Medical Acupuncture最新文献

Objective: To assess the lifetime cost-effectiveness of acupuncture in the prevention of episodic migraine from both a Canadian public health care payer and societal perspective.

Background: Acupuncture has been used for pain relief for thousands of years in China and could be an alternative to drugs in managing pain. Nevertheless, there is limited evidence to determine if acupuncture is cost-effective in migraine prevention in the Canadian setting.

Methods: A cost-utility analysis with a decision-analytic Markov model was constructed to compare acupuncture with drug prophylaxis and no active treatment among adult patients with episodic migraine over their lifetime. The efficacy inputs (migraine days) were based on a Cochrane systematic literature review. Quality-adjusted life years (QALYs) were the modeled health outcome. Direct and indirect medical costs were derived from a Canadian burden of illness study on patients with migraine. All costs were inflated and reported as the present value of lifetime costs in 2021 Canadian dollars (CAD), discounting at 1.5%.

Results: From a health system perspective, acupuncture was cost-effective when compared with no active treatment (CAD 35,060/QALY) and drug prophylaxis (CAD 47,128/QALY) at a willingness-to-pay threshold of CAD 50,000/QALY gained. Acupuncture was dominant compared with no active treatment and drug prophylaxis from a societal perspective. Cost savings were driven by reduced productivity loss from fewer migraine days with acupuncture treatment.

Conclusion: Acupuncture could be a cost-effective option for patients with episodic migraine. Future studies are encouraged to inform decisions regarding the use of acupuncture in the management of episodic migraine.

Background: Low anterior resection syndrome (LARS) comprises a series of bowel symptoms after low anterior resection for rectal cancer that seriously decrease the patients' quality of life. Current treatments for LARS include antidiarrheal medications, pelvic floor muscle exercises, biofeedback training, and transanal irrigation, all of which lack high-quality supporting evidence or have low patient acceptance. Acupuncture has been found to have a therapeutic effect on LARS; however, further research is warranted because the available clinical studies have small sample sizes and different acupuncture treatment protocols and durations of treatment. This study is designed to investigate the effectiveness and safety of electroacupuncture in clinical settings.

Methods: This is a multicenter, prospective, observational, comparative study of data obtained from a registry platform. Patients are classified into electroacupuncture and non-electroacupuncture exposure groups based on whether they receive electroacupuncture treatment or not, and the exposure dose is categorised in accordance with the timing and frequency of electroacupuncture treatment. The bowel function and quality of life will be compared between the two groups during a 6-month follow-up period. Propensity score matching and the inverse probability of weighting method will be used to reduce the risk of bias and control confounding factors.

Discussion: This prospective, observational, comparative study aims to evaluate the effectiveness and safety of electroacupuncture at BL33, BL35, and SP6 in improving the defecation function of patients with LARS, and to explore the dose-response relationship of electroacupuncture and defecation function. The results of this study will provide support for further research.