Korean Journal of Acupuncture

Society for Meridian and Acupoint (경락경혈학회)
권호 표지

Systematic Review of Selection of Acupuncture Points for Lower Back Pain

요통 침치료를 위한 경혈 선정에 관한 체계적 문헌 고찰

  • Lee, In-Seon (Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University) ;
  • Jo, Hee-Jin (Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University) ;
  • Lee, Soon-Ho (Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University) ;
  • Jung, Won-Mo (Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University) ;
  • Kim, Song Yi (Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University) ;
  • Park, Hi-Joon (Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University) ;
  • Lee, Hyejung (Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University) ;
  • Chae, Younbyoung (Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University)
  • 이인선 (경희대학교 한의과대학 침구경락과학연구센터) ;
  • 조희진 (경희대학교 한의과대학 침구경락과학연구센터) ;
  • 이순호 (경희대학교 한의과대학 침구경락과학연구센터) ;
  • 정원모 (경희대학교 한의과대학 침구경락과학연구센터) ;
  • 김송이 (경희대학교 한의과대학 침구경락과학연구센터) ;
  • 박히준 (경희대학교 한의과대학 침구경락과학연구센터) ;
  • 이혜정 (경희대학교 한의과대학 침구경락과학연구센터) ;
  • 채윤병 (경희대학교 한의과대학 침구경락과학연구센터)
  • Received : 2012.11.16
  • Accepted : 2012.12.17
  • Published : 2012.12.27
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives : The purpose of this study is to figure out which acupoints are selected to treat low back pain and attempt to analyze the effectiveness of those acupoints in current clinical trials. Methods : We searched the three electronic databases(PUBMED, RISS, KISS) and manually checked related Korean journals and reference lists up to April 2012. We included randomized controlled trials, clinical controlled trials, and case reports/series using needle type acupuncture( manual acupuncture, electronic acupuncture) to treat low back pain in English and Korean. We investigated the frequency of selected acupoints, change of visual analogue scale of low back pain and statistical significance in each study among trials. Results : We included 37 articles(Domestic 17, International 20) 53 studies(Domestic 28, International 25) in this study. The most frequently adopted acupoints were BL23, BL24, BL25, GB30, BL26, BL60, BL32, BL40, KI3, GV3, ST36 in domestic studies and BL23, BL25, BL40, BL60, GB30, GB34, BL32, BL26 in international studies. There were differential effectiveness of acupoints between domestic and the international studies using statistical significance of visual analog scale for low back pain. Conclusions : These results suggest that both proximal and distal acupoints based on meridian theory were used in clinical trials to treat low back pain. It would be helpful to provide clinical guideline, evaluate the results of clinical trials appropriately, and reveal the effectiveness of acupoints.

