Placebo Acupuncture Treatment Research Articles

Efficacy of acupuncture as an adjunctive treatment to patients with stable COPD: a multicenter, randomized, sham-controlled trial protocol

BackgroundChronic obstructive pulmonary disease (COPD) is a common respiratory disease and the third leading cause of death worldwide. Previous evidence has shown that acupuncture may be an effective complementary alternative therapy for stable COPD. However, large-sample, rigorously designed long-term follow-up studies still need to be completed. Notably, the relationship between the frequency of acupuncture and clinical efficacy in studies on acupuncture for stable COPD still needs further validation. This study aims to evaluate the efficacy and safety of acupuncture for stable COPD and further investigate the dose–effect relationship of acupuncture.Methods/designThis is a multicenter, randomized, controlled trial that uses central randomization to randomly allocate 550 participants in a 1:1:1:1:1 ratio to once a week acupuncture group, twice a week acupuncture group, three times a week acupuncture group, sham acupuncture group and waiting-list control group. The sham acupuncture group will receive placebo acupuncture treatments three times per week, and the waiting-list control group will not receive any form of acupuncture intervention. The study consists of a 2-week baseline, 12-week of treatment, and 52-week of follow-up. Patients with COPD between 40 to 80 years old who have received stable Western medication within the previous 3 months and have had at least 1 moderate or severe acute exacerbation within the past 1 year will be included in the study. Basic treatment will remain the same for all participants. The primary outcome is the proportion of responders at week 12. Secondary outcomes include the proportion of responders at week 64, change in the St. George's Respiratory Questionnaire (SGRQ) Scale, change in the Modified-Medical Research Council (mMRC) Scale, change in the COPD Assessment Test (CAT) Scale, change in the Lung Function Screening Indicators (LFSI), change in the 6-min walk distance (6-MWD), change in Short-Form 36 Health Survey (SF-36) Scale, the number of moderate and severe acute exacerbations and adverse event rate during the follow-up period.DiscussionThis study will provide robust evidence on whether acupuncture is safe and effective for treating stable COPD. Meanwhile, comparing the differences in efficacy between different acupuncture frequencies will further promote the optimization of acupuncture for stable COPD.Trial registrationThis study was registered in the Chinese Clinical Trial Registry (ChiCTR2200058757), on April 16, 2022.

The Treatment of Nocturnal Enuresis in Children: An Overview

Background: The aim of this review was to compare the efficacy of acupuncture therapy in the treatment of nocturnal enuresis with placebo acupuncture or oral pharmacological treatment based on randomized controlled trials. Materials and Methods: Two independent researchers screened the meta-analysis articles on the effect of treatment nocturnal enuresis in children. The databases included Scopus, EMBASE, Cochrane, Web of Science, and Medline, with no time and language restrictions from the beginning up to March 10, 2020. Results: The first meta-analysis showed that therapy with the combination of desmopressin and anticholinergics (combination therapy) was significantly better than desmopressin monotherapy. The second meta-analysis showed that structured withdrawal from desmopressin treatment compared with the abrupt withdrawal results in a significantly better relapse-free rate (pooled RR: 1.38; 95% confidence interval [CI]: 1.17–1.63; P=0.0001). The third meta-analysis reported a 31% rate of successful treatment for rapid palatal expansion, which is promising compared to the spontaneous cure rate. In the fourth meta-analysis, the pooled data showed a significant difference between acupuncture and meclofenoxate therapy (OR=2.81). No significant difference was observed between acupuncture, desmopressin (OR = 1.57), imipramine hydrochloride (OR = 1.71), and oxybutynin (OR = 3.57). In the fifth meta-analysis, a statistically significant difference was observed between the frequency of enuresis per week (P < 0.001), the number of patients with clinical response (P Conclusion: Therapy with the combination of desmopressin and anticholinergics (combination therapy) produced significantly better results than desmopressin monotherapy. The findings showed the positive effects of acupuncture therapy and rapid palatal expansion on nocturnal enuresis in children.

