ランダム化比較試験による頚肩部痛に対する鍼治療と局所注射の検討

Abstract

[Objective] The purpose of this study was to compare the effectiveness of acupuncture and local injection for neck pain. [Methods] A randomized controlled clinical trial was conducted in which 33 patients with neck pain were randomly allocated to either an acupuncture group or a local injection group. For the acupuncture group (n = 16), a stainless steel needle was inserted to depths from 10 to 20 mm and manually stimulated (sparrow pecking method) for 20 seconds. While a 25 gauge needle was inserted to depths from 10 to 20 mm, neovitacain (dibucaine hydrochloride 0.1 percent, sodium salicylate 0.3 percent, calcium bromide 0.2 percent) and neurotropin (a non protein component extracted from the skin of rabbits treated with vaccinia virus) were injected for the local injection groups (n = 17). Both groups received each treatment at the most painful points weekly during four weeks. Primary outcome measurement was intensity of the pain evaluated with a visual analogue scale (VAS). Secondary outcomes were Neck Disability Index (NDI) and a standardized questionnaire of cervical root disease (developed by Tanaka et al. at Tohoku Univ.). The evaluations were independent from the therapists. [Results] The acupuncture group showed better results in all the outcome measurements than those in the local injection group for the effect immediately after the treatment, the effect of sequential treatment and the sustained effect after completion of treatment. [Discussion] The result of this study suggested that acupuncture can become a more useful treatment method compared with local injection. The difference of the effects between two treatment methods may be due to the difference of the mechanism to suppress pain.