NCT02384928

Brief Summary

This trial will evaluate the comparative clinical effectiveness of pharmacopuncture for severe non-acute sciatic pain patients diagnosed with lumbar disc herniation (LDH) with usual care of conventional medicine and that of Korean medicine (acupuncture). Sixty patients with severe non-acute sciatic pain patients diagnosed with LDH (NRS ≥5, 4 weeks - 6 months) will be recruited, and randomized 20 each to the Shinbaro pharmacopuncture, acupuncture, and usual care group, respectively. The 2 acupuncture groups will receive 2 sessions/week of acupuncture alone or with pharmacopuncture for 4 weeks, and the usual care group will receive conventional medication 2 times/day and 2 sessions/week of physical therapy. Post-treatment evaluations will take place 5, 7, 9, and 12 weeks after randomization.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
60

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Sep 2015

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 27, 2015

Completed
11 days until next milestone

First Posted

Study publicly available on registry

March 10, 2015

Completed
6 months until next milestone

Study Start

First participant enrolled

September 9, 2015

Completed
1.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 31, 2017

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

March 16, 2017

Completed
Last Updated

July 26, 2022

Status Verified

July 1, 2022

Enrollment Period

1.4 years

First QC Date

February 27, 2015

Last Update Submit

July 22, 2022

Conditions

Keywords

AcupuncturePharmacopunctureUsual Care

Outcome Measures

Primary Outcomes (1)

  • Visual analogue scale (VAS) of sciatic pain

    On the 10cm line which represent the severity of pain, the patient mark point which best represent the severity that he feels.

    Week 5

Secondary Outcomes (9)

  • Visual analogue scale (VAS) of sciatic pain

    Week 1, 2, 3, 4, 7, 9, 12

  • Visual analogue scale (VAS) of low back pain (LBP)

    Week 1, 2, 3, 4, 5, 7, 9, 12

  • Numeric rating scale (NRS) of low back pain (LBP)

    Baseline(screening), Week 1, 2, 3, 4, 5, 7, 9, 12

  • Numeric rating scale (NRS) of sciatic pain

    Baseline(screening), Week 1, 2, 3, 4, 5, 7, 9, 12

  • Oswestry Disability Index (ODI)

    Week 1, 2, 3, 4, 5, 7, 9, 12

  • +4 more secondary outcomes

Study Arms (3)

Shinbaro pharmacopuncture group

EXPERIMENTAL

The Shinbaro pharmacopuncture group will receive 8 interventional sessions of Shinbaro pharmacopuncture at one Hyeopcheok (Huatuo Jiaji, EX B2) point and acupuncture at 5 acupoints (GB30, BL40, BL25, BL23, GB34) 2 times/week over 4 weeks. All groups will take 4 educational program sessions supervised by physicians once a week.

Procedure: Shinbaro pharmacopunctureDevice: AcupunctureBehavioral: Educational program

Acupuncture group

ACTIVE COMPARATOR

The acupuncture group will receive 8 interventional sessions of acupuncture at one Hyeopcheok (Huatuo Jiaji, EX B2) point and 5 other acupoints (GB30, BL40, BL25, BL23, GB34) 2 times/week over 4 weeks. All groups will take 4 educational program sessions supervised by physicians once a week.

Device: AcupunctureBehavioral: Educational program

Usual care group

ACTIVE COMPARATOR

The usual care group will receive conventional medicine 2 times/day and 2 sessions/week of physical therapy over 4 weeks. Conventional drugs will be prescribed in an individually-tailored, pragmatic method with reference to most frequently used treatments in patients with a primary diagnosis of LDH (KCD disease classification: M51, M541) according to Korean Health Insurance Review and Assessment (HIRA) 2011 statistics, which include aceclofenac, tramadol hydrochloride, talniflumate, diclofenac sodium, and loxoprofen sodium. All groups will take 4 educational program sessions supervised by physicians once a week.

Drug: Conventional medicineProcedure: Physical therapyBehavioral: Educational program

Interventions

Pharmacopuncture is a treatment that combines 2 of the most frequented Korean medicine treatment methods - traditional acupuncture and herbal medicine - by injecting herbal medicine extract at acupoints. One Hyeopcheok (Huatuo Jiaji, EX B2) acupoint most relevant to patient symptoms with reference to MRI will be administered Shinbaro pharmacopuncture.

