Table 2.5Neck Pain - Acupuncture - Mixed - Specific Pain

Author ID CountryStudy CharacteristicsPopulation CharacteristicsPain CharacteristicsIntervention DetailOutcome results: Pain, DisabilityOutcome results: Other outcomes; Harms
Bin, X (2007)217

Country: China

Quality score: 5/13

Initial of reviewer: SG
Trial Design
RCT

Tx duration: 10ds
Fu duration (last assessment): NR

N screened: NR
N randomized: 57
N completed tx: 54
N attended last fu: NR

Inclusion: age 18-70 yrs; diagnosed with cervical spondylopathy; abnormal findings in X -ray exam; excluding ocular or aural vertigo, cases caused by poor blood supply in basilare arterial due to pressure on the verebroartery section I and III; also cases due to neurosis and intracranial tumor)

Exclusion: conditions caused by such diseases as Meniere's cerebral arteri sclerosis, postural vetigo, drug intoxication of inner ear, neurosis, and sublavian steal syndrome
Mean age (SD/range): 35-68 yrs

% of male: 73% total

Racial composition: assume Asian

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: NR

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Region of pain:


Cause of Pain:
Cervical spondylopathy of the vertebroarterial type

Duration of Pain, mean (SD/range): Mixed (1 wk-10 yrs), NR

Severity of pain (Grading): excluded mild; total: majority moderate (8 severe, and 49 moderate)

Current tx/ co-intervention common in all groups: NR
Groups
IG (n = 29) – Electro-acu:on acu points: GB 20; GV 20; GB 8; oblique insertion (75° angle) -gentle lifting thrusting and rotating manipulation was performed to induce the arrival of qi before and electric stimulator was connected to the needles; The points selected wer divided into two groups wich were used alternately; 20 min/session, once daily with a 10 d course
Drop outs: 1

CG (n = 28) – simple acu: same acupoints and manipulation methods as IG; Same as IG
Drop outs: 2
Outcomes (describe instrument used):
Pain: NA

Disability: NA

Results:
Baseline: NA
Pain:
Disability:

Immediate post tx:
Pain: NA
Disability: NA

Short term: NR

Intermediate: NR

Long term: NR
Outcomes (describe instrument used):
QoL/ well being:
Life and work- mean (SD) Post tx: 3.38 (2.43) vs. 2.74 (2.39)

Cure rates
Immediate post tx: pts completely cured (n): 10 vs. 6; cured & markedly effective rate: 82.21 vs. 53.84; Effective rate: 92.86 vs. 84.62

Change of physica signs: data not shown

Quality of life:
Short term: NR

Intermediate: NR

Long term: NR

Harms: NR
Chu J (1997)221

Country: US

Quality score: 1/13

Initial of reviewer: SG
Trial Design
RCT

Tx duration: NR
Fu duration (last assessment): immediate post-tx

N screened: 296
N randomized: 164
N completed tx: NR
N attended last fu: NR

Inclusion: Neck and arm pain, MPS due to cervical nerve root irritation

Exclusion: Pts with peripheral neuropathy
Mean age (SD/range): NR

% of male: IG = 41%, CG = 28.5%

Racial composition: NR

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: Cervical nerve root irritation

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Region of pain:
Neck, shoulder
Cause of Pain:
S, NR

Duration of Pain, mean (SD/range): Mixed, NR

Severity of pain (Grading): NR

Current tx/ co-intervention common in all groups: NR
Groups
IG (n = 122) – Acu (dry needling) – tender points: Done bilaterally on levator scapulae C3, trapezus C4, anteroir deltoid C5, romboid major C5, infraspinatus C5, posterior deltoid C6, biceps brachii-short head C7, brachialis C6, teres major C6, triceps C7, extensor communis C7, and cervical muscles at C3-C7 level; NR
Drop outs: NR

CG (n = 42) – Acu (dry needling) – random points: Same as IG; NR
Drop outs: NR
Outcomes (describe instrument used):
Pain: ≥ 50% pain relief, n (%)]

Results:
Baseline:
Pain: ---

Immediate post tx:
Pain: IG = 38 (31%), CG = 7 (16.6%) Average pain relief: 51.8% (21.9) vs. 39.0% (18.7%)