Overall adjustment acupuncture for postmenopausal osteoporosis (PMOP): a study protocol for a randomized sham-controlled trial

BackgroundOsteoporosis is becoming more prevalent in aging societies worldwide, and the economic burden attributable to osteoporotic fractures is substantial. The medications presently available to treat osteoporosis have side effects. Acupuncture is widely used for treating osteoporotic postmenopausal women because it is non-invasive and has fewer side effects, but the powerful clinical evidence for its efficacy remains insufficient. Our study intends to explore the effect of overall adjustment acupuncture (OA) in the treatment of postmenopausal osteoporosis (PMOP).Methods/designThis study is a randomized, sham-controlled, patient- and assessor-blinded trial and aims to evaluate the effect of OA in women with PMOP. We will recruit 104 women aged 45–70 years with a diagnosis of PMOP. Participants will be randomly allocated in a 1:1 ratio to the OA group and the sham acupuncture (SA) group. Both groups will receive real herbal medicine treatment as a basic treatment twice a day for 3 months, the OA group receives real acupuncture treatment and the SA group receives placebo acupuncture treatment (non-penetrating, sham skin-needle therapy, sham cupping). All patients will receive acupuncture treatment twice per week for 3 months. The primary outcome is bone mineral density (BMD) and the secondary outcomes include estradiol (E2), follicle-stimulating hormone (FSH), bone gla protein (BGP), bone alkaline phosphatase (BALP), total antioxidant capacity (TAC), advanced oxidation protein products (AOPP), PPARγ, β-catenin, FoxO3a levels, visual analog pain scale score (VAS), Traditional Chinese medicine (TCM) syndrome scores and quality of daily life score (QOL). Outcome measures will be collected at baseline, middle of the treatment (1.5 months), the end of treatment (3 months). The present protocol followed the SPIRIT guidelines and fulfills the SPIRIT Checklist.ConclusionThis study will be conducted to compare the efficacy of OA versus SA. This trial should help to evaluate whether OA can effectively prevent and treat PMOP by improving the estrogen levels of postmenopausal women. The mechanism is to improve the imbalance of osteogenic differentiation and lipogenesis of bone-marrow cells under oxidative stress.Trial registrationChinese Clinical Trial Registry, ID: ChiCTR1800017581. Registered on 5 August 2018. URL: http://www.chictr.org.cn.

Manual acupuncture for the infertile female with polycystic ovary syndrome (PCOS): study protocol for a randomized sham-controlled trial

BackgroundPolycystic ovary syndrome (PCOS) is one of the most common endocrine diseases for women. Acupuncture is widely used for the infertile female because of it is non-invasive and has fewer side effects, but the powerful evidence for the clinic is still insufficient. Our study intends to explore the effect of manual acupuncture (MA) in the infertile female with PCOS.MethodsThis study is a randomized, sham-controlled, patient-and assessor-blinded trial and aims to evaluate the effect of MA in women with PCOS and infertility. We will recruit 86 women aged 20–40 years with a diagnosis of infertility with PCOS. Participants will be randomly allocated in a 1:1 ratio to the MA group and the sham acupuncture (SA) group. Both groups will receive real herbal medicine treatment as a basic treatment twice a day for three menstrual cycles, the MA group receive real acupuncture treatment and the SA group received placebo acupuncture treatment (non-penetrating). All patients will receive acupuncture treatment twice per week for three menstrual cycles. The primary outcome is pregnancy rate and secondary outcomes include ovulation rate, sex hormones, insulin resistance index (IRI), PCOS symptoms, and Traditional Chinese Medicine (TCM) syndrome scores. Outcome measures will be collected at baseline, each menstrual cycle, the end of treatments, and six months after the last acupuncture treatment. The present protocol followed the SPIRIT guidelines and fulfilled the SPIRIT checklist.DiscussionThis study will be conducted to compare the efficacy of MA versus SA. This trial will help to evaluate whether MA is effective in increasing pregnancy and ovulation rates of the infertile female with polycystic ovary syndrome.Trial registrationChinese Clinical Trial Registry, ChiCTR1800014997. Registered on 27 February 2018.

Acupuncture for mumps in children.