Shinbaro pharmacopuncture group

Five acupoints will be needled to about 1cm depth assisted by an acupuncture guide tube with no manual stimulation such as twirling or lifting and thrusting.

Acupuncture groupShinbaro pharmacopuncture group

Conventional drugs will be prescribed in an individually-tailored, pragmatic method with reference to most frequently used treatments in patients with a primary diagnosis of LDH (KCD disease classification: M51, M541) according to Korean Health Insurance Review and Assessment (HIRA) 2011 statistics. The most frequently prescribed conventional drugs for LDH include aceclofenac (Drug class: nonsteroidal antiinflammatoy drugs (NSAIDs)), tramadol hydrochloride (Drug class: Opioids), talniflumate (Drug class: NSAIDs), diclofenac sodium (Drug class: NSAIDs), and loxoprofen sodium (Drug class: NSAIDs).

Also known as: Conventional drugs
Usual care group

Physical therapy will be prescribed with reference to most frequently used treatments in patients with a primary diagnosis of LDH (KCD disease classification: M51, M541) according to Korean Health Insurance Review and Assessment (HIRA) 2011 statistics.

Also known as: Physiotherapy
Usual care group

Educational program sessions supervised by physicians will be provided once a week for 4 weeks.The education program will inform the patient of the favorable prognosis of LDH, and instructions for everyday activities and self-management. The education program will consist of handbooks handed out to each participant, and weekly reminders and encouragement from the physician.

Acupuncture groupShinbaro pharmacopuncture groupUsual care group

Eligibility Criteria

Age25 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Sciatica patients with an average sciatic pain NRS of 5 or higher during the preceding 3 days
  • Onset of at least 4 weeks previous for current sciatic pain episode
  • Patients whose sciatic symptoms correlate with the LDH confirmed on MRI
  • Patients who have agreed to follow the trial protocol

You may not qualify if:

  • Patients who have received invasive treatments such as nerve blocks, pharmacopuncture, or acupuncture within the past week
  • Non-spinal or soft tissue pathologies which may cause LBP or sciatic pain (e.g. spinal tumors, rheumatic arthritis)
  • Pregnancy
  • History of spinal surgery, or spinal pathologies other than LDH (e.g. spinal dislocation, fracture)
  • Severe progressive neurologic symptoms (e.g. cauda equina syndrome, progressive muscle weakness)
  • Patients for whom acupuncture may be inappropriate or unsafe (e.g. hemorrhagic diseases, blood clotting disorders, history of anti-coagulation medicine, severe diabetes with risk of infection, severe cardiovascular diseases or other conditions deemed unsuitable)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Jaseng Hospital of Korean Medicine

Seoul, Gangnam-Gu, 135-896, South Korea

Location

Related Publications (1)

  • Lee J, Shin JS, Lee YJ, Kim MR, Ahn YJ, Park KB, Kropf MA, Shin BC, Lee MS, Ha IH. Effects of Shinbaro pharmacopuncture in sciatic pain patients with lumbar disc herniation: study protocol for a randomized controlled trial. Trials. 2015 Oct 12;16:455. doi: 10.1186/s13063-015-0993-6.

MeSH Terms

Conditions

SciaticaIntervertebral Disc Displacement

Interventions

Acupuncture TherapyPhysical Therapy Modalities

Condition Hierarchy (Ancestors)

Sciatic NeuropathyMononeuropathiesPeripheral Nervous System DiseasesNeuromuscular DiseasesNervous System DiseasesNeuralgiaPainNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and SymptomsSpinal DiseasesBone DiseasesMusculoskeletal DiseasesHerniaPathological Conditions, Anatomical

Intervention Hierarchy (Ancestors)

Complementary TherapiesTherapeuticsRehabilitation

Study Officials

  • Jinho Lee

    Jaseng Medical Foundation

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Director

Study Record Dates

First Submitted

February 27, 2015

First Posted

March 10, 2015

Study Start

September 9, 2015

Primary Completion

January 31, 2017

Study Completion

March 16, 2017

Last Updated

July 26, 2022

Record last verified: 2022-07

Data Sharing

IPD Sharing
Will not share

Locations