摘要
目的:评价腕踝针对急性腰痛的即时镇痛作用及其与患者预期的关系。方法:采用随机单盲假针刺对照试验,60例急性腰痛患者随机分成两组,每组30例。观察组采用腕踝针治疗,针刺双侧下5、下6针刺点,不要求得气;对照组用不刺入的假针刺法。两组均治疗1次,留针30min。治疗前3min和治疗过程中第5、10、15、30分钟(拔针后),用简式McGill疼痛问卷(Short-formMcGill Pain Questionnaire,SF-MPQ)记录受试者腰部活动时的疼痛等情况;用重复改良Schober试验(Modified-Modified Schober,MMS)观察腰椎前屈情况;用预期和治疗信任度问卷(Expecta-tion and Treat ment Credibility Scale,ETCS)分析患者治疗前的预期与疗效的关系;记录不良反应。结果:两组治疗前SF-MPQ、MMS和ETCS各项差异均无统计学意义(均P>0.05)。进针后第5分钟,观察组SF-MPQ各项评分均低于对照组(P<0.05,P<0.01);第10分钟,观察组SF-MPQ各项评分均低于对照组,且观察组MMS高于对照组(P<0.05);第15分钟,观察组SF-MPQ除感觉项外其他各项评分低于对照组(P<0.05,P<0.01);第30分钟,观察组SF-MPQ中的情感项和疼痛视觉模拟评分低于对照组(P<0.05,P<0.01)。观察组在进针前对治疗的预期与进针后第5、10、15、30分钟的疼痛视觉模拟评分呈负相关(P<0.05),而对照组则无相关性(P>0.05)。两组均未出现不良反应。结论:腕踝针能显著减轻急性腰痛患者的疼痛,起效迅速;患者对腕踝针镇痛疗效预期越高,镇痛作用越好;该疗法具有很高的安全性。
Objective To assess the immediate analgesic effect of wrist-ankle acupuncture on acute lumbago and the relationship between the analgesic effect and the expectation of patients. Methods A randomized, single-blind, sham-controlled trial was designed. Sixty cases of acute lumbago were randomly divided into two groups, 30 cases in each one. In observation group, wrist-ankle acupuncture was adopted to the Lower 5 and Lower 6 bilaterally, no requirement of Deqi （arrival of qi）. In control group, sham acupuncture was adopted. The treatment was applied once in either group, with the needles retained for 30 min. The Short-form McGill Pain Questionnaire （SF-MPQ） and the Modified-Modified Schober （MMS） test were used to assess the motion related pain and the situation of spinal flexion in 3 rain before treatment and 5 min, 10 min, 15 min, during treatment and 30 min （needle removed）, respectively. The Expectation and Treatment Credibility Scale （ETCS） was applied to analyze the relationship between the expectation of patients and the analgesic effect. The adverse reaction was recorded, Results There were no statistically significant differences in SF-MPQ, MMS and ETCS before treatment between two groups （all P〉0. 05）. In 5 rain after needles insertion, the scores of the items in SF-MPQ in observation group were lower than those in control group （P〈0. 05,P〈0. 01）. In 10 min after needles insertion, the scores of SF-MPQ in observation group were lower than those in control group and the scores of MMS were higher than those in control group （P〈0. 05）. In 15 min after needles insertion, except the sensory pain rating index, the scores of the rest items in SF-MPQ in observation group were all lower than those in control group （P〈0.05,P〈0.01）. In 30 min （needles removed）, the scores of affective pain rating index of SF-MPQ and Visual Analogue Scale （VAS） in observation group were lower than those in control group （P〈0. 05,P〈0. 01）. The expectation before treatment was negatively correlated with VAS scores in 5 min, 10 min, 15 min and 30 min after needle insertion separately in observation group （P〈0. 05）, while the correlation was not found in control group （P〉0.05）. No adverse reaction was reported. Conclusion Wrist-ankle acupuncture can reduce acute lumbago immediately and significantly. The higher the expectation on the analgesic effect of wrist-ankle acupuncture the patients have, the better the analgesic effect will be. This therapy is highly safe in the treatment.
出处
《中国针灸》
CAS
CSCD
北大核心
2010年第8期617-622,共6页
Chinese Acupuncture & Moxibustion
关键词
急性腰痛
腕踝针
针灸疗法
镇痛
随机对照试验
Acute Lumbago
Wrist-Ankle Acupuncture
Acupuncture-Moxibustion
Analgesia
Randomized Controlled Trials （RCT）
