Positive Health Online

Abstract

MACPHERSON and others, Foundation for Traditional Chinese Medicine, York YO10 5DD, UK, hml@york.ac.uk, report on a clinical trial of diagnosis and acupuncture treatment for low back pain.

Background

The aim of the study was to assess patterns of diagnosis and treatment within a clinical trial of acupuncture for low back pain.

Methodology

148 patients presenting with low back pain of between 1 and 12 months' standing were offered individualized acupuncture and received up to 10 treatments. Standardized diagnosis and treatment records were completed by practitioners. The diagnosis was based on 3 pre-defined low back pain syndromes. A subgroup of patients were independently re-examined by a second practitioner who was blinded to the original diagnosis. Diagnostic inter-rater reliability was assessed.

Results

The most commonly diagnosed syndrome was Qi and blood flow stagnation (88%), followed by kidney deficiency (53%) and Bi Syndrome (28%). In 65% of patients more than one syndrome was identified. For the subgroup examined twice, practitioner concordance was reasonable, lying between 47 and 80% of congruent classifications, with Kappa values between 0 and 0.67. Practitioners provided 1269 treatments in total using 177 different acupoints. Most commonly used channels were Bladder and Gall Bladder, and the commonest points were BL-23 and the two lowest Huatuojiaji points.

Conclusion

Diagnostic concordance among practitioners of traditional Chinese acupuncture was reasonable, and clear themes emerged from the treatment.

References

MacPherson H, Thorpe L, Thomas K, Campbell M. Acupuncture for low back pain: traditional diagnosis and treatment of 148 patients in a clinical trial. Complementary Therapies in Medicine 12 (1): 38-44, Mar 2004.