Chronic low-back pain(CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP...Chronic low-back pain(CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP in older adults. Clinical acupuncture experts in the American Traditional Chinese Medicine Association(ATCMA) were interested in the recent grant on CLBP research announced by the National Center for Complementary and Integrative Health. The ATCMA experts held an online discussion on the subject of real-world acupuncture treatments for CLBP in older adults. Seven participants, each with more than 20 years of acupuncture practice, discussed their own unique clinical experience while another participant talked about the potential mechanism of acupuncture in pain management. As a result of the discussion, a picture of a similar treatment strategy emerged across the participants for CLBP in older adults. This discussion shows that acupuncture may have complicated mechanisms in pain management, yet it is effective for the treatment of chronic pain involving maladaptive neuroplasticity;therefore, it should be effective for CLBP in older adults.展开更多
Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain p...Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain patients with lumbar disc herniation were treated with balanced acupuncture or body acupuncture. Central mechanisms of vaded acupunctures were compared using resting-state functional MRI. Patients from both groups received functional MRI before and after acupuncture. Functional connectivity in brain regions that were strongly associated with the bilatera amygdala was analyzed utilizing AFNI software. Visual analogue scale scores were greater in the balanced acupuncture group compared with the body acupuncture group. Function of the endogenous pain regulation network was enhanced in patients in the balanced acupuncture group, but was not changed in the body acupuncture group. This result indicates that the analgesic effects of body acupuncture do not work through the central nervous system. These data suggest that balanced acupuncture exerts analgesic effects on low-back and leg pain patients with lumbar disc herniation by regulating the function of the endogenous pain regulation network.展开更多
Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rat...Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in this trial.Conclusion The effectiveness of TCM combined with the new physiotherapy tool is superior to that of NSAID combined with topical plasters,regarding to pain intensity,TCM symptoms and quality of life.The TCM plus physiotherapy also showed more stable and long-lasting therapeutic effects.展开更多
目的观察电针联合悬吊训练(sling exercise therapy,SET)治疗慢性非特异性下腰痛(chronic nonspecific low back pain,CNLBP)的临床疗效。方法将72例CNLBP患者随机分为观察组和对照组,每组36例。对照组行SET治疗,观察组在对照组基础上...目的观察电针联合悬吊训练(sling exercise therapy,SET)治疗慢性非特异性下腰痛(chronic nonspecific low back pain,CNLBP)的临床疗效。方法将72例CNLBP患者随机分为观察组和对照组,每组36例。对照组行SET治疗,观察组在对照组基础上采用电针腰夹脊穴治疗。观察两组治疗前后视觉模拟评分法(visual analog scale,VAS)、腰椎功能障碍指数(oswestry disability index,ODI)、日本骨科协会(Japanese Orthopaedc Association,JOA)评分的变化,并比较两组治疗前后竖脊肌、多裂肌表面肌电图(surface electromyography,sEMG)中的指标均方根值(root mean square,RMS)和中位频率值(median frequency value,MF)。结果两组治疗2周后VAS、ODI评分低于治疗前,治疗后VAS、ODI评分低于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后VAS、ODI评分低于对照组,差异有统计学意义(P<0.05)。