肩の手術後の標準的な理学療法にバトルフィールド鍼治療を併用しても、痛みの改善に追加的な効果は見られない

肩の手術後の標準的な理学療法にバトルフィールド鍼治療を併用しても、痛みの改善に追加的な効果は見られない

要約

この研究は、肩の安定化手術を受けた患者において、標準的な理学療法（PT）にバトルフィールド鍼治療（BFA）を追加することで、痛み、気分、自己評価の改善、薬物使用に対して追加的な効果があるかを検討するために実施されました。

方法

単盲検のランダム化臨床試験として、肩の安定化手術を受けた95人の参加者が、標準的な理学療法のみを受けるグループ（対照群）と、標準的な理学療法にBFAを追加するグループ（介入群）に無作為に割り当てられました。両グループとも、術後の痛み管理のための標準的な薬物療法を受けました。評価は、術後24～48時間、72時間、1週間、4週間の4つの時点で行われ、痛みの強さ（Visual Analog Scale）、気分（Profile of Mood States）、薬物使用量、症状の自己評価（Global Rating of Change）が測定されました。ネットワークオブケア+3CoLab+3BioMed Central+3

結果

88人の参加者（BFA群43人、対照群45人）が最終的な解析に含まれました。両グループとも、時間の経過とともに痛みや気分の改善が見られましたが、BFAを追加したグループと標準的な理学療法のみのグループとの間に、痛みの強さ、気分、自己評価、薬物使用量において統計的に有意な差は認められませんでした。また、4週間後のオピオイド使用量にも有意な差はありませんでした。

結論

この研究の結果、肩の手術後の痛み管理において、標準的な理学療法にBFAを追加しても、痛みの軽減、気分の改善、自己評価の向上、薬物使用量の減少において追加的な効果は見られませんでした。したがって、術後の痛み管理におけるBFAの有効性を支持する証拠は得られませんでした。今後、BFAの効果を明らかにするためには、さらなる研究が必要です。

この研究は、バトルフィールド鍼治療が術後の痛み管理において追加的な利益をもたらすかどうかを明確にするための重要な一歩となりました。しかし、現時点では、標準的な理学療法にBFAを追加することによる明確な利点は示されていません。今後の研究で、特定の患者群や条件下でのBFAの有効性が検討されることが期待されます。

この様に戦場鍼（BFA）の有効性を否定する論文も世の中にはあります！
要するに――「なんでもかんでも効きます！」なんて魔法のような鍼治療なんて存在しないのです

以下、原文

Battlefield Acupuncture Does Not Provide Additional Improvement in Pain When Combined With Standard Physical Therapy After Shoulder Surgery

Battlefield Acupuncture Does Not Provide Additional Improvement in Pain When Combined With Standard Physical Therapy After Shoulder Surgery: A Randomized Clinical Trial
Michael S Crowell 1 2, Erin M Florkiewicz 2 3, Jamie B Morris 2, John S Mason 4, Will Pitt 4, Timothy Benedict 2, Kenneth L Cameron 5, Donald L Goss 2 6
Affiliations Expand
PMID: 39797512 DOI: 10.1093/milmed/usae577
Abstract
Introduction: Shoulder stabilization surgery is common among military personnel, causing severe acute postoperative pain that may contribute to the development of chronic pain, thereby reducing military readiness. Battlefield Acupuncture (BFA) has shown promise as a non-pharmaceutical intervention for acute postoperative pain. The purpose of this study was to determine the effectiveness of BFA combined with standard physical therapy on pain, self-reported mood, self-reported improvement, and medication use in patients after shoulder stabilization surgery.

Materials and methods: The study design was a single-blind, randomized clinical trial, approved by the Naval Medical Center Portsmouth Institutional Review Board and registered with ClinicalTrials.gov (NCT04094246). Ninety-five participants were recruited after shoulder stabilization surgery. Participants were randomized via concealed allocation into a standard physical therapy (PT) group or a group receiving standard PT and BFA. Both groups received standard postoperative pain medication. The BFA intervention followed a standard protocol with the insertion of gold aiguille d’acupuncture emiermanente needles at 5 specific points in the ear. At 4 time points (baseline [24-48 hours], 72 hours, 1 week, and 4 weeks post-surgery), participants reported worst and average pain using a Visual Analog Scale (VAS), self-reported mood using the Profile of Mood States (POMS), self-recorded medication intake between study visits, and self-reported improvement in symptoms using a Global Rating of Change (GROC) Scale. Outcome assessors were blinded to treatment allocation. An alpha level of 0.05 was set a priori. For pain, a mixed-model analysis of variance was used to analyze the interaction effect between group and time. Differences in baseline data, total opioid usage, and pain change scores between groups were analyzed using independent t-tests.

Results: Of the 95 participants enrolled, 7 failed to provide complete study visits after the baseline, leaving 88 patients (43 BFA, 45 control, mean age 21.8 (2.1) years, 23% female). There were no significant group-by-time interactions for VAS worst pain (F = 0.70, P = .54), VAS average pain (F = 0.99, P = .39), the POMS (F = 1.04, P = .37), or GROC (F = 0.43, P = 0.63). There was a significant main effect of time for VAS worst pain (F = 159.7, P < .001), VAS average pain (F = 122.4, P < .001), the POMS (F = 11.4, P < .001), and the GROC (F = 78.5, P < .001). While both groups demonstrated statistically significant and clinically meaningful improvements in pain and self-reported mood over time, BFA did not provide any additional benefit compared to standard physical therapy alone. There was no significant difference in opioid usage between groups at 4 weeks (t = 0.49, P = .63). Finally, both groups also demonstrated statistically significant and clinically meaningful self-reported improvements in function, but again, there was no additional benefit when adding BFA to standard physical therapy.

Conclusion: The results of this study do not support the effectiveness of BFA for postsurgical pain management as there were no significant differences in pain, self-reported mood, self-reported improvement, and medication use between participants who received BFA and those who did not. As this is the only known study of BFA in postsurgical participants, continued research is needed to determine if BFA is effective for pain reduction in that setting.

Clinical trial registration: ClinicalTrials.gov, NCT04094246. Registered September 16, 2019, http://clinicaltrials.gov/NCT04094246.

Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2025. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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引用元：https://pubmed.ncbi.nlm.nih.gov/39797512/