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JAMA Intern Med:厉害了!针灸预防偏头痛长期有效

2017-05-23 佚名 环球医学

2017年4月,发表在《JAMA Intern Med》的一项由中国科学家进行的随机对照试验,考察了针灸预防偏头痛的长期疗效。

2017年4月,发表在《JAMA Intern Med》的一项由中国科学家进行的随机对照试验,考察了针灸预防偏头痛的长期疗效。

重要性:针灸预防偏头痛的长期疗效不确定。

目的:考察与假针灸和列入等待名单对照组的患者相比,真针灸预防偏头痛的长期疗效。

设计、地点和受试者:这是一项为期24周的随机临床试验(4周治疗之后进行20周随访)。受试者被随机分配至真针灸组、假针灸组或等待名单对照组。从2012年10月至2014年9月,在中国3个临床基地的门诊进行本试验。基于国际头痛协会的标准,共纳入249例年龄在18岁至65岁无先兆偏头痛受试者,偏头痛每月发生2至8次。

干预:真针灸组和假针灸组的受试者接受20次针灸,每周5天,为期4周。等待名单对照组的受试者不接受针灸,但在试验结束时被告知可以获得免费的20次针灸治疗。

主要结局和测量:受试者使用日记记录偏头痛发作。主要结局为基线至16周偏头痛发作频率的变化。次要结局测量包括24周内偏头痛天数、平均头痛强度和每4周药物的服用量。

结论:共纳入249例年龄在18岁至65岁的受试者,其中245例被纳入意向治疗分析。189例为女性(77.1%)。3组的基线特征相似。随机化后,3组的偏头痛发作频率的平均(SD)变化有差异(P<0.001);真针灸组平均(SD)偏头痛发作频率降低3.2(2.1),假针灸组降低2.1(2.5),等待名单对照组降低1.4(2.5);真针灸组偏头痛发作频率的降低幅度大于假针灸组(发作差异1.1;95% CI,0.4~1.9;P=0.002),真针灸组偏头痛发作频率的降低幅度也大于等待名单对照组(发作差异1.8;95% CI,1.1~2.5;P<0.001)。假针灸组与等待名单对照组之间没有显着差异(发作差异0.7;95% CI,-0.1~1.4;P=0.07)。

结论和相关性:在无先兆偏头痛的患者中,与假针灸或列入等待名单相比,真针灸或与偏头痛发作频率的长期降低相关。

原始出处:

Zhao L, Chen J, Li Y, et al. The Long-term Effect of Acupuncture for Migraine Prophylaxis: A Randomized Clinical Trial. JAMA Intern Med. 2017 Apr 1;177(4):508-515. doi: 10.1001/jamainternmed.2016.9378.

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1820072, encodeId=c51718200e209, content=<a href='/topic/show?id=fa3a10028630' target=_blank style='color:#2F92EE;'>#预防偏头痛#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100286, encryptionId=fa3a10028630, topicName=预防偏头痛)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c737344, createdName=lg.zhao, createdTime=Mon Jun 05 18:17:00 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=205919, encodeId=5e3d205919da, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=114, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6EF3hKja8nER8RMzxQdria9eCYFhgLTLsDOeqnvIYdeLDz5eP6EnicLuE5gibiawgno4zUA0jAR7Nbtp2llQ9fs3Mk/0, createdBy=278f1986883, createdName=医鸣惊人, createdTime=Sat Jun 03 08:49:33 CST 2017, time=2017-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1607550, encodeId=216f160e550c1, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Thu May 25 06:17:00 CST 2017, time=2017-05-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201885, encodeId=e2d920188588, content=前一段时间也有一个研究,但是阴性结果, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Wed May 24 06:59:17 CST 2017, time=2017-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201731, encodeId=dbfe201e31e1, content=中医药博大精深。, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Tue May 23 19:05:23 CST 2017, time=2017-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201717, encodeId=4c44201e17f6, content=古人研究的东西今人用科学来验证, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDcohE5MKT1FYlH69x7qib45icLgBDMANxIiauEA62nuQI1eE8Ez2rO3yqOkRLH6ha6Lw0x1IBRm0N7g/0, createdBy=e1ff2033933, createdName=187****0626, createdTime=Tue May 23 18:46:51 CST 2017, time=2017-05-23, status=1, ipAttribution=)]
    2017-06-03 医鸣惊人

    学习了

    0

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    2017-05-24 baihao215

    前一段时间也有一个研究,但是阴性结果

    0

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    2017-05-23 Y—xianghai

    中医药博大精深。

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    2017-05-23 187****0626

    古人研究的东西今人用科学来验证

    0

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