Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain

被引:259
作者
Cherkin, DC
Eisenberg, D
Sherman, KJ
Barlow, W
Kaptchuk, TJ
Street, J
Deyo, RA
机构
[1] Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA
[2] Harvard Univ, Sch Med, Beth Israel Deaconess Ctr Alternat Med Res & Educ, Dept Med, Boston, MA 02115 USA
[3] NW Inst Acupuncture & Oriental Med, Seattle, WA USA
[4] Univ Washington, Dept Med, Seattle, WA 98195 USA
[5] Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA
关键词
D O I
10.1001/archinte.161.8.1081
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Because the value of popular forms of alternative care for chronic back pain remains uncertain, we compared the effectiveness of acupuncture, therapeutic massage, and self-cart education for persistent back pain. Methods: We randomized 262 patients aged 20 to 70 years who had persistent back pain to receive Traditional Chinese Medical acupuncture (n=94), therapeutic massage (n=78), or self-care educational materials (n=90). Up to 10 massage or acupuncture visits were permitted over 10 weeks. Symptoms (0-10 scale) and dysfunction (0-23 scale) were assessed by telephone interviewers masked to treatment group. Follow-up was available for 95% of patients after 4, 10, and 52 weeks, and none withdrew for adverse effects. Results: Treatment groups were compared after adjustment for prerandomization covariates using an intent-to-treat analysis. At 10 weeks, massage was superior to self-care on the symptom scale (3.41 vs 4.71, respectively; P=.01) and the disability scale (5.88 vs 8.92, respectively; P<.001). Massage was also superior to acupuncture on the disability scale (5.89 vs 8.25, respectively; P=.01). After 1 year, massage was not better than self care but was better than acupuncture (symptom scale: 3.08 vs 4.74, respectively; P=.002; dysfunction scale: 6.29 vs 8.21, respectively; P=.05). The massage group used the least medications (P<.05) and had the lowest costs of subsequent care. Conclusions: Therapeutic massage was effective for persistent low back pain. apparently providing long-lasting benefits. Traditional Chinese Medical acupuncture was relatively ineffective. Massage might be an effective alternative to conventional medical care for persistent back pain.
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页码:1081 / 1088
页数:8
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