两组治疗2周后JOA评分高于治疗前,治疗后JOA评分高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后JOA评分高于对照组,差异有统计学意义(P<0.05)。对照组竖脊肌、多裂肌双侧RMS值治疗2周后与治疗前比较,差异无统计学意义(P>0.05);治疗后竖脊肌、多裂肌双侧RMS值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后竖脊肌、多裂肌双侧RMS值高于治疗前,治疗后竖脊肌、多裂肌双侧RMS值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后、治疗后竖脊肌和多裂肌双侧RMS值高于对照组,差异有统计学意义(P<0.05)。两组治疗2周后竖脊肌、多裂肌双侧MF值高于治疗前,治疗后竖脊肌、多裂肌双侧MF值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后竖脊肌、多裂肌双侧MF值高于对照组,差异有统计学意义(P<0.05)。结论电针联合SET训练能更好地减轻患者疼痛,改善椎旁核心肌(多裂肌、竖脊肌)的肌电信号,促进腰椎核心肌群功能恢复。展开更多
目的:传统Meta分析证实运动干预可有效改善慢性腰背痛,但哪种特定的运动方式疗效更好目前证据还不够充分。鉴于此,此次研究通过网状Meta分析探讨不同运动要素改善成年人慢性腰背痛影响的差异。方法:检索PubMed、Web of Science、Embase...目的:传统Meta分析证实运动干预可有效改善慢性腰背痛,但哪种特定的运动方式疗效更好目前证据还不够充分。鉴于此,此次研究通过网状Meta分析探讨不同运动要素改善成年人慢性腰背痛影响的差异。方法:检索PubMed、Web of Science、Embase、Cochrane、中国知网、万方、维普数据库中运动干预非特异性慢性腰痛的随机对照试验,其中试验组进行任何形式的运动类型干预,对照组进行药物治疗、物理治疗等非运动干预,检索时限设为各数据库建库至2025-03-01,使用布尔逻辑运算符(AND/OR)组合关键词进行检索。由2位评价员独立完成文献筛选、信息提取及偏倚风险评估后,使用Stata 17.0软件进行网状Meta分析,利用累计排序概率图下面积(SUCRA)对运动剂量变量的影响效果进行排序。结果:①共纳入40项随机对照试验,网状Meta分析结果显示,核心稳定性训练、垫上运动、传统功法运动、组合运动、其他运动改善慢性腰背痛的效果优于对照组[SMD=-0.76,95%CI(-1.39,-0.13),P<0.05;SMD=-1.67,95%CI(-2.48,-0.86),P<0.05;SMD=-2.09,95%CI(-3.37,-0.80),P<0.05;SMD=-1.60,95%CI(-2.71,-0.49),P<0.05;SMD=-1.40,95%CI(-2.40,-0.40),P<0.05],悬吊训练改善慢性腰背痛的效果弱于传统功法运动和垫上运动[SMD=1.50,95%CI(0.05,2.95),P<0.05;SMD=1.09,95%CI(0.11,2.06),P<0.05],传统功法运动改善慢性腰背痛的效果优于核心稳定性训练[SMD=-1.32,95%CI(-2.64,-0.01),P<0.05];单次运动15-20 min、30-40 min的干预效果优于对照组[SMD=-1.96,95%CI(-3.55,-0.36),P<0.05;SMD=-1.44,95%CI(-2.12,-0.76),P<0.05],每周运动3次、六七次的干预效果优于对照组[SMD=-1.03,95%CI(-1.69,-0.37),P<0.05;SMD=-1.83,95%CI(-2.75,-0.91),P<0.05],每周运动六七次的干预效果优于每周运动一二次[SMD=-1.30,95%CI(-2.61,-0.06),P<0.05],运动4周、12-13周和≥16周的干预效果均显著优于对照组[SMD=-0.81,95%CI(-1.50,-0.12),P<0.05;SMD=-1.63,95%CI(-2.82,-0.43),P<0.05;SMD=-2.14,95%CI(-3.36,-0.92),P<0.05],运动≥16周的干预效果显著优于运动6周[SMD=-1.55,95%CI(-3.03,-0.07),P<0.05]。SUCRA结果显示,传统功法运动、单次运动15-20 min、每周运动六七次、运动≥16周在各自对应的因素中排名最高。结论:干预类型为传统功法(太极拳、气功、五禽戏、八段锦)、单次运动15-20 min、每周运动六七次、运动≥16周可能对成年人慢性腰背痛的缓解效果最佳。然而,由于纳入的研究数量有限,需要进一步的研究来提供更有力证据。展开更多
Objective:To assess the efficacy and safety of Bushen Huoxue Formula(BSHXF)for the treatment of discogenic low-back pain(DLBP).Methods:This was a parallel,double-blind,randomized,clinical trial performed between May 2...Objective:To assess the efficacy and safety of Bushen Huoxue Formula(BSHXF)for the treatment of discogenic low-back pain(DLBP).Methods:This was a parallel,double-blind,randomized,clinical trial performed between May 2019 and June 2020.Seventy patients were assigned by computerized random number table to the treatment group(lumbar traction and BSHXF,35 cases)or the control group(lumbar traction and placebo,35 cases).The patients received intervention for 3 weeks.Assessment was conducted before treatment and at week 1,2,3 during treatment.Primary outcome was the self-reported score of Oswestry Disability Index(ODI).Secondary outcomes included Visual Analog Scale(VAS),clinical efficacy rate by minimal clinically important difference(MCID)as well as lumbar tenderness,muscle tone and lumbar spine mobility.Adverse reactions were recorded.Follow-up was performed at 1 and 3 months after the end of treatment.Results:In the treatment group,ODI score was