Keywords

References

  1. Kim JH, Nam DW, Kang JW, Kim EJ, Kim KS, Kang SK, et al. A review of clinical trials for development of assessment criteria for chronic low back pain. The Journal of Korea Acupuncture & Moxibustion Society. 2009 ; 26(6) : 215-24.
  2. Survey on use of Oriental medicine and herbal medicine, Korea Institute for Health and Social Affairs. 2012.
  3. Rubinstein SM, van Middelkoop M, Kuijpers T, Ostelo R, Verhagen AP, de Boer MR, et al. A systematic review on the effectiveness of complementary and alternative medicine for chronic non-specific low-back pain. Eur Spine J. 2010 ; 19(8) : 1213-28. https://doi.org/10.1007/s00586-010-1356-3
  4. Santaguida PL, Gross A, Busse J, Gagnier J, Walker K, Bhandari M, et al. Complementary and alternative medicine in back pain utilization report. Evid Rep Technol Assess (Full Rep). 2009 ; (177) : 1-221.
  5. Trigkilidas D. Acupuncture therapy for chronic lower back pain: a systematic review. Ann R Coll Surg Engl. 2010 ; 92(7) : 595-8. https://doi.org/10.1308/003588410X12699663904196
  6. Lee SH, Nam DW, Kang JW, Kim EJ, Kim HW, Song HS, et al. E-mail survey for developing clinical guideline protocol on acupuncture treatment for low back pain. The Journal of Korea Acupuncture & Moxibustion Society. 2009 ; 26(3) : 115-31.
  7. Park YL. Study on clinical research methodology for acupuncture : Based on review of clinical studies on back pain. Iksan: Wonkwang University. 2011.
  8. Furlan AD, Yazdi F, Tsertsvadze A, Gross A, Van Tulder M, Santaguida L, et al. A systematic review and meta-analysis of efficacy, cost-effectiveness, and safety of selected complementary and alternative medicine for neck and low-back pain. Evid Based Complement Alternat Med. 2012 ; 2012 : 953139.
  9. Yuan J, Purepong N, Kerr DP, Park J, Bradbury I, McDonough S. Effectiveness of acupuncture for low back pain: a systematic review. Spine (Phila Pa 1976). 2008 ; 33(23) : E887-900. https://doi.org/10.1097/BRS.0b013e318186b276
  10. Lewis K, Abdi S. Acupuncture for lower back pain: a review. Clin J Pain. 2010 ; 26(1) : 60-9. https://doi.org/10.1097/AJP.0b013e3181bad71e
  11. Ernst E, White AR. Acupuncture for back pain: a meta-analysis of randomized controlled trials. Arch Intern Med. 1998 ; 158(20) : 2235-41. https://doi.org/10.1001/archinte.158.20.2235
  12. Hutchinson AJ, Ball S, Andrews JC, Jones GG. The effectiveness of acupuncture in treating chronic non-specific low back pain: a systematic review of the literature. J Orthop Surg Res. 2012 ; 7(1) : 36. https://doi.org/10.1186/1749-799X-7-36
  13. Thomas KJ, MacPherson H, Thorpe L, Brazier J, Fitter M, Campbell MJ, et al. Randomised controlled trial of a short course of traditional acupuncture compared with usual care for persistent non-specific low back pain. BMJ. 2006 ; 333(7569) : 623. https://doi.org/10.1136/bmj.38878.907361.7C
  14. MacAuley D. Back pain and physiotherapy. BMJ. 2004 ; 329(7468) : 694-5. https://doi.org/10.1136/bmj.329.7468.694
  15. Miao EY. Clinical critical qualitative evaluation of the selected randomized controlled trials in current acupuncture researches for low back pain. Journal of Chinese Integrative Medicine. 2010 ; 8(12) : 1133-46. https://doi.org/10.3736/jcim20101205
  16. Birch S, Sherman K. Zhong Yi acupuncture and low-back pain: traditional Chinese medical acupuncture differential diagnoses and treatments for chronic lumbar pain. J Altern Complement Med. 1999 ; 5(5) : 415-25; discussion 27-8. https://doi.org/10.1089/acm.1999.5.415
  17. Furlan AD, van Tulder M, Cherkin D, Tsukayama H, Lao L, Koes B, et al. Acupuncture and dry-needling for low back pain: an updated systematic review within the framework of the cochrane collaboration. Spine (Phila Pa 1976). 2005 ; 30(8) : 944-63. https://doi.org/10.1097/01.brs.0000158941.21571.01
  18. Yuan J, Kerr D, Park J, Liu XH, McDonough S. Treatment regimens of acupuncture for low back pain--a systematic review. Complement Ther Med. 2008 ; 16(5) : 295-304. https://doi.org/10.1016/j.ctim.2008.04.006
  19. Witt CM, Manheimer E, Hammerschlag R, Ludtke R, Lao L, Tunis SR, et al. How well do randomized trials inform decision making: systematic review using comparative effectiveness research measures on acupuncture for back pain. PLoS One. 2012 ; 7(2) : e32399. https://doi.org/10.1371/journal.pone.0032399