Short term: NR

Intermediate: NR

Long term: NR
Outcomes (describe instrument used):
QoL/ well being: NR

Results- mean: Baseline: NA

Immediate post tx: NA

Short term: NR

Intermediate: NR

Long term: NR

Harms: NR
Huang, YF (2008)226

Country: China

Quality score: 4/13

Initial of reviewer: SG
Trial Design
RCT

Tx duration: 20 ds
Fu duration (last assessment): immediately post-tx

N screened: NR
N randomized: 107
N completed tx: 107
N attended last fu: 107

Inclusion: numbness, NP, and radiating pain towards upper limb; brachial plexus traction test (+), spurling's test (+); deformity of cervical vertebrae in CT; cervical vertebrae affected determined by clinical evaluation same as those indicated in CT

Exclusion: other cervical disc or joint disease or musculoskeletal disease affect upper limb, such as spinal tuberculosis, tumor, scapulohumeral periarthritis, etc.
Mean age (SD/range): IG1 = 43 (13), IG2 = 41.5 (10), CG = 41.7 (11.7) yrs

% of male: IG1 = 64.9%, IG2 = 61.1%, CG = 70.6%

Racial composition: NR

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: NR

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Region of pain:
NP
Cause of Pain:
Cervical spondylosis of nerve root type

Duration of Pain, mean (SD/range): Mixed: (up to 12 wks)/(>12 wks): IG1 = 4 (3.5), IG2 = 4 (3.5); Chronic (> 12 wks): CG = 4.6 (3.6)

Severity of pain (Grading): NR

Current tx/ co-intervention common in all groups: NR
Groups
IG1 (n = 37)– Acu at Jiquan (HT1) with lifting thrusting manipulation: affected arm needled 25-40mm deep at 5cm below HT1 in abduction position and shoulder flx in 90°, needle stimulated by lifting-thrusting after “deqi” sensation reached; 1 session/2 d over 20 d
Drop outs: A = 0, B = 0

IG2 (n = 36)– Acu at Jiquan (HT1) with twirling manipulation: same as IG1, stimulate needle site by twirling at freq. of 2 Hz till “deqi” sensation; as IG1
Drop outs: A = 0, B = 0

CG (n = 34) – Routine needling: needle 25-40 mm at LI 11, HT1, LI 4, PC6, PC3, manually stimulated till “deqi” sensation, retention time 30 min; as IG1
Drop outs: A = 0, B = 0
Outcomes (describe instrument used):
Pain: NA

Disability: NA

Results:
Baseline: NA
Pain:
Disability:

Immediate post tx: NA
Pain:
Disability:

Short term: NR

Intermediate: NR

Long term: NA
Outcomes (describe instrument used):
QoL/ well being:
Cure rate; effective; ineffective; total efficacy (%)

Immediate post tx: IG1 = 59.5, IG2 = 25, CG = 32.4; IG1 = IG1 = 32.4, IG2 = 33.3, CG = 44.1; IG1 = 8.1, IG2 = 41.7, CG = 23.5; IG1 = 91.9, IG2 = 58.3, CG = 76.5

Short term: NR

Intermediate: NR

Long term: NR

Harms: NR
Ilbuldu E (2004)223

Country: Turkey

Quality score: 5/13

Initial of reviewer: SG
Trial Design
RCT

Tx duration: 4 wks
Fu duration (last assessment): 6 mos

N screened: NR
N randomized: 60
N completed tx: 60
N attended last fu: 60

Inclusion: Women aged 18-50 yrs with MTP in the upper trapezius muscle

Exclusion: Tumor, infectious diseases, osteoarthritis (stage 3-4), pregnancy, scoliosis, COLD
Mean age (SD/range): IG1 = 35.3 (9.18), IG2 = 33.9 (10.36), CG = 32.35 (6.88) yrs

% of male: 0 (all female)

Racial composition: NR

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: NR

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Region of pain:
NP
Cause of Pain:
Myofascial pain

Duration of Pain, mean (SD/range): Mixed, IG = 38.48 (32) mo; IG2 = 32.95 (28.61) mo; CG = 36.95 (33.65) mo

Severity of pain (Grading): NR

Current tx/ co-intervention common in all groups: paracetamol for pain
Groups
IG1 (n = 20)– Acu dry needling: 0.25 x 25 size acu needles; once/wk for 4 wks
Drop outs: NR

