{"title":"个性化针灸治疗慢性颈痛的长期效果：随机对照试验。","authors":"Ling Zhao, Mingsheng Sun, Zihan Yin, Jin Cui, Ruihui Wang, Laixi Ji, Guoyan Geng, Jiao Chen, Dingjun Cai, Qi Liu, Hui Zheng, Fanrong Liang","doi":"10.7326/M23-2425","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Long-term effects of individualized acupuncture in persons with chronic neck pain (CNP) remain unknown.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of pressure pain, sensory-based individualized acupuncture for relieving CNP.</p><p><strong>Design: </strong>A 24-week multicenter randomized controlled clinical trial. (ChiCTR1800016371).</p><p><strong>Setting: </strong>Outpatient settings at 4 clinical centers in China from May 2018 to March 2020.</p><p><strong>Participants: </strong>716 participants with CNP.</p><p><strong>Intervention: </strong>Participants were randomly assigned to a waiting list (WL) group or to 1 of 3 interventions, which consisted of 10 sessions over 4 weeks: higher sensitive acupoints (HSA), lower sensitive acupoints (LSA), and sham acupoints (SA) acupuncture groups.</p><p><strong>Measurements: </strong>The primary outcome was the change in the visual analogue scale (VAS) score for neck pain (range, 0 to 100) from baseline to 4 weeks, with a difference of 10 points considered the minimum clinically important threshold. The VAS was also assessed every 4 weeks through 24 weeks.</p><p><strong>Results: </strong>The modified intention-to-treat population included 683 participants. The mean baseline VAS was 50.36, 50.10, 49.24, and 49.16 for HSA, LSA, SA, and WL, respectively. Compared with a mean baseline to week 4 change of -12.16 in the HSA group, the mean changes were -10.19 in the LSA group (net difference [ND], -1.97 [95% CI, -5.03 to 1.09]), -6.11 in the SA group (ND, -6.05 [CI, -9.10 to -3.00]), and -2.24 in the WL group (ND, -9.93 [CI, -12.95 to -6.90]). The intervention effects persisted at 24-week follow-up.</p><p><strong>Limitation: </strong>Lack of complete blinding and limited generalizability.</p><p><strong>Conclusion: </strong>Individualized acupuncture interventions using high- or low-sensitivity acupuncture points were more effective in reducing CNP than SA and WL control groups sustained through 24 weeks, but the magnitude of relative improvement did not reach a minimal clinically important difference.</p><p><strong>Primary funding source: </strong>National Natural Science Foundation of China.</p>","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":" ","pages":"1330-1338"},"PeriodicalIF":19.6000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-Term Effects of Individualized Acupuncture for Chronic Neck Pain : A Randomized Controlled Trial.\",\"authors\":\"Ling Zhao, Mingsheng Sun, Zihan Yin, Jin Cui, Ruihui Wang, Laixi Ji, Guoyan Geng, Jiao Chen, Dingjun Cai, Qi Liu, Hui Zheng, Fanrong Liang\",\"doi\":\"10.7326/M23-2425\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Long-term effects of individualized acupuncture in persons with chronic neck pain (CNP) remain unknown.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of pressure pain, sensory-based individualized acupuncture for relieving CNP.</p><p><strong>Design: </strong>A 24-week multicenter randomized controlled clinical trial. (ChiCTR1800016371).</p><p><strong>Setting: </strong>Outpatient settings at 4 clinical centers in China from May 2018 to March 2020.</p><p><strong>Participants: </strong>716 participants with CNP.</p><p><strong>Intervention: </strong>Participants were randomly assigned to a waiting list (WL) group or to 1 of 3 interventions, which consisted of 10 sessions over 4 weeks: higher sensitive acupoints (HSA), lower sensitive acupoints (LSA), and sham acupoints (SA) acupuncture groups.</p><p><strong>Measurements: </strong>The primary outcome was the change in the visual analogue scale (VAS) score for neck pain (range, 0 to 100) from baseline to 4 weeks, with a difference of 10 points considered the minimum clinically important threshold. The VAS was also assessed every 4 weeks through 24 weeks.