  20. Kvorning N, Holmberg C, Grennert L, Aberg A, Akeson J. Acupuncture relieves pelvic and low-back pain in late pregnancy. Acta Obstet Gynecol Scand. 2004 ; 83(3) : 246-50.
  21. Itoh K, Itoh S, Katsumi Y, Kitakoji H. A pilot study on using acupuncture and transcutaneous electrical nerve stimulation to treat chronic non-specific low back pain. Complement Ther Clin Pract. 2009 ; 15(1) : 22-5. https://doi.org/10.1016/j.ctcp.2008.09.003
  22. Yun JY, Kim DH, Kim HW, Kim SS, Park SW, Kim EK, et al. The clinical effects of acupuncture and acupotomy therapy for HIVD. The Journal of Korea Acupuncture & Moxibustion Society. 2010 ; 27(4) : 85-97.
  23. Kim HJ, Kim SS, Lee JS, Chung SK, Shin HD. (The) Effect of microcurrent electrical neuromuscular stimulation on low back pain. J Oriental Rehab Med. 2001 ; 11(2) : 1-14.
  24. Moon SE, Lee CB. The experimental study for the balanced restoration on the part of spinal skeletal muscles in low back pain patients - by acupuncture stimuli model of limb skeletal muscle. The Journal of Korean Academy of Physical Therapies. 2001 ; 8(1) : 181-9.
  25. Cho YJ. Effects of acupuncture for chronic low back pain. Seoul: Kyunghee university. 2010.
  26. Lim SY, Yoo SM, Bae KY, Lee YH, Jung JJ. Research on the effect and satisfaction between Independenced and parallelism treatment of acupuncture and physical of lumbago patients. The Journal of Korea Acupuncture & Moxibustion Society. 2005 ; 22(6) : 75.
  27. Lee YK. The comparative study on effect of body acupuncture and 8 constitution acupuncture in acute stage lumbago patients for checked up the pancreotonia. The Journal of East-West Medicine. 2010 ; 35(3) : 95-105.
  28. Jeong SY, Park ZW, Shin JM, Kim JY, Youn IY. The comparative study of effectiveness between acupuncture and its cotreatment with calculus Bovis, Fel Ursi, Moschus pharma-copuncture on the treatment of acute low back pain. The Journal of Korea Acupuncture & Moxibustion Society. 2011 ; 28(4) : 105-10.
  29. Cha JD, Jung SM, Kim KO, Kim KS, Kim NO. The comparison of effectiveness between acupuncture and its cotreatment with bee venom acua-acupuncture therapy on the treatment of herniation of nucleus pulpous. The Journal of Korea Acupuncture & Moxibustion Society. 2004 ; 21(1) : 149-58.
  30. Ahn JL, Lee IS, Cha SC, Kim GT. The clinical effect on low back pain by acupuncture treatment and GCM(General Coordinative Manipulation) treatment. J Oriental Rehab Med. 2002 ; 12(1) : 111-20.
  31. Lee YK, Park SY, Jeon HJ, Kim SH, Kim JH, Lee SM, et al. The comparative study on effect of body acupuncture and 8 constitution acupuncture in acute stage lumbago -For patients checked up the pancreotonia-. The Journal of Korea Acupuncture & Moxibustion Society. 2009 ; 26(2) : 181-8.
  32. Kwon YD, Lee SG, Lee CW, Jung SK, Kim DG, Choi SM. The short-term efficacy of acupuncture for chronic low back pain : Randomized sham controlled trial. J Oriental Rehab Med. 2007 ; 17(2) : 123-32.
  33. Jung SY, Cho YC, Kim TH, Lim SY, Kim CS. The clinical effect of Haenggan and Taechung on low back pain caused by Iliopsoas Muscle Disorder. J Oriental Rehab Med. 2003 ; 13(4) : 123-30.
  34. Son CH, Lim HJ, Lee SH, Han SH, Moon SG. The clinical study on the pain improvement of lumbago patients with electroacupuncture therapy using visual analogue scale. The Journal of Korea Acupuncture & Moxibustion Society. 2004 ; 21(5) : 27-44.
  35. Sung SM, Park MJ, Kim JU, Hwang MS, Yoon JH. A case report of lumbago due to retention of Undigested Food and Damp-heat in ten kinds of lumbago. The Journal of Korea Acupuncture & Moxibustion Society. 2005 ; 22(4) : 143-53.
  36. Kim YS, Chae WS. Clinical studies on the effects of the electrical acupuncture stimulation therapy of low back pain in lumbar spondylosis. The Journal of Korea Acupuncture & Moxibustion Society. 1989 ; 6(1) : 113-28.
  37. Song JG, Lim GS, Kim KS. Effects of acupuncture on the plasma levels of ${\beta}$ - Endorphin, ACTH and Cortisol in chronic low back pain. The Journal of Korea Acupuncture & Moxibustion Society. 1989 ; 6(1) : 63-82.