significantly decreased compared with baseline(P<0.05)and the control group at 2-and 3-week treatment.Similarly,VAS score decreased compared with the baseline(P<0.05)and was lower than that in the control group at 2-and 3-week treatment(P<0.05).The clinical efficacy rate of the treatment group was higher than that of the control group after treatment[32.35%(11/34)vs.3.13%(1/32),P<0.05].Moreover,the tenderness,and muscle tone,as well as the back extension and left flexion in lumbar spine mobility in the treatment group at 3-week treatment were significantly improved compared with the control group(P<0.05).Follow-up showed that at 1-month after treatment,the treatment group had better outcomes than the control group with regard to a total score of ODI and VAS scores,as well as clinical efficacy rate(all P<0.05).Moreover,VAS score was still significantly lower than the control group at 3-month follow-up(P<0.05).No adverse reactions were reported during the study.Conclusion:BSXHF combined with lumbar traction can significantly improve the clinical symptoms including pain intensity,functionality,muscle tone,and lumbar spine mobility in DLBP patients.(Registration No.Chi CTR1900027777).展开更多
目的:通过证据图谱系统梳理和展现刮痧干预颈肩腰腿痛临床研究的证据全貌,为临床和后续研究提供参考。方法:系统检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Web of Science、Cochrane Library、Embase数据库中刮痧...目的:通过证据图谱系统梳理和展现刮痧干预颈肩腰腿痛临床研究的证据全貌,为临床和后续研究提供参考。方法:系统检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Web of Science、Cochrane Library、Embase数据库中刮痧干预颈肩腰腿痛的随机对照试验相关文献,检索时限为建库至2024年11月10日,根据Cochrane系统评价手册对纳入文献进行方法学质量评价,采用图表结合的形式展现证据分布特点。结果:初次检索共获得5093篇文献,通过NoteExpress软件查重剔除3580篇重复文献,阅读题录剔除1032篇,阅读全文剔除251篇,最终纳入230篇文献,包括中文文献228篇,英文文献2篇,发文量总体呈波动上升趋势。聚类#0颈椎病、#1疼痛、#2艾灸、#3护理从出现年份一直延续至今,其中,聚类#0颈椎病跨度时间最长,从2003年一直持续到2024年。“铜砭刮痧”“疼痛”“温通刮痧”“功能障碍”是2021年、2022年的突现关键词,研究热度持续至今,“疼痛”突现强度最强。纳入的研究中共涉及17种病症,排名前3位的为颈椎病、腰椎间盘突出症、肩关节周围炎。在纳入文献的随机对照试验中,对疾病进行中医辨证分型的研究较少,仅有36篇,占15.65%,共涉及12种分型,以气滞血瘀型、寒湿痹阻型、肝肾不足型为主。刮痧工具以水牛角刮痧板最多(18.70%),其次为创新工具铜砭刮痧板(15.65%)、温通刮痧罐(13.04%)。应用方法以循经刮痧最多(58.26%),其次为穴位刮痧(22.61%)、全息理论(2.61%)。在纳入文献中,干预频次以每周1~2次最多,共124篇(53.91%),每周5~7次最少,共17篇(7.39%),有20篇文献未明确刮痧干预频率。结论:刮痧在干预颈肩腰腿痛的临床研究中应用广泛且具有一定疗效,刮痧工具与应用理论也在不断创新,但文献质量较差,存在样本量较小、干预频次与周期不一、忽略中医辨证分型、缺乏客观指标等缺点,未来需开展更多高质量、大样本、规范化的临床研究,为循证医学与临床干预提供更多参考。展开更多
文摘Chronic low-back pain(CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP in older adults. Clinical acupuncture experts in the American Traditional Chinese Medicine Association(ATCMA) were interested in the recent grant on CLBP research announced by the National Center for Complementary and Integrative Health. The ATCMA experts held an online discussion on the subject of real-world acupuncture treatments for CLBP in older adults. Seven participants, each with more than 20 years of acupuncture practice, discussed their own unique clinical experience while another participant talked about the potential mechanism of acupuncture in pain management. As a result of the discussion, a picture of a similar treatment strategy emerged across the participants for CLBP in older adults. This discussion shows that acupuncture may have complicated mechanisms in pain management, yet it is effective for the treatment of chronic pain involving maladaptive neuroplasticity;therefore, it should be effective for CLBP in older adults.
