民間療法的なものと混同されがちですが、鍼灸マッサージは国家資格を突破したもののみが行える医療類似行為です。
整体など民間資格とは異なります。
またそれを証明するかのように多くの治療家や研究者が日々症例報告を行っていり、効果あや変化を証明する活動や記録がなされている。
鍼灸マッサージは国家資格をもってものだけが行える医療類似行為
今回は最新のエビデンスから一つをご紹介します。
椎間板ヘルニアによる慢性坐骨神経痛に対する鍼治療と偽鍼治療
JAMA Intern Med. Published online October 14, 2024. doi:10.1001/jamainternmed.2024.5463
Key Points
Question Does acupuncture alleviate pain and improve function in patients with chronic sciatica from herniated disk?Findings This multicenter randomized clinical trial found a statistically significant difference in the mean decrease in leg pain using the visual analog scale, from baseline to week 4 (30.8 mm with acupuncture vs 14.9 mm with sham acupuncture). The findings for function using the Oswestry Disability Index were similar (13.0 vs 4.9 points).
Meaning Acupuncture alleviates pain and improves function among patients with chronic sciatica from herniated disk and should be considered as a potential treatment option.
Abstract
Importance Sciatica is commonly caused by herniated lumbar disc and contributes to severe pain and prolonged disability. Although acupuncture is widely used by patients with chronic sciatica, the evidence of its efficacy is scarce.Objective To investigate the efficacy and safety of acupuncture compared with sham acupuncture in patients with chronic sciatica from herniated disk.
Design, Settings, and Participants This was a multicenter 2-arm randomized clinical trial conducted in 6 tertiary-level hospitals in China of patients with chronic sciatica from herniated disk. Participants were recruited from March 25, 2021, to September 23, 2021, with a final follow-up through September 22, 2022. Data analyses were performed from December 2022 to March 2023.
Interventions Participants were randomly assigned to receive 10 sessions of acupuncture (n = 110) or sham acupuncture (n = 110) over 4 weeks. Participants, outcome assessors, and statisticians were blinded.
Main Outcomes and Measures The 2 coprimary outcomes were changes in visual analog scale (VAS) for leg pain and Oswestry Disability Index (ODI) from baseline to week 4. Secondary outcomes were adverse events.
Results A total of 216 patients (mean [SD] age, 51.3 [15.2] years; 147 females [68.1%] and 69 males [31.9%]) were included in the analyses. The VAS for leg pain decreased 30.8 mm in the acupuncture group and 14.9 mm in the sham acupuncture group at week 4 (mean difference, −16.0; 95% CI, −21.3 to −10.6; P < .001). The ODI decreased 13.0 points in the acupuncture group and 4.9 points in the sham acupuncture group at week 4 (mean difference, −8.1; 95% CI, −11.1 to −5.1; P < .001). For both VAS and ODI, the between-group difference became apparent starting in week 2 (mean difference, −7.8; 95% CI, −13.0 to −2.5; P = .004 and −5.3; 95% CI, −8.4 to −2.3; P = .001, respectively) and persisted through week 52 (mean difference, −10.8; [95% CI, −16.3 to −5.2; P < .001; and −4.8; 95% CI, −7.8 to −1.7; P = .003, respectively). No serious adverse events occurred.
Conclusions and Relevance This randomized clinical trial found that in patients with chronic sciatica from herniated disk, acupuncture resulted in less pain and better function compared with sham acupuncture at week 4, and these benefits persisted through week 52. Acupuncture should be considered as a potential treatment option for patients with chronic sciatica from a herniated disk.
Trial Registration Chictr.org Identifier: ChiCTR2100044585
Editor’s Note
Moving the Needle on Acupuncture Trials
JAMA Internal Medicine
直訳だと以下のような感じになる。
・2024年10月14日Question：鍼治療は椎間板ヘルニアによる慢性坐骨神経痛の患者の痛みを軽減し、機能を改善しますか？Findings：この多施設ランダム化臨床試験では、ベースラインから 4 週目までの視覚アナログスケールを使用した脚の痛みの平均減少に統計的に有意な差が見られました (鍼治療で 30.8 mm、偽鍼治療で 14.9 mm)。Oswestry 障害指数を使用した機能の結果も同様でした (13.0 対 4.9 ポイント)。Meanin：鍼治療は椎間板ヘルニアによる慢性坐骨神経痛の患者の痛みを軽減し、機能を改善するため、潜在的な治療選択肢として検討されるべきである。