Mumps is an acute, viral illness transmitted by respiratory droplets and saliva. A number of studies published in China have suggested that acupuncture is beneficial for children with mumps but the literature reporting the benefits or harms of acupuncture for mumps has not been systematically reviewed. To determine the efficacy and safety of acupuncture for children with mumps. We searched CENTRAL (2014, Issue 11), MEDLINE (1950 to November week 3, 2014), EMBASE (1974 to December 2014), CINAHL (1981 to December 2014), AMED (1985 to December 2014), the Chinese BioMedical Literature Database (CBM) (1979 to November 2014), China National Knowledge Infrastructure (CNKI) (1979 to November 2014), Chinese Technology Periodical Database (CTPD) (1989 to November 2014) and Wanfang database (1982 to November 2014). We also handsearched a number of journals (from first issue to current issue). Randomised controlled trials comparing acupuncture with placebo acupuncture, no management, Chinese medication, Western medication or other treatments for mumps. Acupuncture included either traditional acupuncture or contemporary acupuncture, regardless of the source of stimulation (body, electro, scalp, fire, hand, fine needle, moxibustion). Two review authors independently extracted data. We identified no trials for inclusion in this updated review. No study met our inclusion criteria. We could not reach any conclusion about the efficacy and safety of acupuncture as we identified no trials for inclusion in this review. More high-quality research is needed.

Abstracts and Commentaries on Key Articles in the Literature

Abstracts and Commentaries on Key Articles in the Literature

Acupuncture for autism spectrum disorders (ASD).

Autism spectrum disorders (ASD) are characterized by impairment in social interaction, impairment in communication and lack of flexibility of thought and behavior. Acupuncture, which involves the use of needles or pressure to specific points on the body, is used widely in Traditional Chinese Medicine and increasingly within a western medical paradigm. It has sometimes been used as a treatment aimed at improving ASD symptoms and outcomes, but its clinical effectiveness and safety has not been rigorously reviewed. To determine the effectiveness of acupuncture for people with ASD in improving core autistic features, as well as communication, cognition, overall functioning and quality of life, and to establish if it has any adverse effects. We searched the following databases on 30 September 2010: CENTRAL (The Cochrane Library, 2010, Issue 3), MEDLINE (1950 to September 2010 Week 2), EMBASE (1980 to 2010 Week 38), PsycINFO, CINAHL, China Journal Full-text Database, China Master Theses Full-text Database, China Doctor Dissertation Full-text Database, China Proceedings of Conference Database, Index to Taiwan Periodical Literature System, metaRegister of Controlled Trials and the Chinese Clinical Trials Registry. We also searched AMED (26 February 2009) and Dissertation Abstracts International (3 March 2009), but these were no longer available to the authors or editorial base at the date of the most recent search. TCMLARS (Traditional Chinese Medical Literature Analysis and Retrieval System) was last searched on 3 March 2009. We included randomized and quasi-randomized controlled trials. We included studies comparing an acupuncture group with at least one control group that used no treatment, placebo or sham acupuncture treatment in people with ASD. We excluded trials that compared different forms of acupuncture or compared acupuncture with another treatment. Two review authors independently extracted trial data and assessed the risk of bias in the trials. We used relative risk (RR) for dichotomous data and mean difference (MD) for continuous data. We included 10 trials that involved 390 children with ASD. The age range was three to 18 years and the treatment duration ranged from four weeks to nine months. The studies were carried out in Hong Kong, mainland China and Egypt.Two trials compared needle acupuncture with sham acupuncture and found no difference in the primary outcome of core autistic features (RFRLRS total score: MD 0.09; 95% CI -0.03 to 0.21, P = 0.16), although results suggested needle acupuncture might be associated with improvement in some aspects of the secondary outcomes of communication and linguistic ability, cognitive function and global functioning.Six trials compared needle acupuncture plus conventional treatment with conventional treatment alone. The trials used different primary outcome measures and most could not demonstrate effectiveness of acupuncture in improving core autistic features in general, though one trial reported patients in the acupuncture group were more likely to have improvement on the Autism Behavior Checklist (RR 1.53; 95% CI 1.09 to 2.16, P = 0.02) and had slightly better post-treatment total scores (MD -5.53; 95% CI -10.76 to -0.31, P = 0.04). There was no evidence that acupuncture was effective for the secondary outcome of communication and linguistic ability, though there seemed to be some benefit for the secondary outcomes of cognitive function and global functioning.Two trials compared acupressure plus conventional treatment with conventional treatment alone and did not report on the primary outcome. Individual study results suggested there may be some benefit from acupressure for certain aspects of the secondary outcomes of communication and linguistic ability, cognitive function and global functioning.Four trials reported some adverse effects, though there was little quantitative information, and at times both intervention and control groups experienced them. Adverse effects noted included bleeding, crying due to fear or pain, irritability, sleep disturbance and increased hyperactivity. None of the trials reported on quality of life.There are a number of problems with the evidence base: the trials were few in number and included only children; six of the trials were at high risk of bias; they were heterogeneous in terms of participants and intervention; they were of short duration and follow-up; they reported inconsistent and imprecise results, and, due to carrying out large numbers of analyses, they were at risk of false positivity. Current evidence does not support the use of acupuncture for treatment of ASD. There is no conclusive evidence that acupuncture is effective for treatment of ASD in children and no RCTs have been carried out with adults. Further high quality trials of larger size and longer follow-up are needed.