IG2 (n = 20)– Laser therapy: He-Ne laser at 632.8 nm wavelength applied to the three TP in the upper trapezius muscles on both sides; 3 sessions/wk, 12 sessions over 4 wks
Drop outs: NR

CG (n = 20) – Laser-placebo: everything the same as in Laser group but no beam was applied; same as IG2
Drop outs: NR
Outcomes:
Pain: NHP; VAS (at rest)

Results:
Baseline:
Pain: IG1 = 70 IG2 = 59.54 (30.71), (19.47), CG = 60.42 (31.39); IG1 = 5.1 (1.97), IG2 = 5.5 (1.96), CG = 5.7 (1.81)

Immediate post tx:
Pain: NR

Short term: IG1 = 33.9 (28.37), IG2 = 13.5 (14.07), CG = 32.2 (28.4); IG1 = 3.71 (2.33), IG2 = 2.05 (1.43), CG = 3.65 (2.03)

Intermediate: IG1 = 32.66 (35.15), IG2 = 19.02 (23.02), CG = 27.89 (23.65); IG1 = 2.59 (2.18), IG2 = 2.12 (1.9), CG = 2.89 (2.63)
QoL/ well being: Nottingham Health profile inventory: laser grp was sig better than IG1 and CG at post tx but not at 6 mos

Cervical ROM: sig increase in flexio at post tx in dry needling & laser grps, range of ext sig increased in laser grp vs. dry needling & placebo

Analgesic use:
Immediate post tx: analgesic use: 3.62 (4.41) vs. 0.85 (1.53) vs. 2.05 (3.38)

Short term: NR

Intermediate: NR Analgesic use: 2.53 (2.74) vs. 1.41 (3.43) vs. 2.5 (3.49)

Long term: NR

Harms: NR
Jia, CS (2007)225

Country: China

Quality score: 5/13

Initial of reviewer: SG
Trial Design
RCT

Tx duration: one tx
Fu duration (last assessment): immediate post-tx

N screened: NR
N randomized: 98
N completed tx: 98
N attended last fu: 98

Inclusion: diagnosed as cervical spondylosis according to “The diagnostic criteria for cervical spondylosis”; NP; informed consent obtained

Exclusion: other spinal disease; pregnant and postnatal woman; cardio-cerebrovascular disease, hematransverse oscillatory rotoietic disease, psychosis; not complete tx sessions
Mean age (SD/range): NR

% of male: 51% total

Racial composition: NR

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: NR

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Region of pain:
NP
Cause of Pain:
Disc/joint disease

Duration of Pain, mean (SD/range): Mixed (sub-acute/chronic)

Severity of pain (Grading): NR

Current tx/ co-intervention common in all groups: head movements (rot, flx, ext, etc.)
Groups
IG1 (n = 49) – Otransverse oscillatory rotoint- penetrative needling: needles inserted at unilateral and bilateral (AH 13) otransverse oscillatory rotoints and subsequently crossed one otransverse oscillatory rotoint area to another between epidermis and cartilage of muscle, stimulate with twirling 5-7 times, retention time 30 min., twirling 2-3 times during retention; one 30 min. tx
Drop outs: A = 0

IG2 (n = 49) – Otransverse oscillatory rotoint- straight needling: needles directly inserted at selected otransverse oscillatory rotoints, needle retention time and twirling times same as IG1; Same as IG1
Drop outs: A = 0
Outcomes:
Pain: SF-MPQ (15 descriptors)

Disability: NA

Results:
Baseline:
Pain: IG1 = 28 (7.4), IG2 = 27.9 (7.3)
Disability: NA

Immediate post tx:
Pain: IG1 = 12.6 (4.9), IG2 = 21.4 (6.4)
Disability: NA

Short term: NR

Intermediate: NR

Long term: NR
Outcomes (describe instrument used):
QoL/ well being: NR

Results- mean:
Baseline: NA

Immediate post tx: NA

Short term: NR

Intermediate: NR

Long term: NR

Harms: NR
Li, Xiang-hui (2004)219

Country: China

Quality score: 4/13

Initial of reviewer: SG
Trial Design
RCT

Tx duration: 40 ds
Fu duration (last assessment): 12 mos

N screened: 780
N randomized: 780
N completed tx: 780
N attended last fu: 780

Inclusion: Pts diagnosed as cervical spondylosis using Chinese Medical Diagnostic and Effectivenes Standard

