Effect of Acupuncture on Neurogenic Claudication Among Patients With Degenerative Lumbar Spinal Stenosis : A Randomized Clinical Trial.

Zhu, Lili; Sun, Yuanjie; Kang, Jing; Liang, Jun; Su, Tongsheng; Fu, Wenbin; Zhang, Wei; Dai, Rongshui; Hou, Yan; Zhao, Hong; Peng, Weina; Wang, Weiming; Zhou, Jing; Jiao, Ruimin; Sun, Biyun; Yan, Yan; Liu, Yan; Liu, Zhishun

Zhu, Lili; Sun, Yuanjie; Kang, Jing; Liang, Jun; Su, Tongsheng; Fu, Wenbin; Zhang, Wei; Dai, Rongshui; Hou, Yan; Zhao, Hong; Peng, Weina; Wang, Weiming; Zhou, Jing; Jiao, Ruimin; Sun, Biyun; Yan, Yan; Liu, Yan; Liu, Zhishun.

Afiliación

Zhu L; Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (L.Z., Y.S., J.L., W.P., W.W., J.Z., R.J., B.S., Y.Y., Z.L.).
Sun Y; Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (L.Z., Y.S., J.L., W.P., W.W., J.Z., R.J., B.S., Y.Y., Z.L.).
Kang J; The Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China (J.K., Y.L.).
Liang J; Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (L.Z., Y.S., J.L., W.P., W.W., J.Z., R.J., B.S., Y.Y., Z.L.).
Su T; Department of Acupuncture and Moxibustion, Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi'an, China (T.S.).
Fu W; Department of Acupuncture and Moxibustion, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, China (W.F.).
Zhang W; Department of Acupuncture and Moxibustion, The First Hospital of Hunan University of Chinese Medicine, Changsha, China (W.Z.).
Dai R; Department of Acupuncture and Moxibustion, The Third Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China (R.D.).
Hou Y; Peking University Clinical Research Center, Peking University, Beijing, China (Y.H.).
Zhao H; Luohu District Hospital of Traditional Chinese Medicine, Shenzhen, China (H.Z.).
Peng W; Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (L.Z., Y.S., J.L., W.P., W.W., J.Z., R.J., B.S., Y.Y., Z.L.).
Wang W; Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (L.Z., Y.S., J.L., W.P., W.W., J.Z., R.J., B.S., Y.Y., Z.L.).
Zhou J; Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (L.Z., Y.S., J.L., W.P., W.W., J.Z., R.J., B.S., Y.Y., Z.L.).
Jiao R; Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (L.Z., Y.S., J.L., W.P., W.W., J.Z., R.J., B.S., Y.Y., Z.L.).
Sun B; Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (L.Z., Y.S., J.L., W.P., W.W., J.Z., R.J., B.S., Y.Y., Z.L.).
Yan Y; Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (L.Z., Y.S., J.L., W.P., W.W., J.Z., R.J., B.S., Y.Y., Z.L.).
Liu Y; The Key Laboratory of Chinese Internal Medicine of the Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China (J.K., Y.L.).
Liu Z; Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China (L.Z., Y.S., J.L., W.P., W.W., J.Z., R.J., B.S., Y.Y., Z.L.).

Ann Intern Med ; 2024 Jul 02.

Article en En | MEDLINE | ID: mdl-38950397

ABSTRACT

ABSTRACT

BACKGROUND:

Acupuncture may improve degenerative lumbar spinal stenosis (DLSS), but evidence is insufficient.

OBJECTIVE:

To investigate the effect of acupuncture for DLSS.

DESIGN:

Multicenter randomized clinical trial. (ClinicalTrials.gov NCT03784729).

SETTING:

5 hospitals in China.

PARTICIPANTS:

Patients with DLSS and predominantly neurogenic claudication pain symptoms. INTERVENTION 18 sessions of acupuncture or sham acupuncture (SA) over 6 weeks, with 24-week follow-up after treatment. MEASUREMENTS The primary outcome was change from baseline in the modified Roland-Morris Disability Questionnaire ([RMDQ] score range, 0 to 24; minimal clinically important difference [MCID], 2 to 3). Secondary outcomes were the proportion of participants achieving minimal (30% reduction from baseline) and substantial (50% reduction from baseline) clinically meaningful improvement per the modified RMDQ.

RESULTS:

A total of 196 participants (98 in each group) were enrolled. The mean modified RMDQ score was 12.6 (95% CI, 11.8 to 13.4) in the acupuncture group and 12.7 (CI, 12.0 to 13.3) in the SA group at baseline, and decreased to 8.1 (CI, 7.1 to 9.1) and 9.5 (CI, 8.6 to 10.4) at 6 weeks, with an adjusted difference in mean change of -1.3 (CI, -2.6 to -0.03; P = 0.044), indicating a 43.3% greater improvement compared with SA. The between-group difference in the proportion of participants achieving minimal and substantial clinically meaningful improvement was 16.0% (CI, 1.6% to 30.4%) and 12.6% (CI, -1.0% to 26.2%) at 6 weeks. Three cases of treatment-related adverse events were reported in the acupuncture group, and 3 were reported in the SA group. All events were mild and transient.

LIMITATION:

The SA could produce physiologic effects.

CONCLUSION:

Acupuncture may relieve pain-specific disability among patients with DLSS and predominantly neurogenic claudication pain symptoms, although the difference with SA did not reach MCID. The effects may last 24 weeks after 6-week treatment. PRIMARY FUNDING SOURCE 2019 National Administration of Traditional Chinese Medicine "Project of building evidence-based practice capacity for TCM-Project BEBPC-TCM" (NO. 2019XZZX-ZJ).

Texto completo

Añadir a Mi BVS

Imprimir

XML

PubMed Links

Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Ann Intern Med Año: 2024 Tipo del documento: Article