腰痛に対する腰部への鍼の刺入深度の違いによる治療効果の相違―ランダム化比較試験―

Abstract

[Objective] The purpose of this study was to compare the effects of superficial and deep insertion of acupuncture needles in the treatment of patients with low back pain and to search for more effective acupuncture methods. [Methods] A randomized controlled clinical trial was conducted in which 32 patients with low back pain for more than three months of duration were randomly allocated either to a superficial acupuncture group (n = 16) or a deep acupuncture group (n = 16). Treatment was done for the most painful points of the patients. In the superficial insertion group, the needle was only inserted to a depth of 5 mm, whereas in the deep insertion group, the needle was inserted to a depth of about 20 mm, and was manually stimulated (sparrow pecking method) for 20 seconds. Both groups were treated weekly for four weeks. The visual analog scale (VAS) of pain, Roland-Morris Disability Questionnaire (RDQ), and Pain Disability Assessment Scale (PDAS) were used for outcome measurement. [Result] VAS, RDQ and PDAS scores showed significant differences between groups (VAS: p < 0.05, RDQ: p <0.001, PDAS: p < 0.05) in change over time with the deep insertion group having more favorable results than the superficial insertion group. The degree of change from the baseline at the time of each evaluation was calculated and results for the two groups were compared. The deep insertion group was significantly better in tendency to improve directly after the first treatment (p < 0.01), in cumulative effect after repeated treatment (VAS: p = 0.13, RDQ: p < 0.05, PDAS: p < 0.01), and in sustained effect after completion of treatment (VAS: p < 0.05, RDQ: p < 0.01, PDAS: p <0.05). [Discussion and Conclusion] The study showed that deep stimulation is a more effective treatment than superficial stimulation. It is thought that the differences of the effects are due to different influences of the treatments on the pain threshold, muscle blood flow, and muscle tones..