Exclusion: NR
Mean age (SD/range): IG = 49.1, CG1 = 50.2, CG2 = 48.1 yrs

% of male: IG1 = 47.3%, CG1 = 45.8%, CG2 = 46.2%

Racial composition: Asian

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: NR

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Region of pain:
NP
Cause of Pain:
Spondylosis

Duration of Pain, mean (SD/range): Mixed (1 mo-20 yrs, acute, sub-acute, chronic)

Severity of pain (Grading): NR

Current tx/ co-intervention common in all groups: NR
Groups
IG (n = 260) – Acu centro-square needling Danzhui: Dazui point, supplement acupoints: jianyu, jianzhen, jianqian, quchi, hegu, fengchi, huantiao, yanglingquan, neiguan and zusanli
Diameter 0.30-0.35mm, 25-125mm long needle; 1 tx/d, 20 tx/course, 2 courses
Drop outs: B = 0, E = 0

CG1 (n = 260) – Acu needling cervical Jiaji point: Jiaji point, Diameter 0.30-0.40mm; Same as IG1
Drop outs: B = 0, E = 0

CG2 (n = 260) – Traction-massage: traction 2-10kg, retention 30min, 10-15 neck massage; Same as IG1
Drop outs: B = 0, E = 0
Outcomes (describe instrument used):
Pain: NA

Disability: NA

Results:
Baseline:
Pain: NA
Disability: NA

Immediate post tx:
Pain: NA
Disability: NA

Short term: NR

Intermediate: NR

Long term: NR
Outcomes:
QoL/ well being: Based on Chinese Medical Diagnostic n (%)

Results- mean:

Immediate post tx: IG = 254 (97.7), CG1 = 247 (95), CG2 = 224 (86.2)

Short term: NR

Intermediate: NR

Long term: NR

Harms: NR
Summary: The therapeutic effect in IG1 was stable and better than that in the CGs. IG has the best therapeutic effect for cervical spondylosis and therapeutic effect of CG1 is better than that in CG2
Lin, M (2004)220

Country: China

Quality score: 3/13

Initial of reviewer: SG
Trial Design
RCT

Tx duration: 3 mos
Fu duration (last assessment): 6 mos

N screened: 100
N randomized: 100
N completed tx: NR
N attended last fu: NR

Inclusion: Cervical spondylopathy of nerve root type, aged 25-76 yrs

Exclusion: NR
Mean age (SD/range): 46 (8.5) yrs total

% of male: 65% total

Racial composition: NR

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: NR

Prior CAM intervention: NR

Prior surgery related to current complaint:
Region of pain:
NP & Vertebrae
Cause of Pain:
Cervical spondylopathy of nerve root type

Duration of Pain, mean (SD/range): Mixed(Acute-Chronic: 15 d – 32 yrs), NR

Severity of pain (Grading): NR

Current tx/ co-intervention common in all groups: NR
IG (n = 50) – Acu (Needle Scalpel/ Massage Tx): no. 3 or no. 4 small needle scalpel, cut lines parallel to nerves, blood vessels, muscle fiber, inserted vertically, small hole made with Chuanketie after needle withdrawn, pressure applied until bleeding stransverse oscillatory rotped, every 7 d Massage therapy: digital acupoint pressure, pokingchannels, on-the-point pressing, rolling, rotating manipulation used to massage Fengchi, Dazhui acupoints and soft tissue focus in neck area, traction of cervical vertebrae and massage of pain areas, plucking and pressing, two-point and one-site reposition maneuver, once/d; 3 mo
Drop outs: NR

CG (n = 50) – Massage only: Same as IG;
Drop outs: NR
Outcomes (describe instrument used):
Pain: NA

Disability: NA

Results:
Baseline:
Pain: NA
Disability: NA

Immediate post tx:
Pain: NA
Disability: NA

Short term: NR

Intermediate: NR

Long term: NR
Outcomes:
QoL/ well being: TR
Cure rate:
Post tx: 16 vs. 10

Effective rate:
Short term: NR (49/50) 98% vs. (41/50) 83%, p < 0.05

Intermediate: NR

Long term: NR

Harms: NR

Summary: Dose and frequency of tx unclear
Shang, Xiu-kui (2002)218

Country: UK

Quality score: /13

Initial of reviewer: SG
Trial Design
RCT

Tx duration: 54 ds
Fu duration (last assessment): immediate post-tx

N screened: NR
N randomized: 80
N completed tx: 80
N attended last fu: 80

Inclusion: Diagnostic as nerve-toot cervical spondylopathy using Chinese Medical Diagnostic Standard