  38. Chung SM, Kang ES, Park BM. Clinical studies of the low-frequency, electrical acupuncture stimulation therapy of low back pain in degenerative osteoarthritis of the lumbar spine. The Korean Central Journal of Medicine. 1976 ; 31(2) : 165-9.
  39. Lin ML, Lin MH, Fen JJ, Lin WT, Lin CW, Chen PQ. A comparison between pulsed radiofrequency and electro-acupuncture for relieving pain in patients with chronic low back pain. Acupunct Electrother Res. 2010 ; 35(3-4) : 133-46.
  40. Shankar N, Thakur M, Tandon OP, Saxena AK, Arora S, Bhattacharya N. Autonomic status and pain profile in patients of chronic low back pain and following electro acupuncture therapy: a randomized control trial. Indian J Physiol Pharmacol. 2011 ; 55(1) : 25-36.
  41. Tuck CM. A 54-year-old woman with degenerative back pain. Acupunct Med. 2010 ; 28(1) : 46-8. https://doi.org/10.1136/aim.2009.000687
  42. Wasan AD, Kong J, Pham LD, Kaptchuk TJ, Edwards R, Gollub RL. The impact of placebo, psychopathology, and expectations on the response to acupuncture needling in patients with chronic low back pain. J Pain. 2010 ; 11(6) : 555-63. https://doi.org/10.1016/j.jpain.2009.09.013
  43. Liu CT, Chen KC, Chiu EH. Adult degenerative scoliosis treated by acupuncture. J Altern Complement Med. 2009 ; 15(8) : 935-7. https://doi.org/10.1089/acm.2008.0515
  44. Inoue M, Hojo T, Nakajima M, Kitakoji H, Itoi M, Katsumi Y. Pudendal nerve electroacupuncture for lumbar spinal canal stenosis - a case series. Acupunct Med. 2008 ; 26(3) : 140-4. https://doi.org/10.1136/aim.26.3.140
  45. Inoue M, Kitakoji H, Yano T, Ishizaki N, Itoi M, Katsumi Y. Acupuncture treatment for low back pain and lower limb symptoms-the relation between acupuncture or electroacupuncture stimulation and sciatic nerve blood flow. Evid Based Complement Alternat Med. 2008 ; 5(2) : 133-43. https://doi.org/10.1093/ecam/nem050
  46. Inoue M, Kitakoji H, Ishizaki N, Tawa M, Yano T, Katsumi Y, et al. Relief of low back pain immediately after acupuncture treatment-a randomised, placebo controlled trial. Acupunct Med. 2006 ; 24(3) : 103-8. https://doi.org/10.1136/aim.24.3.103
  47. Forrester M. Low back pain in pregnancy. Acupunct Med. 2003 ; 21(1-2) : 36-41. https://doi.org/10.1136/aim.21.1-2.36
  48. Thomas M, Lundberg T. Importance of modes of acupuncture in the treatment of chronic nociceptive low back pain. Acta Anaesthesiol Scand. 1994 ; 38(1) : 63-9. https://doi.org/10.1111/j.1399-6576.1994.tb03839.x
  49. Garvey TA, Marks MR, Wiesel SW. A prospective, randomized, double-blind evaluation of trigger-point injection therapy for low-back pain. Spine. 1989 ; 14(9) : 962-4. https://doi.org/10.1097/00007632-198909000-00008
  50. Wang YY. Electro-acupuncture treatment of 55 cases of soft tissue lumbar pain. J Tradit Chin Med. 1987 ; 7(1) : 72.
  51. Dong SH. Acupuncture of Yanglao (S.I. 6) point in the treatment of lumbar pain. J Tradit Chin Med. 1982 ; 2(2) : 124.
  52. Fox EJ, Melzack R. Transcutaneous electrical stimulation and acupuncture: comparison of treatment for low-back pain. Pain. 1976 ; 2(2) : 141-8. https://doi.org/10.1016/0304-3959(76)90109-3
  53. Ceccherelli F, Rigoni MT, Gagliardi G, Ruzzante L. Comparison of superficial and deep acupuncture in the treatment of lumbar myofascial pain: a double-blind randomized controlled study. Clin J Pain. 2002 ; 18(3) : 149-53. https://doi.org/10.1097/00002508-200205000-00003
  54. Weiss SL. Acupuncture in low back pain. Med Times. 1975 ; 103(10) : 137-9, 44-6.
  55. Leung PC. Treatment of low back pain with acupuncture. Am J Chin Med. 1979 ; 7(4) : 372-8. https://doi.org/10.1142/S0192415X79000350
  56. Edelist G, Gross AE, Langer F. Treatment of low back pain with acupuncture. Can Anaesth Soc J. 1976 ; 23(3) : 303-6. https://doi.org/10.1007/BF03005706
  57. Berman BM, Langevin HM, Witt CM, Dubner R. Acupuncture for chronic low back pain. N Engl J Med. 2010 ; 363(5) : 454-61. https://doi.org/10.1056/NEJMct0806114
  58. Lee HS, Cha SJ, Park HJ, Seo JC, Park JB, Lee HJ. Revised Standards for Reporting Interventions in Clinical Rrials of Acupuncture (STRICTA):Extending the CONSORT Statement. Korean Journal of Acupuncture. 2010 ; 27(3) : 1-23.