疼痛更有效,但一些研究问题仍未得到解决,阻碍了进一步的进展。观察结果和进展与常规护理相比,针灸治疗疼痛的有效性已经得到证明,这显著提高了针灸在这些研究后的多种疼痛指南中的地位。然而,这些研究也产生了一些相互矛盾的结果,难以相互比较。研究以最佳干预参数和时间表检查足够剂量的针灸治疗也一直被忽视,现在也很紧迫。针灸的剂量取决于刺激参数:手动针灸(MA)或电针(EA)的力度/强度、速度/频率以及时间表(治疗次数和持续时间)。MA和EA刺激的不同频率和强度已被用于个体研究。在这些临床试验中使用了不同的针灸治疗疗程(每周一次、两次、三到五次)和周期(4、6、8和12周)。一项在12周时使用一次针刺和激光的临床试验(8至12次治疗)并没有改善慢性膝关节疼痛患者的疼痛,但类似的膝关节骨性关节炎试验在两周一次的针刺治疗8周后对疼痛的改善有显著效果。结论与相关性确定正确的针灸穴位治疗方案是针灸临床试验的关键第一步。在针灸临床试验中,必须考虑适当的针灸参数,如针灸刺激技术、治疗疗程和治疗持续时间。在研究之前,应在针灸剂量发现研讨会之后为临床试验确定足够的针灸剂量,这不仅可以提高疗法的治疗效果,还可以在试验之间以及针灸界/实践和试验研究之间进行比较。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Establishing an adequate dose of acupuncture is essential for clinical trial studies.
Importance A number of recent clinical trials have demonstrated that acupuncture is more effective for treating chronic pain conditions compared to sham and no acupuncture, but some research questions have remained unaddressed and are standing in the way of further progress. Observations and Advances The effectiveness of acupuncture for pain conditions compared to usual care have been demonstrated, which has significantly enhanced the position of acupuncture in multiple pain guidelines following these studies. However, the studies also generated some conflicting results with difficulty in comparing each other. Research examining an adequate dose of acupuncture therapy with optimal intervention parameters and time table has also long been neglected and is now urgent. The dose of acupuncture depends on stimulation parameters: force/intensity and speed/frequency of manual acupuncture (MA) or electroacupuncture (EA) and time table (number of treatment sessions and duration). Various frequencies and intensities of MA and EA stimulation have been utilized in individual research. Different acupuncture treatment sessions (once, twice, three to five times per week) and periods (4, 6, 8, and 12 weeks) have been used in these clinical trials. One clinical trial using one session of needle acupuncture and laser at 12 weeks (8 to 12 treated sessions) did not improve pain in patients with chronic knee pain but similar trials of osteoarthritis knee have significant effects of pain improvement after biweekly sessions of needle acupuncture for 8 weeks of treatment. Conclusions and Relevance Determining a right treatment regimen on correct acupuncture point(s) for acupuncture is a critical first step for acupuncture clinical trials. Appropriate acupuncture parameters such as acupuncture stimulation technique, treatment sessions, and treatment duration must be considered in acupuncture clinical trials. An adequate dose of acupuncture for clinical trials should be established following dose finding workshops for acupuncture before the studies, which not only improve the therapeutic effects of the therapies but also allow the comparisons between trials and between the acupuncture community/practice and trial studies.
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