Exclusion: NR
Mean age (SD/range): NR

% of male: NR

Racial composition: Asian

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: NR

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Region of pain:
NP
Cause of Pain:
Spondylosis

Duration of Pain, mean (SD/range): Mixed (acute – chronic), NR

Severity of pain (Grading): NR

Current tx/ co-intervention common in all groups: NR
Groups
IG (n = 50)– Acu, acupoint Sitianxue: tianyong, tianrong, tianchuan, tianding, and liequan for major acupoints, all points on affected side for cold dampness, add dazhui and fengmen for qi stagnant, add xuehai add touzhui and houxi for headache add jianzhongshu and jianwaishu add shenmai for neck rot limitation add kenlun for pain in lumbar sacrum, 40-50mm, retention 30min; 1 tx/2 d, 9 tx/course, 3 courses
Drop outs: A = NR, B =0

CG (n = 30) – Acu acupoint Jiajixue; retention 30 min; Same as IG
Drop outs: A = NR, B =0
Outcomes:
Pain: pain score instrument not mentioned (%)

Results:
Baseline:
Pain: IG = 0.8 (0.03), CG = 0.79 (0.04)

Immediate post tx:
Pain: IG = 0.1 (0.02); CG = 0.32 (0.03)

Short term: NR

Intermediate: NR

Long term: NR
Outcomes:
QoL/ well being: Score based on Chinese Medical Diagnostic and Effective Standard

Results- mean: Baseline: IG = 0.62 (0.04), CG = 0.65 (0.03)

Immediate post tx: IG = 3.31 (0.01), CG =3.4 (0.05) N (%) improved: IG = 46 (92), CG = 21 (70)
Short term: NR
Intermediate: NR
Long term: NR

Harms: NR

Summary: IG as main therapy has a marked effect on spondylopathy. This study found the effect of the tx is better with the younger 20 - 40 yr pts than the older pts > 40 yrs
Wang, Xi-Lin (2008)227

Country: China

Quality score: 4/13

Initial of reviewer: SG
Trial Design
RCT

Tx duration: 30 ds
Fu duration (last assessment): immediately post-tx

N screened: NR
N randomized: 102
N completed tx: 102
N attended last fu: 102

Inclusion: NP, neck PPT and/or radiating pain towards chest, shoulder, back, and upper limb, upper limb and figure numb, neck stiff and ROM reduced; Lasègue sign (-); CT or MRT indicate deficits on cervical discs

Exclusion: NR
Mean age (SD/range): IG = 43.3 (13.3) vs. CG = 45.2 (14.1) yrs

% of male: IG = 49%, CG = 52.9%

Racial composition: NR

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: NR

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Region of pain:
NP
Cause of Pain:
Disc/joint disease, degenerative disease

Duration of Pain, mean (SD/range): Unknown (mixed), IG = 2.8 (1.62) yrs; CG = 3.1 (1.71) yrs

Severity of pain (Grading): NR

Current tx/ co-intervention common in all groups: NR
Groups
IG (n = 51)– Shu-needling + elecro-acu: GV14, S13, TE5, & EX-B2 were selected, needles were deeply inserted into the cervical vertebrae of corresponding Jiaji (EX-B2), until “deqi” sensation reached, connected with G 6805 electrical impulse device and stimulated at freq. of 3.3 Hz, needle retention for 30 min.; 30min/tx, 1 tx/d, 10 d/period, 30 d total
Drop outs: A = 0, B = 0

CG (n = 51) – Routine needling + electro-acu: same acupoints as IG and routine needling applied, tx duration, needle retention and electrical impulse and freq. same as IG; saem as IG
Drop outs: A = 0, B = 0
Outcomes:
Disability: NR

Results:
Baseline:
Disability: ---

Immediate post tx:
Disability: NR

Short term: NR

Intermediate: NR

Long term: NR
Outcomes (describe instrument used):
QoL/ well being: NR
Efficacy of TCM diagnostic criteria:

