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Raziskava, objavljena v Medical Journal of Australia, je pokazala, da je pri zdravljenju bolečine pri zvinu gležnja in bolečinah v spodnjem delu hrbta akupunktura tako učinkovita kot običajna zdravila.
Ta raziskava je bila ena največjim randomiziranih nadzorovanih poskusov akupunkture na Emergency Department (ED) (urgentnem oddelku). Bil je pragmatičen, multicentričen, enojno slep, randomiziran, nadzorovan poskus, ki je primerjal učinke akupunkture in farmakoterapije za zdravljenje pacientov, ki pridejo na urgentni oddelek zaradi zvina gležnja, migrene ali bolečine v spodnjem delu hrbta. Izvedena je bila v štirih velikih terciarnih bolnišnicah v Melbournu- dva javna urgentna oddelka (travmatološki in urgentni oddelek v Northern Hospital in Alfred Hospital) – v obdobju od januarja 2010 do decembra 2011.
To je bila 'ekvivalenčna' raziskava, kar pomeni, da je bil glavni cilj raziskati, ali so različna zdravljenja ekvivalentna, raje kot da bi prikazali, da so boljša kot placebo.
Raziskovalci so naključno ocenjevali več kot 500 pacientov, ki so prejeli standardna protibolečinska zdravila, standardna protibolečinska zdravila z akupunkturo ali samo akupunkturo, ko so se prijavili z bolečino v hrbtu, migreno ali zvinom v gležnju v štirih melbournških bolnišnicah (nekatere zasebne, nekatere javne). Medtem ko so pacienti vedeli, kakšno zdravljenje so prejeli, raziskovalci, ki so ocenjevali njihovo bolečino, niso vedeli nič (to je poznano kot enojno slepa raziskava).
Vrsta v raziskavi vključene akupunkture je bilo predvsem zabadanje iglic v glede na stanje specifične telesne točke, tako kot tudi v točke, ki jih je izbral akupunkturist. Ta način je bil izbran z namenom, da bi videli, kaj se bo zgodilo med običajno klinično prakso.
Akupunkturo so izvajali zdravniki, ki so bili prav tako izurjeni za zdravniške akupunkturiste in izvajalce tradicionalne kitajske medicine (registrirani v Viktoriji na Chinese Medicine Registration Board of Australia).
Po zdravljenju so raziskovalci ocenili bolečino pri pacientih po eni uri in potem po vsaki uri vse do odpusta iz bolnišnice. Po odpustu so izvedli tudi kontrolo s telefonskim klicem.
Rezultati so pokazali, da je akupunktura sama ali kombinirana s protibolečinskimi zdravili bila ekvivalentno uspešna kot sama zdravila pri lajšanju bolečine v spodnjem delu hrbta, pri zvinu gležnja, ampak ne pri migreni.
Akupunktura je lahko uspešno delujoča možnost za paciente, ki pridejo na urgentni oddelek zaradi nevzdržne bolečine. To je še posebej pomembno za tiste, ki se ne morejo odločiti, ali želijo ali ne želijo poseči po analgetikih.
To je tudi pomembno odkritje, kar se tiče osvetlitve potenciala alternativ namesto s stranskimi učinki bogatimi opioidnimi analgetiki in njihovega prekomernega izkoriščanja, ko pride do lajšanja bolečin na urgentnem oddelku.
Referenca:
Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial
Marc M Cohen, De Villiers Smit, Nick Andrianopoulos, Michael Ben-Meir, David McD Taylor, Shefton J Parker, Chalie C Xue and Peter A Cameron
Med J Aust 2017; 206 (11): 494-499. || doi: 10.5694/mja16.00771
Objavljeno na spletu 19. junija 2017
https://www.mja.com.au/journal/2017/206/11/acupuncture-analgesia-emergency-department-multicentre-randomised-equivalence
prevod: Tanja Topić
Study found acupuncture has pain relief effect compatiable to analgesic
The study, published in the Medical Journal of Australia, finds acupuncture is as effective as medication in treating pain for lower back pain and ankle sprain.
The study was the largest randomised controlled trial of acupuncture in an Emergency Department (ED).
It was a pragmatic, multicentre, single blinded, randomised, controlled trial comparing
the effects of acupuncture, pharmacotherapy, and combined acupuncture and pharmacotherapy for treating patients presenting to EDs with ankle sprain, migraine or lower back pain. It was undertaken in four large tertiary hospitals in Melbourne — two public EDs (the Northern Hospital and the Alfred Hospital Emergency and Trauma Centre) and two private EDs (the Epworth and Cabrini Hospitals) — between January 2010 and December 2011.
The trial was an “equivalence” study, which means it was aimed to see if the different treatments were equivalent rather than seeing if they were better than placebo.
The researchers randomly assigned more than 500 patients to receive standard painkillers, standard painkillers plus acupuncture, or acupuncture alone when they presented with back pain, migraine or ankle sprain at four Melbourne hospitals (some private, some public). While the patients knew which treatment they had, the researchers involved in assessing their pain didn’t (known as a single-blind study).
The type of acupuncture used included applying needles at specific points on the body for each condition, as well as along points chosen by the treating acupuncturist. This was to reflect what would happen during regular clinical practice.
Doctors who were also qualified medical acupuncturists and practitioners of traditional Chinese medicine (registered in Victoria with the Chinese Medicine Registration Board of Australia) performed the acupuncture.
After treatment, the researchers assessed patients’ pain after an hour, and every hour until discharge. There was also a phone follow up 24-48 hours after being discharged.
The result shows that acupuncture, either alone or with painkillers, was equivalent to drugs-alone in providing pain relief for lower back pain, ankle sprain, but not for migraine.
Acupuncture may be a viable option for patients who come to the emergency department for pain relief. This is especially important for those who cannot or choose not to have analgesic drugs.
This is also an important finding in light of the potential for side effects and abuse with opioid analgesics, which might otherwise be used to relieve pain in the emergency department.
Reference:
Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non-inferiority trial
Marc M Cohen, De Villiers Smit, Nick Andrianopoulos, Michael Ben-Meir, David McD Taylor, Shefton J Parker, Chalie C Xue and Peter A Cameron
Med J Aust 2017; 206 (11): 494-499. || doi: 10.5694/mja16.00771
Published online: 19 June 2017
https://www.mja.com.au/journal/2017/206/11/acupuncture-analgesia-emergency-department-multicentre-randomised-equivalence