從實證醫學的角度看針刺對於下背痛的療效

Aupuncture Treatment for Low Back Pain

吳瀚德(Han-Der Wu) ； 邱信文(Hung-Lung Lin) ； 林宏隆(Shin-Wen Chiou) ； 謝佳蓉(Chia-Jung Hsieh) ； 陳光偉(Guang-Wei Chen)

《中華針灸醫學會雜誌》 12卷4期 (2009/12) Pp. 15-21

https://doi.org/10.30076/JCMAA.200912.0003

摘要

下背痛(low back pain)是中醫門診常見的疾病，這是因爲腰椎是負擔人體大部份重量，工作最多的部份，也是最可能發生背痛之處，尤其以下方的第四、第五椎處最易發生「下背痛」。腰椎承受重大的壓力，加上人們運動、工作傷害、用力不當或老化等等因素，下背痛便漸漸發生了。如果未加以治療，可能會變成隱性的疼痛。本篇文章是討論利用針刺的方法來對下背痛的療效進行實證醫學的評估。
目的：了解針刺對於下背痛的療效之評估。
方法：搜尋Cochrane Library、ACP Journal Club、UptoDate、PubMed、Medline等資料庫，以acupuncture、low back pain爲關鍵子，選取randonmized controlled trial之文獻進行評讀。
結果：在ACP Journal Club找到二篇文獻、Cochrane Library找到一篇文獻，在UptoDate找到一篇文獻，經過嚴格評讀後，有三篇符合標凖的randomized controlled trial文獻。
結論：在這三篇文章中可以發現，對於下背痛病患，針刺組比控制組或常規治療組有明顯的療效，然而方法學方面比須再研究以求突破實驗限制。

關鍵字

實證醫學evidence-based medicine, EBM ； 針刺acupuncture ； 下背痛low bock pain

並列摘要

Low back pain (sometimes referred to generally as lumbago) is a common symptom of musculoskeletal disorders or of disorders involving the lumbar vertebrae and related soft tissue structures such as muscles, ligaments, nerves and intervertebral discs. It can be either acute, subacute or chronic in its clinical presentation. Most often, the symptoms of low back pain show significant improvement within a few days to a few weeks from onset. In a significant number of individuals, low back pain can be recurrent in nature with a waxing and waning quality to it. In a small proportion of individuals this condition can become chronic.
Objective: The objective was to study the effectiveness of acupuncture treatment for low back pain.
Method: We searched papers on EBM websites, such as Pubmed, Medline, The Cochrane Library, ACP Journal Club, UPtoDate, EBMR.
Result: We searched two papers on ACP Journal Club, one paper on UptoDate, and thirty-six papers on the Cochrane Library. After critical appraisal, there are three papers meets our standards.
Conclusion: After treatment, pain and joint function are improved more with acupuncture than with shame acupuncture or no acupuncture in patients with low back pain. However, this benefit decreases over time.

並列關鍵字

EBM ； acupuncture ； low back pain