针罐药结合治疗纤维肌痛综合征:多中心随机对照研究

Combination of acupuncture,cupping and medicine for treatment of fibromyalgia syndrome:a multi-central randomized controlled trial

目的:评价针罐药结合治疗纤维肌痛综合征的临床疗效。方法:采用多中心、单盲、随机、对照研究方法,将186例患者分为针罐药组(62例)、针罐组(64例)和西药组(60例)。针罐药组及针罐组针刺选五志穴,行背部河车路走罐,针罐隔日治疗1次,每周治疗3次;针罐药组及西药组口服阿米替林,每天1次,各组均治疗4周。比较各组麦吉尔疼痛量表(MPQ)、压痛点数、起效时间及采用汉密尔顿抑郁量表(HAMD)评价疗效。结果:针罐药组愈显率65.0%(39/60),优于针罐组的15.9%(10/63)和西药组的16.1%(9/56)(P<0.001);3组患者治疗后MPQ量表评分、HAMD量表评分、压痛点数目与自身治疗前比较均明显减少,针罐药组较针罐组和西药组减少更为显著(均P<0.001)。针罐药组的起效时间较针罐组和西药组明显缩短(P<0.001)。结论:针罐药结合治疗纤维肌痛综合征较单纯针罐或西药具有疗效优势。

Objective To evaluate the clinical effect of combination of acupuncture, cupping and medicine for treatment of fibromyalgia syndrome. Methods By using multi-central randomized controlled method, 186 cases were randomly divided into an acupuncture combined with cupping and western medicine group （group A）, an acupuncture combined with cupping group （group 13） and a western medicine group （group C） and treated continuously for 4 weeks. The treatment of acupuncture combined with cupping was produced by acupuncture at five mental points and moving cupping on the Hechelu of the back, once evrey other day, thrice each week, and the western medicine therapy by oral administration of Amitriptyline, once each day. The scores of McGill Pain Questionnaire （MPQ）, the amount of tenderness point and the time of producing effect were compared and the therapeutic effects were assessed with the Hamilton Depression Scale （HAMD）. Results The cured and markedly effective rate was 65.0%（39/60） in the group A, which was superior to 15.9%（10/63） in the group B and 16.1%（9/56） in the group C （both P〈0. 001）. After treatment, the scores of MPQ and HAMD and the amount of tenderness point all decreased in the three groups, group A being significantly better than group B and group C, and the time of producing effect in the group A was more earlier than those in the group B and the group C. Conclusion The therapeutic effect of combination of acupuncture, cupping and medicine on fibromyalgia syndrome is superior to that of the simple acupuncture combined with cupping or the simple medicine.