Tratamientos acupunturales para el dolor: una revisión sistemática de ensayos clínicos aleatorizados con grupos de acupuntura, acupuntura placebo y no acupunturales

To study the analgesic effect of acupuncture and placebo acupuncture and to explore whether the type of the placebo acupuncture is associated with the estimated effect of acupuncture. Cochrane Library, Medline, Embase, Biological Abstracts, and PsycLIT. Three armed randomised clinical trials (including both a placebo or sham acupuncture group and a group receiving no acupuncture). Standardised mean differences from each trial were used to estimate the effect of acupuncture and placebo acupuncture. The different types of placebo acupuncture were ranked from 1 to 5 according to assessment of the possibility of a physiological effect, and this ranking was meta-regressed with the effect of acupuncture. Thirteen trials (3,025 patients) involving a variety of pain conditions were eligible. The allocation of patients was adequately concealed in eight trials. The clinicians managing the acupuncture and placebo acupuncture treatments were not blinded in any of the trials. One clearly outlying trial (70 patients) was excluded. A small difference was found between acupuncture and placebo acupuncture: standardised mean difference −0.17 (95% confidence interval −0.26 to −0.08), corresponding to 4 mm (2 mm to 6 mm) on a 100 mm visual analogue scale. No statistically significant heterogeneity was present (P = 0.10, I2 = 36%). A moderate difference was found between placebo acupuncture and no acupuncture: standardised mean difference −0.42 (−0.60 to −0.23). However, considerable heterogeneity (P < 0.001, I2 = 66%) was also found, as large trials reported both small and large effects of placebo. No association was detected between the type of placebo acupuncture and the effect of acupuncture (P = 0.60). : A small analgesic effect of acupuncture was found, which seems to lack clinical relevance and cannot be clearly distinguished from bias. Whether needling at acupuncture points, or at any site, reduces pain independently of the psychological impact of the treatment ritual is unclear.

"Maybe I made up the whole thing": placebos and patients' experiences in a randomized controlled trial.

Patients in the placebo arms of randomized controlled trials (RCT) often experience positive changes from baseline. While multiple theories concerning such “placebo effects” exist, peculiarly, none has been informed by actual interviews of patients undergoing placebo treatment. Here, we report on a qualitative study (n = 27) embedded within a RCT (n = 262) in patients with irritable bowel syndrome. Besides identical placebo acupuncture treatment in the RCT, the qualitative study patients also received an additional set of interviews at the beginning, midpoint, and end of the trial. Interviews of the 12 qualitative subjects who underwent and completed placebo treatment were transcribed. We found that patients (1) were persistently concerned with whether they were receiving placebo or genuine treatment; (2) almost never endorsed “expectation” of improvement but spoke of “hope” instead and frequently reported despair; (3) almost all reported improvement ranging from dramatic psychosocial changes to unambiguous, progressive symptom improvement to tentative impressions of benefit; and (4) often worried whether their improvement was due to normal fluctuations or placebo effects. The placebo treatment was a problematic perturbation that provided an opportunity to reconstruct the experiences of the fluctuations of their illness and how it disrupted their everyday life. Immersion in this RCT was a co-mingling of enactment, embodiment and interpretation involving ritual performance and evocative symbols, shifts in bodily sensations, symptoms, mood, daily life behaviors, and social interactions, all accompanied by self-scrutiny and re-appraisal. The placebo effect involved a spectrum of factors and any single theory of placebo—e.g. expectancy, hope, conditioning, anxiety reduction, report bias, symbolic work, narrative and embodiment—provides an inadequate model to explain its salubrious benefits.