</p><p><strong>Results: </strong>The modified intention-to-treat population included 683 participants. The mean baseline VAS was 50.36, 50.10, 49.24, and 49.16 for HSA, LSA, SA, and WL, respectively. Compared with a mean baseline to week 4 change of -12.16 in the HSA group, the mean changes were -10.19 in the LSA group (net difference [ND], -1.97 [95% CI, -5.03 to 1.09]), -6.11 in the SA group (ND, -6.05 [CI, -9.10 to -3.00]), and -2.24 in the WL group (ND, -9.93 [CI, -12.95 to -6.90]). The intervention effects persisted at 24-week follow-up.</p><p><strong>Limitation: </strong>Lack of complete blinding and limited generalizability.</p><p><strong>Conclusion: </strong>Individualized acupuncture interventions using high- or low-sensitivity acupuncture points were more effective in reducing CNP than SA and WL control groups sustained through 24 weeks, but the magnitude of relative improvement did not reach a minimal clinically important difference.</p><p><strong>Primary funding source: </strong>National Natural Science Foundation of China.</p>\",\"PeriodicalId\":7932,\"journal\":{\"name\":\"Annals of Internal Medicine\",\"volume\":\" \",\"pages\":\"1330-1338\"},\"PeriodicalIF\":19.6000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Internal Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.7326/M23-2425\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Internal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.7326/M23-2425","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/3 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Long-Term Effects of Individualized Acupuncture for Chronic Neck Pain : A Randomized Controlled Trial.
Background: Long-term effects of individualized acupuncture in persons with chronic neck pain (CNP) remain unknown.
Objective: To evaluate the efficacy and safety of pressure pain, sensory-based individualized acupuncture for relieving CNP.
Design: A 24-week multicenter randomized controlled clinical trial. (ChiCTR1800016371).
Setting: Outpatient settings at 4 clinical centers in China from May 2018 to March 2020.
Participants: 716 participants with CNP.
Intervention: Participants were randomly assigned to a waiting list (WL) group or to 1 of 3 interventions, which consisted of 10 sessions over 4 weeks: higher sensitive acupoints (HSA), lower sensitive acupoints (LSA), and sham acupoints (SA) acupuncture groups.
Measurements: The primary outcome was the change in the visual analogue scale (VAS) score for neck pain (range, 0 to 100) from baseline to 4 weeks, with a difference of 10 points considered the minimum clinically important threshold. The VAS was also assessed every 4 weeks through 24 weeks.
Results: The modified intention-to-treat population included 683 participants. The mean baseline VAS was 50.36, 50.10, 49.24, and 49.16 for HSA, LSA, SA, and WL, respectively. Compared with a mean baseline to week 4 change of -12.16 in the HSA group, the mean changes were -10.19 in the LSA group (net difference [ND], -1.97 [95% CI, -5.03 to 1.09]), -6.11 in the SA group (ND, -6.05 [CI, -9.10 to -3.00]), and -2.24 in the WL group (ND, -9.93 [CI, -12.95 to -6.90]). The intervention effects persisted at 24-week follow-up.
Limitation: Lack of complete blinding and limited generalizability.
Conclusion: Individualized acupuncture interventions using high- or low-sensitivity acupuncture points were more effective in reducing CNP than SA and WL control groups sustained through 24 weeks, but the magnitude of relative improvement did not reach a minimal clinically important difference.
Primary funding source: National Natural Science Foundation of China.
期刊介绍：
Established in 1927 by the American College of Physicians (ACP), Annals of Internal Medicine is the premier internal medicine journal. Annals of Internal Medicine’s mission is to promote excellence in medicine, enable physicians and other health care professionals to be well informed members of the medical community and society, advance standards in the conduct and reporting of medical research, and contribute to improving the health of people worldwide. To achieve this mission, the journal publishes a wide variety of original research, review articles, practice guidelines, and commentary relevant to clinical practice, health care delivery, public health, health care policy, medical education, ethics, and research methodology. In addition, the journal publishes personal narratives that convey the feeling and the art of medicine.
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