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研究发现针灸确实能缓解慢性疼痛

Acupuncture Provides True Pain Relief in Study
研究发现针灸确实能缓解慢性疼痛

A new study of acupuncture - the most rigorous and detailed analysis of the treatment to date - found that it can ease migraines and arthritis and other forms of chronic pain.

一项有关针灸的新研究——迄今为止最严格和详细的治疗分析——表明,针灸能缓解偏头痛、关节炎和其他形式的慢性疼痛。

The findings provide strong scientific support for an age-old therapy used by an estimated three million Americans each year. Though acupuncture has been studied for decades, the body of medical research on it has been mixed and mired to some extent by small and poor-quality studies. Financed by the National Institutes of Health and carried out over about half a decade, the new research was a detailed analysis of earlier research that involved data on nearly 18,000 patients.

这一发现为这项古老的治疗方法提供了强有力的科学支持,估计每年大约有300万美国人接受针灸治疗。虽然针灸已经被研究了数十年,但大多是小型低质量的研究,因此使这类医学研究陷入混乱。新的研究超过五年之久,由美国国家卫生研究院(National Institutes of Health)资助,分析的早期研究数据涵盖近1.8万名患者。

The researchers, who published their results in Archives of Internal Medicine, found that acupuncture outperformed sham treatments and standard care when used by people suffering from osteoarthritis, migraines and chronic back, neck and shoulder pain.

研究人员已经把结果发表在《内科学文献》(Archives of Internal Medicine)上,表明针灸在骨关节炎、偏头痛,以及慢性背部、颈部和肩部疼痛的患者中,治疗效果优于安慰治疗和标准护理。
 

"This has been a controversial subject for a long time," said Dr. Andrew J. Vickers, attending research methodologist at Memorial Sloan-Kettering Cancer Center in New York and the lead author of the study. "But when you try to answer the question the right way, as we did, you get very clear answers.

“长期以来,这都是一个有争议的话题。” 纽约纪念斯隆-凯特琳癌症中心(Memorial Sloan-Kettering Cancer Center)的主诊研究方法论学者、也是本次研究的主要作者安德鲁·J·维克斯博士(Dr. Andrew J. Vickers)这样说:“但一旦你像我们这样正确解答问题,答案就非常明晰了。”

"We think there's firm evidence supporting acupuncture for the treatment of chronic pain."

“我们认为,有确凿的证据支持针灸能治疗慢性疼痛。”

Acupuncture, which involves inserting needles at various places on the body to stimulate so-called acupoints, is among the most widely practiced forms of alternative medicine in the country and is offered by many hospitals. Most commonly the treatment is sought by adults looking for relief from chronic pain, though it is also used with growing frequency in children. According to government estimates, about 150,000 children in the United States underwent acupuncture in 2007.

针灸,即将针插入身体不同部位刺激“穴位“的方法,是美国最常见的替代医疗(也称非主流医疗)形式,很多医院都提供这项治疗。使用这项治疗最多的是慢性疼痛的成人患者,但儿童应用也越来越多了。根据政府的估计,2007年大约有15万名儿童接受了针灸治疗。

But for all its popularity, questions about its efficacy have long been commonplace. Are those who swear by it experiencing true relief or the psychological balm of the placebo effect?

但是,虽然针灸治疗非常流行,关于其有效性的疑问也很普遍。那些声称自己疼痛缓解的人,是否只是被安慰剂效应吻了吻心灵?

Dr. Vickers and a team of scientists from around the world - England, Germany, Sweden and elsewhere - sought an answer by pooling years of data. Rather than averaging the results or conclusions from years of previous studies, a common but less rigorous form of meta-analysis, Dr. Vickers and his colleagues first selected 29 randomized studies of acupuncture that they determined to be of high quality. Then they contacted the authors to obtain their raw data, which they scrutinized and pooled for further analysis. This helped them correct for statistical and methodological problems with the previous studies, allowing them to reach more precise and reliable conclusions about whether acupuncture actually works.

维克斯博士和来自世界各地的科学家团队——英国、德国、瑞典和其他地方——在多年的数据中挖掘出了答案。以往常用的荟萃分析是将之前的研究结果或结论平均化,但这不够严谨。维克斯博士及其同事首先选出了他们认为质量较高的29个关于针灸的随机研究,然后联系作者得到了原始数据,再进行仔细检查和采集。这使他们避免了之前研究的统计学和方法学问题,从而对“针灸是否有用”得到了更精确可靠的结论。

All told, the painstaking process took the team about six years. "Replicating pretty much every single number reported in dozens of papers is no quick or easy task," Dr. Vickers said.

总之,这个艰苦的过程花费了团队大概6年时间。“几十篇论文中几乎每个数字都抄一遍真不是个快速简单的任务,”维克斯博士说。

The meta-analysis included studies that compared acupuncture with usual care, like over-the-counter pain relievers and other standard medicines. It also included studies that used sham acupuncture treatments, in which needles were inserted only superficially, for example, or in which patients in control groups were treated with needles that covertly retracted into handles.

这次荟萃分析包括了比较针灸与常规护理的研究,如非处方止痛药和其他标准药品。它也包括了伪针灸安慰治疗,比如针刺入得非常浅,或者对照组患者的针会缩回手柄内。

Ultimately, Dr. Vickers and his colleagues found that at the end of treatment, about half of the patients treated with true acupuncture reported improvements, compared with about 30 percent of patients who did not undergo it.

最终,维克斯博士和他的团队发现,在治疗结束时,接受真正针灸治疗的患者约有一半报告有改善,而未接受治疗的患者约有30%有改善。

"There were 30 or 40 people from all over the world involved in this research, and as a whole the sense was that this was a clinically important effect size," Dr. Vickers said. That is especially the case, he added, given that acupuncture "is relatively noninvasive and relatively safe."

“在全球,有30到40位研究者参与了此项研究,总体来说感觉这是个具有临床重要效应的规模。”维克斯博士说。他补充说,考虑到针灸“是相对非创伤性和相对安全的”,这一点尤为重要。

Dr. Vickers said the results of the study suggest that people undergoing the treatment are getting more than just a psychological boost. "They're not just getting some placebo effect," he said. "It's not some sort of strange healing ritual."

维克斯博士说,研究结果表明,接受治疗的患者不仅仅获得了心理上的鼓励。“他们不仅获得了安慰效应,”他说,“这不是什么怪异的治愈仪式。”

In an accompanying editorial, Dr. Andrew L. Avins, a research scientist at Kaiser Permanente who focuses on musculoskeletal pain and preventive medicine, wrote that the relationship between conventional medical care "and the world of complementary and alternative medicine remains ambiguous." But at least in the case of acupuncture, he wrote, the new study provides "robust evidence" that it provides "modest benefits over usual care for patients with diverse sources of chronic pain."

凯萨医疗机构(Kaiser Permanente)专事研究肌肉骨骼疼痛和预防医学的研究科学家安德鲁·L·埃文斯博士(Dr. Andrew L. Avins)在文后的编者按中,把传统医疗保健与“补充和替代医学世界” 之间的关系描述为“含糊不清”,但他写道,至少就针灸而言,新的研究提供了“强有力的证据”,“相比常规治疗,针灸对于不同原因慢性疼痛的患者都有一定程度的益处。”
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