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針刺療法治療慢性下背痛的實證醫學研究回顧

Acupuncture Treatment for Chronic Low Back Pain-A Review Article for Evidence-Based Medicine

摘要


慢性下背痛(Low back pain)是現代人常見的疾病,除了會帶來身體上的僵硬、疼痛及痠麻等症狀,更會損害患者的工作能力,甚至干擾日常生活。目前已經有許多研究證實針刺治療對於下背痛的療效,其中不乏設計良好且實驗嚴謹的臨床研究,但系統性的回顧研究仍十分缺乏。 本文回顧過去十年(2000~2010年)實證醫學證據等級(Evidence-Based Medicine Level)二級以上的臨床試驗,從中選擇七篇進行系統性研究,分析並比較各篇之研究設計、治療方式、療效測量方法以及研究結果,進而提出對下背痛針刺治療應用方式,以及針刺配合現代醫學治療模式的建議。 本文分析後發現,治療方法上最常被臨床試驗所採用的針刺選穴經絡為膀胱經、督脈與膽經,而最常用的穴位為腰陽關、委中、腎俞、命門等。在針刺療效與安全性上,本研究回顧發現針刺是一種安全的治療方式,且能改善下背痛引起的功能障礙、降低背痛程度、改善生活品質。針刺治療不論在緩解疼痛或是恢復生活功能上,都比對照組有更好的療效,且在分析之後發現有統計上顯著的差異。若能正確配合針刺治療與現代醫學,對慢性下背痛患者會有很大的幫助。另一方面,本研究發現針刺組與偽針組的療效並無顯著性差異,這是未來研究設計中可望努力加強的部分。

並列摘要


Chronic low back pain is a common symptom in modern life. It causes physical stiffness, pain, and tingling, which undermines patients' ability to work, and interfere with the conduct of daily life. Acupuncture effective for low back pain has been confirmed by many studies so far, including some well-designed and rigorous clinical trials, but there is still lack of systematic review. This study reviews seven Evidence-based Medicine Level Ⅱ (or higher) clinical trials in the past decade (2000~2010), and compares the studies design, randomized methods, experimental procedures, effective measurement and results, then consequently making recommendations of acupuncture treatment, and the clinical applications combined with modern medicine. After review, this study finds that acupuncture is a safe treatment, which can relieve pain, restore functional impairment caused by low back pain, and improve quality of life. In all seven clinical trial, The most commonly used for the chronic low back pain treatment were the bladder, Du and gall bladder meridian, and the most commonly used acupuncture points were the Yao-yang-guan (GV3), Wei-zhong (BL54), Shen-shu (UB23), Ming-men (GV4).Comparing with the control groups with usual care, the participants in acupuncture groups had achieve statistical significant in clinical improvements of both pain relief and functional recovery. However, this study also found out that there is no statistical significance difference in treatment efficacy between acupuncture and the simulated acupuncture groups, further study can strengthen this section.

被引用紀錄


陳怡如、王月雲、施玉雙、方月燕(2019)。運動於緩解護理從業人員下背痛之成效高雄護理雜誌36(3),1-14。https://doi.org/10.6692%2fKJN.201912_36(3).0001

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