acupuncture for chronic pain针灸治疗慢性疼痛.pdf

ClinicalReviewEducation

JAMAClinicalEvidenceSynopsis

AcupunctureforChronicPain

AndrewJ.Vickers,DPhil;KlausLinde,MD

CLINICALQUESTIONIsacupunctureassociatedwithreducedpainoutcomesforpatientswith

chronicpaincomparedwithsham-acupuncture(placebo)orno-acupuncturecontrol?

BOTTOMLINEAcupunctureisassociatedwithimprovedpainoutcomescomparedwith

sham-acupunctureandno-acupuncturecontrol,withresponseratesofapproximately30%

fornoacupuncture,42.5%forshamacupuncture,and50%foracupuncture.

Althoughacupunctureiswidelyusedtomanagechronicpain,itre-Discussion

mainshighlycontroversial,largelyduetothelackofaclearmecha-Acupunctureisassociatedwithreductionsinchronicpaincom-

nismofbenefit.Severalsystematicreviewsofacupunctureforchronicparedwithshamacupunctureandnoacupuncture.Differencesbe-

painhaveincludedtrialsofvariablequality,typicallyleadingtoafind-

ingthatlimitationsinthedatadonotallowdefinitiveconclusionsto

bedrawn.1Meta-analyseshavebeenlimitedduetovariationinstudytrialswasrepeatedinOctober2013.AneTableofeligiblepaperspub-

endpointsusedinrandomizedtrials.2Weconductedanindividualpa-lished2011–2013isincludedintheSupplement.Thereisnoreason

tientdatameta-analysisofacupunctureforchronicpain,restrictedtobelievethatrecentlypublisheddatawouldchangetheresultsof

tohigh-qualitytrialsfrom29of31eligibletrials.3themeta-analysisbecauseeithertheresultsareverysimilartothe

meta-analyticestimatesorthetrialsareverysmall.

SummaryofF