Akupunktura za sindrom nemirnih nogu
Abstract
Background
Restless legs syndrome (RLS) is a common movement disorder for which patients may seek treatment with acupuncture. However, the benefits of acupuncture in the treatment of RLS are unclear and have not been evaluated in a systematic review until now.
Objectives
To evaluate the efficacy and safety of acupuncture therapy in patients with RLS.
Search methods
We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2007), MEDLINE (January 1950 to February 2007), EMBASE (January 1980 to 2007 Week 8), Chinese Biomedical Database (CBM) (1978 to February 2007), China National Knowledge Infrastructure (CNKI) (1979 to February 2007), VIP Database (1989 to February 2007), Japana Centra Revuo Medicina (1983 to 2007) and Korean Medical Database (1986 to 2007). Four Chinese journals, relevant academic conference proceedings and reference lists of articles were handsearched.
Selection criteria
Randomized controlled trials and quasi‐randomized trials comparing acupuncture with no intervention, placebo acupuncture, sham acupuncture, pharmacological treatments, or other non‐acupuncture interventions for primary RLS were included. Trials comparing acupuncture plus non‐acupuncture treatment with the same non‐acupuncture treatment were also included. Trials that only compared different forms of acupuncture or different acupoints were excluded.
Data collection and analysis
Two authors independently identified potential articles, assessed methodological quality and extracted data. Relative risk (RR) was used for binary outcomes and weighted mean difference for continuous variables. Results were combined only in the absence of clinical heterogeneity.
Main results
Fourteen potentially relevant trials were identified initially, but twelve of them did not meet the selection criteria and were excluded. Only two trials with 170 patients met the inclusion criteria. No data could be combined due to clinical heterogeneity between trials. Both trials had methodological and/or reporting shortcomings. No significant difference was detected in remission of overall symptoms between acupuncture and medications in one trial (RR 0.97, 95% CI 0.76 to 1.24). Another trial found that dermal needle therapy used in combination with medications and massage was more effective than medications and massage alone, in terms of remission of unpleasant sensations in the legs (RR 1.36, 95% CI 1.06 to 1.75; WMD ‐0.61, 95% CI ‐0.96 to ‐0.26) and reduction of RLS frequency (WMD ‐3.44, 95% CI ‐5.15 to ‐1.73). However, there was no significant difference for the reduction in either the longest or the shortest duration of RLS (WMD ‐2.58, 95% CI ‐5.92 to 0.76; WMD ‐0.38, 95% CI ‐1.08 to 0.32).
Authors' conclusions
There is insufficient evidence to determine whether acupuncture is an efficacious and safe treatment for RLS. Further well‐designed, large‐scale clinical trials are needed.
PICO
Plain language summary
Ne postoji dovoljno dokaza za podržavanje korištenja akupunkture za simptomatsko liječenje sindroma nemirnih nogu.
Sindrom nemirnih nogu (SNG) je senzorimotorni poremećaj pokreta obilježen neugodnim sjetima u nogama i potreba za njihovim pomicanjem. SIndrom je veoma čest i negativno utječe na kvalitetu života, što opravdava potragu za djelotvornijom i prihvatljivijom terapijom.
Akupunktura je drevna kineska metoda liječenja. Za akupunkturu se tvrdi da regulira funkciju unutrašnjih organa i vraća u ravnotežu tjelesne energije podražavanjem određenih aku‐točaka. Kao nefarmakološka terapija, odnosno terapija koja ne ukljčuje lijekove, akupuntura bi možda mogla biti korisna u liječenju SNG‐a.
Ovaj Cochraneov sustavni pregled literature je istražio djelotvornost i sigurnost akupunkture u liječenju SNG‐a. U procjeni nisu pronađeni dosljedni dokazi za određivanje djelotvornosti akupunkture u liječenju SNG‐a, a taj zaključak se temelji na dva pronađena istraživanja. Potrebno je provesti više visokokvalitetnih istraživanja prije nego što se rutinska upotreba akupunkture može preporučiti pacijentima koji pate od SNG‐a.
