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首页> 外文期刊>Spine >The case of acupuncture for chronic low back pain: when efficacy and comparative effectiveness conflict.
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The case of acupuncture for chronic low back pain: when efficacy and comparative effectiveness conflict.

机译：针灸治疗慢性下腰痛的情况：当疗效和比较效果发生冲突时。

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Efficacy signifies superiority over placebo controls in randomized controlled trials (RCTs). Effectiveness implies greater or equal clinical benefits compared to an already-established treatment. Two recent RCTs of acupuncture for chronic low-back pain (cLBP)-notable for their size, rigor, and innovative research designs that included both efficacy and effectiveness hypotheses-raise the interesting conundrum of what happens when these two forms of evidence conflict. In the first German trial, patients with cLBP (n = 1162) were randomized to acupuncture treatments, placebo acupuncture treatments, or optimal mainstream care.1 At 6 months, the primary endpoint, the proportion of positive clinical response was 47.6%, 44.2%, and 27.4% in acupuncture, placebo acupuncture, and conventional care, respectively. There was no statistical difference between acupuncture and placebo acupuncture (P = 0.39), but both acupuncture and placebo acupuncture were statistically and clinically superior to mainstream care that included physiotherapy, exercises, and nonsteroidal anti-inflammatory drugs (P < 0.001).
机译：在随机对照试验（RCT）中，疗效表明其优于安慰剂对照。与已经建立的治疗方法相比，有效性意味着更大或相等的临床收益。近期针对慢性腰背痛（cLBP）的两种针灸随机对照试验（RCT）均因其规模，严谨性和创新性研究设计而闻名，其中包括有效性和有效性假设，这引发了有趣的难题，即这两种形式的证据冲突时会发生什么。在德国的第一项试验中，cLBP（n = 1162）患者被随机分配到针灸治疗，安慰剂针灸治疗或最佳主流护理中。1在6个月（主要终点）时，临床阳性反应的比例分别为47.6％，44.2％在针灸，安慰剂针灸和常规护理中分别占27.4％。针灸和安慰剂针灸之间无统计学差异（P = 0.39），但针灸和安慰剂针灸在统计学和临床​​上均优于包括物理治疗，锻炼和非甾体抗炎药在内的主流护理（P <0.001）。

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