基金funded by the Scientific Research Innovation Program regarding Traditional Chinese Medicine of Guangzhou University of Chinese Medicine (Central mechanism of balanced acupuncture for lumbar disc herniationusing functional MRI), No. 09CX068
文摘Balanced acupuncture, a single-acupoint balance therapy, regulates the balance of the cerebral center, and is characterized by exerting quick effects and a short treatment course. A total of 20 low-back and leg pain patients with lumbar disc herniation were treated with balanced acupuncture or body acupuncture. Central mechanisms of vaded acupunctures were compared using resting-state functional MRI. Patients from both groups received functional MRI before and after acupuncture. Functional connectivity in brain regions that were strongly associated with the bilatera amygdala was analyzed utilizing AFNI software. Visual analogue scale scores were greater in the balanced acupuncture group compared with the body acupuncture group. Function of the endogenous pain regulation network was enhanced in patients in the balanced acupuncture group, but was not changed in the body acupuncture group. This result indicates that the analgesic effects of body acupuncture do not work through the central nervous system. These data suggest that balanced acupuncture exerts analgesic effects on low-back and leg pain patients with lumbar disc herniation by regulating the function of the endogenous pain regulation network.
基金supported by the 13th Five-Year Army Key Discipline Construction Project(No.2020SZ06-17).
文摘Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in this trial.Conclusion The effectiveness of TCM combined with the new physiotherapy tool is superior to that of NSAID combined with topical plasters,regarding to pain intensity,TCM symptoms and quality of life.The TCM plus physiotherapy also showed more stable and long-lasting therapeutic effects.
文摘目的观察电针联合悬吊训练(sling exercise therapy,SET)治疗慢性非特异性下腰痛(chronic nonspecific low back pain,CNLBP)的临床疗效。方法将72例CNLBP患者随机分为观察组和对照组,每组36例。对照组行SET治疗,观察组在对照组基础上采用电针腰夹脊穴治疗。观察两组治疗前后视觉模拟评分法(visual analog scale,VAS)、腰椎功能障碍指数(oswestry disability index,ODI)、日本骨科协会(Japanese Orthopaedc Association,JOA)评分的变化,并比较两组治疗前后竖脊肌、多裂肌表面肌电图(surface electromyography,sEMG)中的指标均方根值(root mean square,RMS)和中位频率值(median frequency value,MF)。结果两组治疗2周后VAS、ODI评分低于治疗前,治疗后VAS、ODI评分低于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后VAS、ODI评分低于对照组,差异有统计学意义(P<0.05)。两组治疗2周后JOA评分高于治疗前,治疗后JOA评分高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后JOA评分高于对照组,差异有统计学意义(P<0.05)。对照组竖脊肌、多裂肌双侧RMS值治疗2周后与治疗前比较,差异无统计学意义(P>0.05);治疗后竖脊肌、多裂肌双侧RMS值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后竖脊肌、多裂肌双侧RMS值高于治疗前,治疗后竖脊肌、多裂肌双侧RMS值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后、治疗后竖脊肌和多裂肌双侧RMS值高于对照组,差异有统计学意义(P<0.05)。两组治疗2周后竖脊肌、多裂肌双侧MF值高于治疗前,治疗后竖脊肌、多裂肌双侧MF值高于治疗2周后和治疗前,差异有统计学意义(P<0.05);观察组治疗2周后和治疗后竖脊肌、多裂肌双侧MF值高于对照组,差异有统计学意义(P<0.05)。结论电针联合SET训练能更好地减轻患者疼痛,改善椎旁核心肌(多裂肌、竖脊肌)的肌电信号,促进腰椎核心肌群功能恢复。
基金Supported by National Natural Science Foundation of China(No.81930118)Central Public Welfare Research Institutes(No.ZZ13-YQ-038)+1 种基金Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(No.ZYYCXTD-C-202003)National Key R&D Program of China(No.2021YFC1712800)。
