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Evaluation of the effect of acupuncture on hand pain,functional deficits and health-related quality of life in patients with rheumatoid arthritis--A study protocol for a multicenter,double-blind,randomized clinical trial

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Journal of Integrative Medicine 2016年第3期14卷 219-227页

作者： susana seca Sebastian Kirch António S.Cabrita Henry J.Greten Faculty of Medicine University of Coimbra3045-137 CoimbraPortugal Institute of Biomedical Sciences Abel Salazar University of Porto4050-313 PortoPortugal Heidelberg School of Chinese Medicine 69126 HeidelbergGermany

BACKGROUND： Rheumatoid arthritis（RA） is a systemic inflammatory disease characterized by functional disability and pain. Although acupuncture is widely used, until now Western acupuncture studies on RA have not shown conclusive positive results. Acupuncture is regarded as a reflex therapy that has effects on the human autonomic nervous system. By establishing a traditional Chinese medicine（TCM） diagnosis first, the practitioner is able to choose acupoints according to the state of each individual ***/DESIGN： We are interested if acupuncture, using a classical diagnostic procedure to allocate acupoints to the patient according to the Shang Han Lun theory, can be effective in relieving pain, improving hand function and increasing health-related quality of life in *** authors intend to harmonize TCM diagnosis according to clinical and genetic profiles. Patients with the TCM diagnosis of a so-called Turning Point syndrome will be followed up in a randomized, prospective, double-blind, placebo-controlled, multicenter and three-armed parallel-group study with a standardized treatment in order to optimize potential therapeutic effects of acupuncture on pain, strength and muscle function of patients with RA as well as the influence on inflammation and quality of ***： The findings of this study will provide important clinical information about the feasibility and efficacy of acupuncture treatment for RA patients. In addition, it will explore the feasibility of further acupuncture *** REGISTRATION NUMBER： Clinical *** Identifier NCT02553005.

关键词： acupuncture rheumatoid arthritis quality of life pain hand strength study protocol randomized clinical trial double-blind method

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Effectiveness of Acupuncture on Pain, Physical Function and Health-Related Quality of Life in Patients with Rheumatoid Arthritis: A Systematic Review of Quantitative Evidence

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Chinese Journal of Integrative Medicine 2019年第9期25卷 704-709页

作者： susana seca Diana Miranda Daniela Cardoso Bernice Nogueira Henry J.Greten Antonio Cabrita Manuel Alves Rodrigues Faculty of Medicine University of CoimbraInstitute of Science Biomedicine Abel Salazar University of Porto Porto PortugalHeidelberg School of Chinese Medicine Heidelberg Germany Institute of Science Biomedicine Abel Salazar University of Porto Porto Portugal Health Sciences Research Unit:Nursing (UICISA: E) Nursing School of Coimbra (ESEnfC) Portugal Centre for Evidenee Based Practice: A Joanna Briggs Institute Centre of Excellence Coimbra Portugal School of Health Sciences Macao Polytechnic Institute Macao SAR China Institute of Science Biomedicine Abel Salazar University of PortoHeidelberg School of Chinese Medicine Heidelberg Germany Faculty of Medicine University of Coimbra Portugal Health Sciences Research Unit: Nursing (UICISA:E) Nursing School of Coimbra (ESEnfC)Portugal Centre for Evidence Based Practice: A Joanna Briggs Institute Centre of Excellence Portugal

Objective: To identify and synthesize the most recent available evidence of effectiveness of acupuncture on pain, physical function and health-related quality of life(HRQoL) in patients with rheumatoid arthritis(RA). Methods: A comprehensive search of 12 Western and Chinese databases was undertaken from their inception up to end of 2016. Randomized controlled trials(RCTs), concerning patients with RA treated with needle acupuncture, written in English, Portuguese, German or Chinese were included. Primary outcomes included pain, physical function and HRQoL. Secondary outcomes included morning stiffness, functional impairment, number of tender and swollen joints and serum concentrations of inflamatory markers. Methodological quality was assessed by three independent reviewers using the standardized critical appraisal instrument from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. Results: Twenty-two studies met the inclusion criteria. Of those, 9 studies were excluded after assessment of their methodological quality. The remaining 13 original RCTs included 974 patients. Ten of these studies published in China, showed favorable statistical significant effects of acupuncture in relieving symptoms of RA compared with controls. Conclusions: Evidence suggests that acupuncture interventions may have a positive effect in pain relief, physical function and HRQo L in RA patients. However, due to the heterogeneity and methodologic limitations of the studies included in this systematic review, evidence is not strong enough to produce a best practice guideline.

关键词： acupuncture rheumatoid arthritis quality of life pain physical function randomized clinical trial

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Diagnosis and Objective Pain Assessment of Traditional Chinese Medicine May Be Useful to Demonstrate Specific Effects of Acupuncture in Low Back Pain: A Prospective, Randomized, Controlled and Single Blinded Pre-study

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Journal of Acupuncture and Tuina Science 2013年第3期11卷 155-159页

作者： susana seca Paula Capelo Thomas Efferth Christoph Alexander Doenitz Sven Schroeder Ana Anjos Jorge Machado Henry Johannes Greten Institute of Biomedical Sciences Abel Salazar (ICBAS) University of PortoPortoPortugal Heidelberg School of Chinese Medicine Heidelberg Germany University Hospital Center of Coimbra CoimbraPortugal Department of Pharmaceutical Biology Institute of Pharmacy and BiochemistryJohannes Gutenberg UniversityMainzGermany Institute of Biomedical Sciences Abel Salazar (ICBAS) University of Porto Porto Portugal HanseMerkur Center for Traditional Chinese Medicine University Medical Center Hamburg-Eppendorf Hamburg Germany Porto Biomechanics Laboratory (LABIOMEP) University of Porto Portugal German Society of Traditional Chinese Medicine Heidelberg Germany

Objective: To prove specific effects of acupuncture on chronic pain. It was speculated that the potential specific effectiveness of acupuncture could be better shown in more properly designed studies. Therefore, diagnoses of both Western medicine and traditional Chinese medicine (TCM) were used as inclusion criteria to allocate acupoints more precisely to the complaints of the patients. Secondly, objectively measurable parameters of pain relief in addition to usual Visual Analogue Scale (VAS) were chosen to quantify the effects of acupuncture. Methods: The study was prospective, randomized, controlled and single-blinded. Eighteen patients with chronic back pain and TCM diagnosis of a Taiyang/Yangming syndrome received one single session of acupuncture chosen according to TCM diagnosis or acupuncture on points outside the meridian system (controls). We evaluated pain via VAS and increased mobility via inclinometry of the back. Results: Although the sample size was small, there was a statistically significant improvement in pain and mobility in the intervention group (n=13), but not in the control group (n=5). The calculated sample size adequate power was lower for inclinometry than for VAS, indicating that VAS is less probable to discriminate acupuncture effects. Conclusion: Objectively measurable physical parameters such as the angle of flexion before and after acupuncture (inclinometry) may be more suitable to measure pain relief than subjective assessment by VAS in acupuncture studies. TCM diagnosis may be a helpful inclusion criterion in studies on acupuncture, so as to potentially allocate interventions better to the complaints of patients.

关键词： Low Back Pain Traditional Chinese Medicine Acupuncture Therapy Sham Acupuncture Randomized Controlled Trial

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