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　　针灸对中风的恢复无效

　　王新军 编译
　　滨州医学院

　　（路透社健康频道） 根据对10个使用假针灸或“伪”针灸作为对照的试验
分析的的结果表明，针灸并不能帮助中风后患者加速恢复。

　　“我们从严格的随机伪对照试验的分析数据没有显示出针灸对治疗脑卒中后
功能恢复具有积极作用。”南韩Wonkwang大学的Jae Cheol Kong博士等发表在加
拿大医学协会期刊（CMAJ）上的论文总结道。

　　最近的一些研究发现，与假针灸相比，针灸对患者无益。假针灸是传统中医
技术的一种安慰对照方式，即并不按照穴位针刺、刺入浅层皮肤或根本就不刺入
皮肤。

　　例如，最近的研究发现，针灸对引产无效，而另一项研究显示，传统中医技
术对于提高体外受精的成功无益。

　　虽然已经有一些关于针灸对中风康复的医学文献综述，本研究报告的作者注
意到，很多研究具有局限性，例如不包括亚洲国家发表的研究报告。

　　为了解决这个问题，Kong等检索了25个数据库和12个韩国的传统医学期刊。
在664份关于这个问题的研究中，有10份研究符合他们的标准，共包括711名患者。

　　其中有两个试验是比较真针灸与假电刺激的试验，而其他八个试验是用伪针
灸做安慰对照的。多项不同的分析发现针灸并不能改善患者进行日常生活活动的
能力，也没有表现出改善神经功能的测量指标。虽然其中两项研究也曾发现了针
灸的益处，“但这两项研究粗糙的报告和严重的偏倚难以提供可靠的证据，”
Kong等写道。 

　　研究人员承认，假针灸可能并不是真正的安慰剂，实际上也可能产生生理效
应，这或许可以解释假针灸治疗组与真针灸治疗组之间没有差别。本研究结果的
其他“缺点”包括数据缺乏且数据的质量较差，他们补充说。

　　在与本研究同时发表的评论中，成都华西医院Hongmei Wu博士认为，鉴于本
研究规模较小，而且假针灸实际上可能也有一定效果的事实，“得出针刺治疗中
风康复无效的结论仍为时尚早。”

　　“需要设计严格、大规模、多中心的随机试验进一步评估针灸对中风康复的
效果。”Wu说。

　　Acupuncture not helpful for stroke recovery
　　(Reuters Health) - Acupuncture does not help speed recovery after 
stroke, according to an analysis of 10 trials using fake or "sham" 
acupuncture as a control.
　　"Our meta-analysis of data from rigorous randomized 
sham-controlled trials did not show a positive effect of acupuncture 
as a treatment for functional recovery after stroke," Dr. Jae Cheol 
Kong of Wonkwang University in Iksan, South Korea, and colleagues 
conclude in the Canadian Medical Association Journal (CMAJ).
　　Some recent studies have found no benefit for acupuncture when it 
is compared to sham acupuncture, a placebo version of the traditional 
Chinese medicine technique that can involve needling non-acupuncture 
points, penetrating the skin shallowly, or not penetrating the skin at 
all.
　　For example, recent studies found acupuncture was not effective 
for inducing labor, while another showed no benefit of the traditional 
Chinese technique for improving the success of in vitro fertilization 
(IVF).
　　While several reviews of the medical literature on acupuncture for 
stroke recovery have been published, the authors of the current study 
note, many have had limitations, for example failing to include 
studies published in Asian countries.
　　To address this issue, Kong and colleagues searched 25 databases 
and 12 Korean traditional medicine journals. Among 664 studies on the 
topic, the researchers found 10 that met their criteria, including 711 
patients in all.
　　Two of the trials compared real acupuncture to sham 
electrostimulation, while the other eight used sham acupuncture as a 
placebo. Several different analyses of the trials found acupuncture 
did not improve patients' ability to perform activities of daily living, 
nor did it show improvement in measurements of neurological function. 
While two studies did find a benefit for acupuncture, "poor reporting 
and high risks of bias rendered both studies less than reliable," Kong 
and colleagues write.
　　The researchers acknowledge that sham acupuncture may not be a 
true placebo, and could actually be producing physiological effects, 
which could explain the lack of difference between the fake and real 
acupuncture groups. Other "drawbacks" to their findings include the 
lack of data and the often-poor quality of that data, they add.
　　In an editorial accompanying the study, Dr. Hongmei Wu of West 
China Hospital in Chengdu argues that given the small size of the 
studies, as well as the fact that sham acupuncture may actually have 
some effect, "it is premature to refute the effects of acupuncture in 
treatment of stroke rehabilitation."
　　"Rigorously designed, large, multicentre randomized trials are 
needed to assess the effects of acupuncture on stroke rehabilitation 
further," Wu concludes. 

(XYS20101001)

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