文摘Objective:To assess the efficacy and safety of Bushen Huoxue Formula(BSHXF)for the treatment of discogenic low-back pain(DLBP).Methods:This was a parallel,double-blind,randomized,clinical trial performed between May 2019 and June 2020.Seventy patients were assigned by computerized random number table to the treatment group(lumbar traction and BSHXF,35 cases)or the control group(lumbar traction and placebo,35 cases).The patients received intervention for 3 weeks.Assessment was conducted before treatment and at week 1,2,3 during treatment.Primary outcome was the self-reported score of Oswestry Disability Index(ODI).Secondary outcomes included Visual Analog Scale(VAS),clinical efficacy rate by minimal clinically important difference(MCID)as well as lumbar tenderness,muscle tone and lumbar spine mobility.Adverse reactions were recorded.Follow-up was performed at 1 and 3 months after the end of treatment.Results:In the treatment group,ODI score was significantly decreased compared with baseline(P<0.05)and the control group at 2-and 3-week treatment.Similarly,VAS score decreased compared with the baseline(P<0.05)and was lower than that in the control group at 2-and 3-week treatment(P<0.05).The clinical efficacy rate of the treatment group was higher than that of the control group after treatment[32.35%(11/34)vs.3.13%(1/32),P<0.05].Moreover,the tenderness,and muscle tone,as well as the back extension and left flexion in lumbar spine mobility in the treatment group at 3-week treatment were significantly improved compared with the control group(P<0.05).Follow-up showed that at 1-month after treatment,the treatment group had better outcomes than the control group with regard to a total score of ODI and VAS scores,as well as clinical efficacy rate(all P<0.05).Moreover,VAS score was still significantly lower than the control group at 3-month follow-up(P<0.05).No adverse reactions were reported during the study.Conclusion:BSXHF combined with lumbar traction can significantly improve the clinical symptoms including pain intensity,functionality,muscle tone,and lumbar spine mobility in DLBP patients.(Registration No.Chi CTR1900027777).
文摘目的:通过证据图谱系统梳理和展现刮痧干预颈肩腰腿痛临床研究的证据全貌,为临床和后续研究提供参考。方法:系统检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Web of Science、Cochrane Library、Embase数据库中刮痧干预颈肩腰腿痛的随机对照试验相关文献,检索时限为建库至2024年11月10日,根据Cochrane系统评价手册对纳入文献进行方法学质量评价,采用图表结合的形式展现证据分布特点。结果:初次检索共获得5093篇文献,通过NoteExpress软件查重剔除3580篇重复文献,阅读题录剔除1032篇,阅读全文剔除251篇,最终纳入230篇文献,包括中文文献228篇,英文文献2篇,发文量总体呈波动上升趋势。聚类#0颈椎病、#1疼痛、#2艾灸、#3护理从出现年份一直延续至今,其中,聚类#0颈椎病跨度时间最长,从2003年一直持续到2024年。“铜砭刮痧”“疼痛”“温通刮痧”“功能障碍”是2021年、2022年的突现关键词,研究热度持续至今,“疼痛”突现强度最强。纳入的研究中共涉及17种病症,排名前3位的为颈椎病、腰椎间盘突出症、肩关节周围炎。在纳入文献的随机对照试验中,对疾病进行中医辨证分型的研究较少,仅有36篇,占15.65%,共涉及12种分型,以气滞血瘀型、寒湿痹阻型、肝肾不足型为主。刮痧工具以水牛角刮痧板最多(18.70%),其次为创新工具铜砭刮痧板(15.65%)、温通刮痧罐(13.04%)。应用方法以循经刮痧最多(58.26%),其次为穴位刮痧(22.61%)、全息理论(2.61%)。在纳入文献中,干预频次以每周1~2次最多,共124篇(53.91%),每周5~7次最少,共17篇(7.39%),有20篇文献未明确刮痧干预频率。结论:刮痧在干预颈肩腰腿痛的临床研究中应用广泛且具有一定疗效,刮痧工具与应用理论也在不断创新,但文献质量较差,存在样本量较小、干预频次与周期不一、忽略中医辨证分型、缺乏客观指标等缺点,未来需开展更多高质量、大样本、规范化的临床研究,为循证医学与临床干预提供更多参考。
