氣功穴道治療在疼痛症候群上的實證醫學研究

Abstract

疼痛是基層醫療最常見的症狀，也是人們最常遭受到的苦難。人們除利用醫藥物治療外，也尋求氣功穴道治療法以解除疼痛。特以實證醫學研究方法評估氣功穴道治療法在解除疼痛症候群上的療效。研究包括參部份:第一、疼痛及治療結果的評量工具。將國際通用標準的疼痛問卷及下背痛標準治療結果評估工具翻譯成中文，經信、效度之檢驗及臨床試驗，證明其對台灣民眾疼痛上的評估具有適用性。第二、利用該中文問卷，以實證醫學研究方法，復健治療為對照，比較氣功穴道治療在解除下背痛的療效；及以肌肉鬆弛劑加上止痛藥物為對照，比較氣功穴道治療在解除頭痛上的療效。結果顯示氣功穴道治療法在解除下背痛和頭痛上，為具統計上顯著差異的有效治療方法。第三、以經濟評估方法，復健治療為對照，估計醫療成本，分析氣功穴道治療法的相對成本比、相對成本效率比。以意願償付法，探討接受另類治療的族群對減輕不同程度的下背痛時，所意願償付的最高金額為利益，分析氣功穴道治療法的相對成本利益比。經濟評估結果顯示氣功穴道治療法，具較為有利的成本效率比和成本利益比。

Pain is the major complaint in the primary medical care clinics and is the most commonly reported health problem that a large part of general population suffers from. Aside from occidental medications, people look for acupressure to alleviate the discomfort. Our study, aiming to investigate efficacy of acupressure in pain syndromes, includes three parts. Part 1: Standard pain outcome measures. Chinese versions of international standard pain measuring tools for low back pain are developed with proofs of reliability, validity, and adequacy and ability in distinguishing pain intensity and characters in Taiwanese people; Part 2: Studies to investigate the efficacy of acupressure in relieving pains in low back compared with that of physical therapy and in head with that of muscle relaxant in adding to analgesic medication are conducted by evidence-based medicine study designs. The results reveal that acupressure is a statistically significant efficacious pain relieving modality; and Part 3: Economic evaluations on acupressure, compared with physical therapy, are performed by cost estimates, cost-effectiveness analyses and cost-benefit analyses. While analyzing the cost-benefit, the “willingness to pay” approach is adopted for different percentage reductions for low back pain from a population who seek acupressure for pain relieving. Results show that acupressure is of lower costs and with cost effective and beneficial in pain syndromes.