Acupuncture treatment for pain: systematic review of randomised clinical trials with acupuncture, placebo acupuncture, and no acupuncture groups

Objectives To study the analgesic effect of acupuncture and placebo acupuncture and to explore whether the type of the placebo acupuncture is associated with the estimated effect of acupuncture.Design Systematic...

Efficacy of acupuncture for the treatment of non-specific acute low back pain: different components of the therapeutic effect

Background The aim of this study was to evaluate the efficacy of acupuncture in treating non-specific acute low back pain, and to identify the different components of the therapeutic effect of the technique. Methods Randomized controlled multicentre prospective study, with four Branches, aimed at comparing real semi-standardized acupuncture at specific Points Group A), acupuncture at non-specific points (Group B), placebo acupuncture (Group C) and conventional treatment (analgesics, antirugs, inflammatory drugs, myorelaxants, postural advice) (Group D). The patients were blinded for the specific, non-specific and placebo acupuncture treatments. Evaluation of the patients and analysis of the results were carried out by experts who were blinded as regards the allocation to the different treatment groups. The patients selected were of working age and presented symptoms of acute non-specific low back pain; they had been referred by their GPs at Primary Healthcare Clinics to one of the four clinics participating in the study, all of which belonged to the Andalusian Public Health System (Spain). The participants were evaluated before randomization and at the end of weeks 3, 12 and 48 from the start of treatment. The primary outcome measure was significant clinical improvement (SCI) at 3 weeks after randomization, defined as a reduction of 35% of more in the RMQ score. Results 275 patients were randomized; mean duration of 6 days of the low back pain episode. 59% were women, with a mean age of 42.7 years. 75% of the participants were in paid work, and over 50% of these said they were satisfied with it. The patients suffered a high mean baseline pain intensity level (70.4 mm on a scale of 100 mm), an index of fear and avoidance conduct related to physical activity of 18.8 (SD 5.6) and a corresponding work-related index of 24.3 (SD 9.8). For 44% of the patients, this was their first episode of back pain, while 61.7% were on sick leave due to the back pain being suffered at the outset of the study. Over half of the participants (57.8%) remarked that their pain was work related. By ITT analysis, the SCI at 3 weeks from the start of the treatment was obtained for 77.1% of the participants in Group A, for 73.5% of those in Group B, for 62.3% of those in Group C, and for 42.9% of those in Group D. The differences between Groups A, B and C with respect to Group D were statistically significant, as were those between Groups A and C (see table). Conclusion Acupuncture, both at specific points and at non-specific ones or as a placebo, achieves a rate of significant clinical improvement that is superior to that obtained by conventional treatment for acute non-specific back pain, and this difference is statistically significant. No differences were found between the different types of acupuncture, as regards specific or non-specific points, for this type of pain.

Brain Activity Associated with Expectancy-Enhanced Placebo Analgesia as Measured by Functional Magnetic Resonance Imaging

In this study, a well established expectancy manipulation model was combined with a novel placebo intervention, a validated sham acupuncture needle, to investigate the brain network involved in placebo analgesia. Sixteen subjects completed the experiment. We found that after placebo acupuncture treatment, subjective pain rating reduction (pre minus post) on the placebo-treated side was significantly greater than on the control side. When we calculated the contrast that subtracts the functional magnetic resonance imaging (fMRI) signal difference between post-treatment and pretreatment during pain application on placebo side from the same difference on control side [e.g., placebo (post - pre) - control (post - pre)], significant differences were observed in the bilateral rostral anterior cingulate cortex (rACC), lateral prefrontal cortex, right anterior insula, supramarginal gyrus, and left inferior parietal lobule. The simple regression (correlation) analysis between each subject's fMRI signal difference of post-treatment and pretreatment difference on placebo and control side and the corresponding subjective pain rating difference showed that significant negative correlation was observed in the bilateral lateral/orbital prefrontal cortex, rACC, cerebellum, right fusiform, parahippocampus, and pons. These results are different from a previous study that found decreased activity in pain-sensitive regions such as the thalamus, insula, and ACC when comparing the response to noxious stimuli applied to control and placebo cream-treated areas of the skin. Our results suggest that placebo analgesia may be configured through multiple brain pathways and mechanisms.

