하지불안 증후군의 침 치료
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
하지불안 증후군의 증상 치료를 위한 침 사용을 지지하는 근거는 불충분하다.
하지불안 증후군 (Restless legs syndrome) 은 감각운동성 운동장애로서 다리에 불편한 감각을 느껴 움직이고 싶어하는 특징적인 증상을 보인다. 이 증후군은 매우 흔하면서도 일상생활에 상당한 영향을 주기 때문에, 보다 효과적이고 수용 가능한 치료방법에 대한 연구가 필요하다.
침은 고대 중국에서 유래한 치료 방법이며, 경혈에 침을 놓아 장부 기능을 조절하고 신체의 기운을 조정한다. 침은 하지불안 증후군에 대해 비약물적 치료로서 잠재적인 가치를 지닐 수 있다.
이 리뷰는 하지불안 증후군의 침 치료 효능과 이상반응을 조사하였다. 검색된 두 건의 임상시험 분석 결과, 침 치료가 효과적이며 안전하다는 일관된 근거는 찾을 수 없었다. 하지불안 증후군으로 고통받는 침 치료 환자에게 침 치료의 일상적 적용을 권고할 수 있게 되기까지는, 더 많은 양질의 임상시험이 필요하다.
