Supplementary Material for: The Effects of Cupping Massage in Patients with Chronic Neck Pain - A Randomised Controlled Trial

Background: Chronic neck pain is a major public health burden with only limited evidence for the effectiveness of complementary therapies. This study aimed to test the efficacy of cupping massage in patients with neck pain. Patients and Methods: Patients with chronic non-specific neck pain were randomly assigned to cupping massage or a wait list control. The intervention group received 5 cupping massages on a twice-weekly basis while the control patients continued their usual treatments. The primary outcome measure was neck pain intensity (0–100 mm visual analogue scale (VAS)) after 3 weeks. Secondary outcomes included pain on movement, functional disability, health-related quality of life, mechanical detection and pain thresholds and adverse events. Results: 50 patients (52.6 ± 10.3 years, 92% female) were randomised to either cupping massage or a wait list (N = 25 each). Patients in the cupping group reported significantly less neck pain post intervention (difference per protocol –14.3 mm, 95% confidence interval (CI) –27.7 to –1.0, p = 0.037; difference intention-to-treat –10.8 mm, 95% CI –21.5 to –0.1, p = 0.047). Significant group differences in favour of the intervention were further found for pain on movement (p = 0.019) and functional disability (p &lt; 0.001), the quality-of-life subscales pain (p = 0.002) and mental health (p = 0.003) and the mental component summary (p = 0.036). Changes were also found for pressure pain sensitivity at the site of maximal pain (p = 0.022). Five adverse events were reported. Conclusions: Cupping massage appears to be effective in reducing pain and increasing function and quality of life in patients with chronic non-specific neck pain. More rigorous studies are needed to confirm and extend these results.背景：慢性非特异性颈痛是一项重大公共卫生负担，目前关于补充疗法有效性的相关证据仍较为有限。本研究旨在验证拔罐按摩（cupping massage）对颈痛患者的疗效。患者与方法：本研究将慢性非特异性颈痛患者随机分为拔罐按摩组与等候队列对照组。干预组每周接受2次拔罐按摩，共5次；对照组则维持其常规治疗方案。本研究的主要结局指标为干预3周后的颈痛强度，采用0~100 mm视觉模拟评分法（VAS）进行评估。次要结局指标包括活动时疼痛程度、功能障碍、健康相关生存质量、机械检测与痛阈，以及不良事件。结果：本研究共纳入50例患者，年龄为52.6±10.3岁，其中女性占92%，随机分为两组，每组各25例。干预组患者在干预后颈痛程度显著低于对照组：符合方案集分析显示组间差异为-14.3 mm，95%置信区间（CI）为-27.7~-1.0，p=0.037；意向治疗（intention-to-treat）分析显示组间差异为-10.8 mm，95%CI为-21.5~-0.1，p=0.047。此外，干预组在活动时疼痛（p=0.019）、功能障碍（p<0.001）、生存质量量表疼痛维度（p=0.002）、心理健康维度（p=0.003）以及精神成分总结得分（p=0.036）方面均显著优于对照组。在最大疼痛部位的压力痛觉敏感性方面，两组亦存在显著差异（p=0.022）。本研究共报告5例不良事件。结论：拔罐按摩可有效缓解慢性非特异性颈痛患者的疼痛症状，改善其功能状态与生存质量。未来仍需开展更严谨的研究以验证并拓展本研究结果。