Acupuncture for Overactive Bladder – A Randomized Controlled Trial [Emmons SL, Otto L. Obstetrics and Gynecology 2005; 106:138–143

ObjectiveTo compare acupuncture treatment for overactive bladder with urge incontinence with a placebo acupuncture treatment. MethodsEighty-five women enrolled in this randomized, placebo-controlled trial. Women were randomly assigned to either receive an acupuncture treatment expected to improve their bladder symptoms, or a placebo acupuncture treatment designed to promote relaxation. They underwent cystometric testing, completed a 3-day voiding diary, and completed the urinary distress inventory and incontinence impact questionnaire, validated quality-of-life inventories, before and after 4 weekly acupuncture treatments. The primary endpoint was number of incontinent episodes over 3 days. Secondary endpoints included voiding frequency and urgency, cystometric bladder capacity, maximum voided volume, and the urinary distress inventory and incontinence impact questionnaire symptom scores. ResultsSeventy-four women completed all aspects of the study. Women in both treatment and placebo groups had significant decreases in number of incontinent episodes (59 % for treatment, 40 % for placebo) without a significant difference in the change between the groups. Women in the treatment group had a 14 % reduction in urinary frequency (P = .013), a 30 % reduction in the proportion of voids associated with urgency (P = .016), and a 13 % increase in both maximum voided volume and maximum cystometric capacity (P =.01). Both groups also had an improvement in the urinary distress inventory and incontinence impact questionnaire scores. (54 % decrease for treatment, 30 % decrease for placebo, P < .001 for the difference in change between the groups). ConclusionWomen who received 4 weekly bladder-specific acupuncture treatment had significant improvements in bladder capacity, urgency, frequency, and quality-of-life scores as compared with women who received placebo acupuncture treatments.(Obstet Gynecol 2005;106:138-43)

Acupuncture for Overactive Bladder

To compare acupuncture treatment for overactive bladder with urge incontinence with a placebo acupuncture treatment. Eighty-five women enrolled in this randomized, placebo-controlled trial. Women were randomly assigned to either receive an acupuncture treatment expected to improve their bladder symptoms, or a placebo acupuncture treatment designed to promote relaxation. They underwent cystometric testing, completed a 3-day voiding diary, and completed the urinary distress inventory and incontinence impact questionnaire, validated quality-of-life inventories, before and after 4 weekly acupuncture treatments. The primary endpoint was number of incontinent episodes over 3 days. Secondary endpoints included voiding frequency and urgency, cystometric bladder capacity, maximum voided volume, and the urinary distress inventory and incontinence impact questionnaire symptom scores. Seventy-four women completed all aspects of the study. Women in both treatment and placebo groups had significant decreases in number of incontinent episodes (59% for treatment, 40% for placebo) without a significant difference in the change between the groups. Women in the treatment group had a 14% reduction in urinary frequency (P = .013), a 30% reduction in the proportion of voids associated with urgency (P = .016), and a 13% increase in both maximum voided volume and maximum cystometric capacity (P = .01). Both groups also had an improvement in the urinary distress inventory and incontinence impact questionnaire scores (54% decrease for treatment, 30% decrease for placebo, P < .001 for the difference in change between the groups). Women who received 4 weekly bladder-specific acupuncture treatments had significant improvements in bladder capacity, urgency, frequency, and quality-of-life scores as compared with women who received placebo acupuncture treatments. I.

