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Acupuncture vs Noninsertive Sham Acupuncture in Aging Patients with Degenerative Lumbar Spinal Stenosis: A Randomized Controlled Trial - 21/04/20

Doi : 10.1016/j.amjmed.2019.08.038 
Zongshi Qin, MD a, b, 1, Yulong Ding, MD c, 1, Chang Xu, MD, PhD d, e, Joey S.W. Kwong, PhD f, Yuan Ji, MD c, Aimin Wu, MD, PhD g, Jiani Wu, MD, PhD a, Zhishun Liu, MD, PhD a,
a Department of Acupuncture and Neurology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China 
b School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, China 
c Department of Acupuncture and Neurology, Beijing Fengtai Hospital of Integrated Traditional and Western Medicine, China 
d Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China 
e Department of Population Medicine, College of Medicine, Qatar University, Doha, Qatar 
f Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, China 
g Department of Spine Surgery, Zhejiang Spine Surgery Centre, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Zhejiang, China 

Requests for reprints should be addressed to Zhishun Liu, MD, PhD, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.Guang'anmen HospitalChina Academy of Chinese Medical SciencesBeijing100053China

Abstract

Background

Acupuncture is commonly used to treat degenerative lumbar spinal stenosis in Asian countries. However, rigorous data regarding the efficacy and safety of acupuncture for aging patients are currently lacking.

Methods

Eighty patients older than 50 years were assigned randomly to the acupuncture group or the noninsertive sham acupuncture for 24 treatments over an 8-week period. Measurements were obtained at baseline and 4 and 8 weeks of treatment; and 3 and 6 months after completion of treatment. The primary outcome was a change in the 24-point Roland Morris Disability Questionnaire scores at the end of treatment. The secondary outcomes included disability, pain intensity, symptoms, and dysfunction.

Results

At the end of treatment, mean changes in the Roland Morris Disability Questionnaire were −4.1 (95% CI, −4.9 to −3.3) in the acupuncture group and −1.5 (95% CI, −2.3 to −0.7) in the sham group, with a statistically significant between-group difference: −2.6 (95% CI, −3.7 to −1.4). Acupuncture was superior to sham acupuncture in reducing pain intensity (between-group difference: −2.9 [95% CI, −3.8 to −2.0] in leg and buttock pain, vs −2.3 [95% CI, −3.0 to −1.5] in back pain), symptoms and dysfunction (between-group difference: −0.9 [95% CI, −1.2 to −0.6] in symptom subscale, and −0.8 [95% CI, −1.1 to −0.5] in dysfunction subscale).

Conclusions

Acupuncture provides immediate functional recovery and pain relief for degenerative lumbar spinal stenosis. However, current evidence is insufficient to support the suggestion that acupuncture could offer clinical benefits as compared with noninsertive sham acupuncture for degenerative lumbar spinal stenosis.

El texto completo de este artículo está disponible en PDF.

Keywords : Acupuncture, Lumbar spinal stenosis, Randomized controlled trial, Sham acupuncture


Esquema


 Funding: None.
 Conflict of Interest: None.
 Authorship: ZQ, YD, and ZL contributed to the design of the study; ZL coordinated the trial and is the study guarantor. YD, YJ, and JW assisted with recruitment and data collection. ZQ wrote the statistical analysis plan. ZQ, YD, and ZL wrote the paper. XC, AW, and JK reviewed and edited the paper. All authors had access to the data and approved the final version of the manuscript.


© 2019  Elsevier Inc. Reservados todos los derechos.
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