Immediate post tx: cure rate IG = 68.6, CG = 47.1 ;

effective IG = 29.4, CG =37.2;

ineffective IG = 2, CG = 15.7

total efficacy (%)IG = 98, CG = 84.3

Short term: NR

Intermediate: NR

Long term: NR

Harms: NR
Zhang, B (2005)228

Country: China

Quality score: 0/13

Initial of reviewer: SG
Trial Design
RCT

Tx duration: 3 wks
Fu duration (last assessment): 3 mos

N screened: NR
N randomized: 96
N completed tx: NR
N attended last fu: NR

Inclusion: NR (appears to include pts with cervical spondylosis only)

Exclusion: NR
Mean age (SD/range): NR

% of male: IG = 65.63%, CG = 56.25%

Racial composition: Asian

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: 4

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Region of pain:
NP
Cause of Pain:
Cervical spondylosis

Duration of Pain, mean (SD/range): Mixed, NR

Severity of pain (Grading): NR

Current tx/ co-intervention common in all groups: NR
Groups
IG (n = 64) – Acupuncture + Massage / Manipulation:. Acupoint injection - Fengchi (GB 20), bilaterally, Ashi points (spot of tenderness or node), 1 to 2; Drugs: VB12500ug (1 ml), Danshen injection 2 mL (1 g/mg), 2 % lidocaine 1 ml. The above drugs were drawn into a one-off 5ml syringe. the doctor inserted the needle into the points and injected the same amount of drugs into each point. If there was no bleeding, the needle was withdrawn with the arrival of qi; 3 tx/wk for 3 wks
Drop outs: NR

CG (n = 32) – Massage: As IG; Same as IG
Drop outs: NR
Outcomes (describe instrument used):
Pain: NA

Disability: NA

Results:
Baseline:
Pain: NA
Disability: NA

Immediate post tx:
Pain: NA
Disability: NA

Short term: NR

Intermediate: NR

Long term: NR
Outcomes (describe instrument used):
QoL/ well being: NR
Cure rate:

Immediate post tx: 81.25% vs. 56.25, p < 0.05
Total effective rate were similar in two grps

Short term: NR

Intermediate: NR

Long term: NR

Harms: NR
Zhang, Honglai (2003)85

Country: China

Quality score: 6/13

Initial of reviewer: SG
Trial Design
RCT

Tx duration: 45 ds
Fu duration (last assessment): NR

N screened: unknown
N randomized: 120
N completed tx: 120
N attended last fu: NR

Inclusion: diagnosed as Cervical Spondylosis using ref [1] 1993-chinese, Special attention (only those who were compliant with the tx, only those who responded to the surveys)

Exclusion: acute external injury cause, not compliant
Mean age (SD/range): NR

% of male: IG = 53.3%, CG = 55%

Racial composition: Asian

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: NR

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Region of pain:
NP
Cause of Pain:
Spondylosis

Duration of Pain, mean (SD/range): Chronic, IG = 81.9 mo, IG2 = 92.2 mo, CG = 91.1 mo

Severity of pain (Grading): McGill, VAS

Current tx/ co-intervention common in all groups: NR
Groups
IG (n = 60)– Electro-acu: tianzhu, jinbailao and dashu (two sides) for major acu points dazhui, fengchi, fengmen, jianjin and waiguan for wind dampness quchi, pishu, fenglong, geshu for tanyuzhu type ganshu, pishu, and zusanli for qi stagnant type ganshu, pishu, zusanli for qi and blood stagnant type yanglao, ganshu, shenshu and taixi for liver and kidney debility. 1.5 Chinese inch, size 30 needle, freq. 120-250/min, retention 30min; 1 tx/d, 15 tx/course, 3 courses, 2 d rest between courses
Drop outs: A = NR, B= 0

CG (n = 60) – Traction: 30 min, average traction = 7.5kg; Same as IG
Drop outs: A = NR, B= 0
Outcomes:
Pain: McGill PRI total; difference between baseline and fu on VAS

Results:
Baseline:
Pain: IG = 8.57 (2.33), CG = 8.61 (2.42); NR

Immediate post tx:
Pain: IG = 6.73 (2.12), CG = 7.55 (2.28); IG = 4.87 (1.67), CG = 3.56 (1.26)

Short term: NR

Intermediate: NR

Long term: NR
Outcomes (describe instrument used):
QoL/ well being: Cure, improved, effective, no effect n(%)
Results- mean: Baseline:
Immediate post tx: IG = 56 (93.3%), CG = 47 (78.3%)