A controlled trial of placebo versus real acupuncture

We sought to determine whether a novel method of placebo acupuncture can be differentiated by subjects from real acupuncture treatment. A single-blind, randomized, controlled clinical trial with an independent observer was performed. Forty-nine healthy subjects over the age of 18 years were randomly assigned to one of 2 experimental groups: 24 subjects received real acupuncture, and 25 subjects received placebo acupuncture. Placebo acupuncture was performed by administering a blunted acupuncture needle through a foam pad at the Large Intestine 4 acupoint. The blunted needle touched but did not penetrate the skin. Real acupuncture was performed by administering an acupuncture needle through a foam pad at the Large Intestine 4 acupoint. The needle pricked and penetrated the skin to a depth of 10 to 20 mm. A simple questionnaire followed, asking whether the subject believed they received real or placebo acupuncture. Twenty-two (88%) of the 25 subjects who received placebo acupuncture believed they received real acupuncture. Nineteen (79.2%) of the 24 subjects who received real acupuncture correctly determined they received real acupuncture. The Fisher exact test showed an insignificant difference between real and placebo acupuncture treatments ( P = .463). Subjects were not able to differentiate between real or placebo acupuncture, thereby validating this novel method of administering placebo acupuncture as a good control for acupuncture-naive patients. Perspective The method of placebo acupuncture herein described is a valid control for acupuncture research involving acupuncture-naive patients.

Acupuncture for crack-cocaine detoxification: Experimental evaluation of efficacy

Anecdotal studies have reported acupuncture alleviating the severity of withdrawal symptoms associated with cocaine abuse. The efficacy of auricular (ear) acupuncture in reducing cocaine/crack craving and consumption was examined via a single-blind, placebo experiment. One hundred and fifty individuals seeking treatment for cocaine/crack abuse were randomly assigned to receive either experimental or placebo acupuncture treatments. Treatments were provided in an outpatient setting for a one-month period. Placebo treatments involved acupuncture at ear locations not used for drug treatment. Subjects provided urine specimens for drug content analysis after each acupuncture session. Urinalysis results over the one-month study period favored the experimental group. Experimental subjects in treatment over 2 weeks had significantly lower cocaine metabolite levels relative to placebo subjects in treatment for a comparable period. Treatment retention with both groups was similar. Relative to pretreatment usage, a significant decrease in cocaine consumption was reported by both groups. Self-report outcomes did not indicate significant between-groups differences.

A Controlled Trial of Acupuncture in Tinnitus

The relationship of tinnitus to pain is examined and a theoretical case made out for the possible use of acupuncture in the treatment of tinnitus. A double-blind cross-over controlled trial is described. The use of Visual Analogue Scales (V.A.S.) is discussed in this context. 35 per cent of patients described some benefit from the active treatment only, although we were unable to demonstrate this objectively. Statistical analysis of the group as a whole revealed no significant differences between placebo and active acupuncture treatment.

A controlled trial of real and simulated acupuncture in the management of chronic asthma

In 25 patients with moderate to severe asthma, we compared the therapeutic effectiveness of classic Chinese acupuncture with that of “placebo” acupuncture administered in a randomly ordered, subject- and evaluator-blind, crossover fashion twice weekly for 4 weeks. Real and placebo acupuncture periods were each preceded and followed by 3- to 4-week periods during which no acupuncture was administered. Outcome variables consisted of the following: daily symptoms and medication use self-scored on patient diaries, spirometry and whole body plethysmography performed once weekly during the entire course of the study and repeated serially during 3 hours after real and placebo acupuncture treatment, patients' self-assessment of acute efficacy of acupuncture therapy, and physician's physical findings before and after acupuncture treatment. Two-way analysis of variance failed to reveal a significant effect of either form of acupuncture on symptoms, medication use, or lung function measurements. Similarly, no significant acute effect of acupuncture on lung function, self-ratings of efficacy, or physician's physical findings was found by covariance analysis or the Wilcoxon signed-rank test. When data during the entire course of the study were examined on an individual basis by analysis of variance with repeated measures, only two subjects demonstrated significantly favorable responses to real versus placebo acupuncture, but one subject demonstrated the reverse, suggesting that these responses were not specifically related to acupuncture therapy. Thus, our findings failed to demonstrate any short- or long-term benefit of acupuncture therapy in the management of moderate to severe asthma.