Efficacy of abdominal acupuncture for neck pain: A randomized controlled trial

Objective
This study aims to provide evidence regarding the clinical efficacy of abdominal acupuncture for neck pain.
Methods
This randomized, patient and assessor-blind, sham-controlled trial was conducted at a Chinese medicine center in Hong Kong between November 2014 and March 2016. A total of 154 eligible participants (age range, 18–65 years) with neck pain were randomly assigned to receive abdominal (n = 77) or non-penetrating sham abdominal (sham group; n = 77) acupuncture. Each participant was administered treatment over six sessions by Registered Chinese Medicine Practitioners, in accordance with a standardized protocol. The primary outcome was mean improvement in neck pain disability scores evaluated by the Northwick Park Neck Pain Questionnaire (NPQ). Secondary outcomes included intensity of neck pain and health-related quality-of-life measures. The outcomes were assessed at baseline and at 2 and 6 weeks from baseline. Patients in the abdominal acupuncture group received additional follow-up evaluation at 14 weeks from baseline. Outcomes were evaluated by intention-to-treat analysis.
Results
All participants provided informed consent for treatment and follow-up evaluation. Patients who received abdominal acupuncture exhibited greater improvement in NPQ scores than those who received sham treatment at both 2 and 6 weeks from baseline (intergroup mean differences, -5.75; 95% confidence interval [CI], -9.48 to -2.03; P = 0.008 and -8.65; 95% CI, -12.13 to -5.16; P < 0.001, respectively). The improvement in NPQ scores in the abdominal acupuncture group was even more significant at 14 weeks from baseline. Patients in the abdominal acupuncture group also exhibited significantly greater improvements in intensity of neck pain and a few quality-of-life measures than those in the sham abdominal acupuncture group, without any serious adverse events.
Conclusion
These findings suggest that abdominal acupuncture is an effective alternative treatment for neck pain.
Trial registration
Chinese Clinical Trial Registry ChiCTR-TRC-14004932.

Objective
本研究旨在为腹针治疗颈痛的临床疗效提供循证依据。
Methods
本研究为随机、受试者及评估者设盲的假对照临床试验，于2014年11月至2016年3月在香港某中医中心开展。共纳入154名符合入组标准的颈痛受试者（年龄范围18~65岁），按1:1比例随机分配至腹针组（n=77）与非穿透性假腹针组（假对照组，n=77）。所有受试者均由注册中医师（Registered Chinese Medicine Practitioners）按照标准化治疗方案完成6次疗程。主要结局指标为采用诺思维克公园颈痛问卷（Northwick Park Neck Pain Questionnaire, NPQ）评估的颈痛残疾评分平均改善值。次要结局指标包括颈痛强度与健康相关生活质量评估指标。分别于基线期、基线后2周及6周进行结局评估；腹针组受试者额外接受基线后14周的随访评估。结局指标采用意向性治疗分析（intention-to-treat analysis）进行统计分析。
Results
所有受试者均签署了治疗与随访的知情同意书。相较于假对照组，腹针组受试者在基线后2周及6周的NPQ评分改善程度均更显著（组间均差分别为-5.75；95%置信区间[CI]：-9.48~-2.03；P=0.008，以及-8.65；95%CI：-12.13~-5.16；P<0.001）。腹针组受试者在基线后14周的NPQ评分改善效果更为显著。相较于假对照组，腹针组受试者的颈痛强度与部分生活质量指标的改善程度亦更为显著，且全程未发生严重不良事件。
Conclusion
本研究结果表明，腹针是治疗颈痛的有效替代疗法。
Trial registration
临床试验注册：中国临床试验注册中心 ChiCTR-TRC-14004932。