腰痛真假针刺设计循证医学研究与动态腧穴定位分析

Evidence-based medicine research on low-back pain with sham-acupuncture controlled design and the analysis on dynamic acupoint positioning

为探讨腧穴定位问题,检索PubMed 2010年1月1日至2017年10月27日采用真、假针刺对照治疗腰痛的综述和临床研究,得到6篇综述和12篇采用假针刺对照的随机对照试验。在8篇采用进皮假针刺设计的随机对照试验中,有6篇采用标准腧穴方案,真、假针刺疗效差异无统计学意义;有2篇采用个体化治疗,针刺捻转得气或采用触诊定位阿是穴,则真假针刺的疗效差异有统计学意义,说明进皮假针刺不是安慰治疗;动态腧穴定位和标准腧穴定位针刺对腰痛都有镇痛作用,动态腧穴定位可能效果更好。

To explore the positioning of acupoints,a research was done with PubMed for system reviews and clinical trials on treatment of low-back pain with sham-acupuncture controlled design from January 1,2010 to October 27,2017.Six system reviews and 12 sham-controlled acupuncture random trials were found.The statistical difference was not found in all the 6 trials with standard acupoint compared with the sham-acupuncture among the 8 penetrating skin sham-control trials.The statistical difference was found in the two trials with penetrating skin sham control,who was used individualized treatment,twirling for qi arrival or palpation for ashi point.It is considered that sham-acupuncture penetrating skin is not a placebo,and needling with standard or dynamic acupoint may reduce low-back pain,and dynamic acupoint positioning may be better than standard acupoint positioning.