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Ann. Intern. Med.:脊椎按摩和颈部锻炼要比药物更好地减轻颈部疼痛

  1. neck pain
  2. 并发症
  3. 止痛药
  4. 脊椎按摩
  5. 醋氨酚
  6. 颈部疼痛
  7. 颈部锻炼

来源:生物谷 2012-11-18 10:48

2012年1月3日发表在《The Annals of Internal Medicine》期刊上的一篇研究论文表明对颈部疼痛(neck pain)而言,访问脊椎按摩师(chiropractor)或者进行定期颈部锻炼要比服用止痛药更能减少颈部疼痛。 颈部疼痛影响美国3/4人的一生。该研究是比较不同治疗方案的为数不多的几项研究之一,是由美国西北健康科学大学Gert Bronfort博士领导的。

2012年1月3日发表在《The Annals of Internal Medicine》期刊上的一篇研究论文表明对颈部疼痛(neck pain)而言,访问脊椎按摩师(chiropractor)或者进行定期颈部锻炼要比服用止痛药更能减少颈部疼痛。

颈部疼痛影响美国3/4人的一生。该研究是比较不同治疗方案的为数不多的几项研究之一,是由美国西北健康科学大学Gert Bronfort博士领导的。他研究了272名遭受颈部疼痛但是又不知确切病因的成年人。这些研究参与者被分成3组,参与为期总共3个月的研究。

第一组在这整个3月时间内参加15次为时20分钟的脊椎按摩治疗。第二组服用诸如醋氨酚(acetaminophen)之类的不需处方就可以出售的止痛药或者他们的医师开出的麻醉药(narcotics)或肌肉松弛剂。第三组参加理疗师开设的两个不同治疗课程,理疗师教导他们进行颈部锻炼,这样他们自己就可以全天在家里进行这些锻炼。

结果表明相对于接受药物治疗的小组,那些没有接受同样治疗的小组颈部疼痛得到显著性下降。接受脊椎按摩治疗的小组当中将近57%的人颈部疼痛至少下降了75%,而进行颈部锻炼的小组当中则是48%的人是这样的。而接受药物治疗的小组只有33%的人颈部疼痛至少下降了75%。

一年之后,研究人员再次询问这些参与者的疼痛缓解情况。接受脊椎按摩治疗和接受颈部锻炼的参与者至少有53%的人颈部疼痛仍然保持下降,而接受药物治疗的参与者只有38%的人是如此。

参加这一研究的接受药物治疗的病人需要增加药物剂量和服用次数才能有效地缓解疼痛。长期服用药物能够导致胃肠道并发症。

Bronfort博士对接受颈部锻炼小组和接受脊椎按摩治小组疼痛缓解情况如此类似感到吃惊,不过他认为这对病人是好消息。积极参与自己的健康护理和而不只是单纯依赖药物治疗实际上可以更好地缓解疼痛,同时减少药物治疗带来的其他并发症的风险。(生物谷:towersimper编译)

Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck Pain

Gert Bronfort, DC, PhD; Roni Evans, DC, MS; Alfred V. Anderson, DC, MD; Kenneth H. Svendsen, MS; Yiscah Bracha, MS; and Richard H. Grimm, MD, MPH, PhD

Background: Mechanical neck pain is a common condition that affects an estimated 70% of persons at some point in their lives. Little research exists to guide the choice of therapy for acute and subacute neck pain.
Objective: To determine the relative efficacy of spinal manipulation therapy (SMT), medication, and home exercise with advice (HEA) for acute and subacute neck pain in both the short and long term.
Design: Randomized, controlled trial. (ClinicalTrials.gov registration number: NCT00029770)
Setting: 1 university research center and 1 pain management clinic in Minnesota.
Participants: 272 persons aged 18 to 65 years who had nonspecific neck pain for 2 to 12 weeks.
Intervention: 12 weeks of SMT, medication, or HEA.
Measurements: The primary outcome was participant-rated pain, measured at 2, 4, 8, 12, 26, and 52 weeks after randomization. Secondary measures were self-reported disability, global improvement, medication use, satisfaction, general health status (Short Form-36 Health Survey physical and mental health scales), and adverse events. Blinded evaluation of neck motion was performed at 4 and 12 weeks.
Results: For pain, SMT had a statistically significant advantage over medication after 8, 12, 26, and 52 weeks (P ≤ 0.010), and HEA was superior to medication at 26 weeks (P = 0.02). No important differences in pain were found between SMT and HEA at any time point. Results for most of the secondary outcomes were similar to those of the primary outcome.
Limitations: Participants and providers could not be blinded. No specific criteria for defining clinically important group differences were prespecified or available from the literature.
Conclusion: For participants with acute and subacute neck pain, SMT was more effective than medication in both the short and long term. However, a few instructional sessions of HEA resulted in similar outcomes at most time points.
Primary Funding Source: National Center for Complementary and Alternative Medicine, National Institutes of Health.

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