Short term: NR

Intermediate: NR

Long term: NR

Harms: NR

Summary: IG in therapeutic effect and improvement of pain for cervicalspondylosis is better than the CG. This study found that both tx have better effect with younger pts compared with older pts
Zhu, HZ (2006)224

Country: China

Quality score: 4/13

Initial of reviewer: SG
Trial Design
RCT

Tx duration: 18-45 ds
Fu duration (last assessment): 6 mos

N screened: 221
N randomized: 221
N completed tx: 221
N attended last fu: 221

Inclusion: cervical sponsylosis, 18-75 yrs of age

Exclusion: Operation; pregnant and breast-feeding women; Cervical TB, tumor and inflammation; Mental
Mean age (SD/range): IG = 46.04 (9.2) vs. CG = 46.5 (10.3) yrs

% of male: IG = 48.7%, CG = 52.8%

Racial composition: NR

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: NR

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Region of pain:
NP
Cause of Pain:
Cervical spondylosis

Duration of Pain, mean (SD/range): Mixed, IG = 4.59 (3.06) yrs; CG = 4.82 (3.25) yrs

Severity of pain (Grading): NR

Current tx/ co-intervention common in all groups: NR
Groups
IG (n = 115) – Needle-knife: needle-knife therapy at the apper and lower interspinal ligaments of the affected vertebaral body and bilateral pasterior joint capsules; 1 time/3-5 d x 3 times/3 course
Drop outs: D = 0

CG (n = 106) – Acupuncture: acu at Luozhen, Ashi and Jiaji points; 1 time/2 d x 5 times/3 course
Drop outs:
Outcomes:
Pain: NR

Results:
Immediate post tx:
Pain: NR

Short term: NR

Intermediate: NR

Long term: NA
Outcomes (describe instrument used):
QoL/ well being: Therapeutic effect

Results- mean:
Baseline: NA

Immediate post tx: NA

Short term: IG = 91.3%, CG = 59.4%

Intermediate: IG = 94.7%, CG = 56.6%

Long term: NR

Harms: NR
Zhuang, Li-Xing (2004) 222

Country: China

Quality score: /13

Initial of reviewer: NH (Chinese extractions)
Trial Design
RCT- Double blind/cross over

Tx duration: 3 wks
Fu duration (last assessment):

N screened: NR
N randomized: 34
N completed tx: 34
N attended last fu: 34

Eligibility criteria:
-

inclusion: diagnosed as vertebral artery type of cervical spondylosis by western medicine, age 36-72, duration 1 mos-5yrs also diagnosed by chinese medicine

-

exclusion: diagnosed as shi zheng

Mean age: IG1 = 53.7 (11.9), IG2 = 53.3 (11.7)

% of male: IG1 = 35.3%, IG2 = 23.5%

Racial composition: Asian

Work status: NR

Other socio-demographics: NR

Co morbidities: NR

Prior episode of pain if acute: NR

Prior CAM intervention: NR

Prior surgery related to current complaint: NR
Region of pain:
NP-specific

Duration of Pain: IG1 = 2.9 (1.12), IG2 = 2.78 (1.09)

Duration of pain: 1 mos-5yrs

Severity of pain (Grading): NR
Groups

IG1 (n=17) – pressed acu at the baihui acupoint + local electro-acupuncture , retention 30 min, by trained professionals 1tx/day, 7tx/course, total of 3 courses
0 dropouts

IG2 (n=17) – local electro-acupuncture by trained professionals, 1tx/day, 7tx/course, total of 3 courses
0 dropouts
Outcomes:
Pain: NR
Disability: NR

Results:
Baseline: NA

Short Term Follow Up: NA
Outcomes:

Curative effect immediately pos-tx:Number of patients cured:
9/17 vs. 4/17 Number of patients with significant effect:
6/17 vs. 4/17 Number of patientswith improvement:
2/17 vs. 7/17 Number of patients without effect: 0/17 vs. 2/17

Other outcomes: chages of contents of plasma thromboxane and 6-keto-prostaglandin 1 alpha and the ratio of these two

Harms:
NR

From: Appendix C, Evidence Tables

Cover of Complementary and Alternative Therapies for Back Pain II
Complementary and Alternative Therapies for Back Pain II.
Evidence Reports/Technology Assessments, No. 194.
Furlan AD, Yazdi F, Tsertsvadze A, et al.

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