针灸是一种约有3,000年历史的中国疗法，尽管长期被西方医学轻视，但其流行度仍在上升，且模型与意见领袖也将其宣传为抗衰老和促进肌肉恢复的方法。对疼痛的证据最为突出：2018年《Pain杂志》汇总39项随机对照试验，共20,827名患者（肩痛、慢性肌肉骨骼疼痛、头痛或骨关节炎），显示针灸组在初次治疗后超过4周时自评疼痛低于假针或未治疗组，且一年后改善仍基本维持。
后续研究在一定程度上支持了这一结论。前美国国立卫生研究院补充与整合健康中心主任Helene Langevin提出，针刺可能扭转筋膜并牵拉神经末梢从而降低疼痛，但更高强度的“真实干预”也会强化大脑的安慰剂镇痛效应。2020年《JAMA Internal Medicine》的一项论文未发现真针与假针在疼痛缓解上的显著差异，说明疗效中的特异作用与安慰剂效应难以区分。
2022年《补充与替代医学》综述由执业针灸师撰写、并由国际中华医学会资助，分析了862篇系统评价和Meta分析；结果显示针灸对术后恶心的改善接近部分止吐药，对偏头痛、紧张型头痛、癌症相关疲劳、联合生育治疗的女性不孕以及男性慢性盆腔痛有积极信号。另一方面，另外86种包括与肌肉恢复相关因素在内的病种证据不足以证明阳性效果，另有6种疾病显示无效，因此针灸在慢性疼痛中因副作用远低于多数药物而可视为合理选择，但在其他适应证上证据仍不确定。
Acupuncture is an approximately 3,000-year-old Chinese practice, and although it was long dismissed by Western medicine, its use continues to rise, with claims and celebrity endorsement linking it to anti-aging and faster muscle recovery. Evidence is strongest for pain: a 2018 Journal of Pain analysis of 39 randomized trials involving 20,827 patients with shoulder pain, chronic musculoskeletal pain, headaches, or osteoarthritis found acupuncture users reported less pain than sham or no-acupuncture controls at more than four weeks after treatment, with benefits changing little after one year.
Later studies have reinforced these findings. Helene Langevin, a former NIH complementary medicine director, proposed that needling may twist fascia and pull on nerve endings to reduce pain, but stronger apparent interventions can also trigger stronger expectation-driven placebo analgesia. A 2020 JAMA Internal Medicine paper found no statistically significant difference in pain relief between true and sham acupuncture, making treatment-specific effects hard to separate from placebo response.
A 2022 review in Complementary Therapies in Medicine, written by practicing acupuncturists and funded by the International Society of Chinese Medicine, analyzed 862 systematic reviews and meta-analyses and found supportive signals for postoperative nausea (about comparable to some antiemetics), migraines and tension headaches, cancer-related fatigue, female infertility when combined with reproductive treatment, and chronic pelvic pain in men. It also found that 86 other conditions, including factors tied to muscle recovery, were not sufficiently robust to demonstrate benefit, while six ailments showed no effect; therefore acupuncture is viewed as a reasonable option for chronic pain because of fewer side effects than many drugs, but evidence outside that area remains unclear.
Source: Does acupuncture work?
Subtitle: It seems useful for pain. The jury’s out on everything else
Dateline: 5月 07, 2026 06:28 上午