Placebo Effect Of Acupuncture Research Articles

Acupuncture for Arthralgia Induced by Aromatase Inhibitors in Patients with Breast Cancer: A Systematic Review and Meta-analysis.

Background:Aromatase inhibitor-induced arthralgia (AIA) is the most common side effect of aromatase inhibitors (AIs) used in breast cancer patients and is related to the rate of adherence to AIs. The clinical effects of acupuncture on AIA have been assessed by some randomized controlled trials (RCTs). However, some studies reported that acupuncture was effective, while others claimed that it was ineffective. To clarify the clinical and placebo effects of acupuncture in treating AIA, we conducted this meta-analysis.Methods:Two reviewers (XL and GW) independently searched for RCTs in 5 English databases (PubMed, Web of Science, Embase, Springer, Cochrane Library) and 4 Chinese databases (China National Knowledge Infrastructure Database (CNKI), SinoMed, VIP and Wanfang Database) from their inception to 30 November 2019. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this meta-analysis was performed by fixed or random-effects models, and data were pooled with mean differences (MDs).Results:Seven trials involving 603 patients were reviewed. The primary outcome, the Brief Pain Inventory (BPI) score, significantly differed between the acupuncture and control groups [pain-related interference: MD = −1.89, 95% confidence interval (CI) [−2.99, −0.79], Z = 3.36 (P = .008 < .05), pain severity: MD = −1.57, 95% CI [−2.46, −0.68], Z = 3.45 (P = .0006 < .05), worst pain: MD = −2.31, 95% CI [−3.15, −1.48], Z = 5.47 (P < .0001 < .05)]. No severe adverse events were reported in any study.Conclusion:This meta-analysis showed that acupuncture is a safe and effective treatment for breast cancer patients with AIA. Additional research with improved blinding methods is warranted to further explore the nature of non-specific and placebo effects in true and sham acupuncture.

Manual acupuncture versus sham acupuncture and usual care for the prevention of primary dysmenorrhea (PD): study protocol for a randomized controlled trial

BackgroundPrimary dysmenorrhea (PD) is a leading cause of dysmenorrhea among adolescent girls. Manual acupuncture may be considered as an effective treatment for PD, but high-quality evidence remains limited. This trial aims to evaluate the efficacy and safety of acupuncture for the prevention of PD as compared with sham acupuncture and usual care.Methods/designThis is a three-arm, randomized, controlled clinical trial in which the patients, assessors, and statisticians will be blinded. A total of 300 acupuncture-naive patients who were diagnosed as PD will be randomly allocated to the verum acupuncture, sham acupuncture, or usual care groups in a 2:2:1 ratio. Patients in the verum acupuncture group will receive manual acupuncture at specific acupuncture points with penetrating needling, while those in the sham acupuncture group will receive non-penetrating needling at non-acupuncture points. They will be given five sessions over a menstrual cycle for 3 menstrual cycles. Patients in the usual care group will receive health education and informed to receive manual acupuncture for free after waiting for 7 menstrual cycles. The primary outcome will be the change from baseline in the Cox Menstrual Symptom Scale Score (CMSS). The secondary outcomes will be the changes in Massachusetts General Hospital Acupuncture Sensation Scale (MASS), visual analog scale (VAS), Short-Form McGill Pain Questionnaire 2 (SF-MPQ-2), Pittsburgh Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), Beck Depression Inventory II (BDI- II), Acupuncture Expectancy Scale (AES), 60-item NEO Personality Inventory-Short Form (NEO-FFI), and acute medication intake. The adverse events will be recorded at every visit. The analyses will be performed base on a full analysis set (FAS) and a per-protocol set (PPS).DiscussionThis study may provide high-quality evidence regarding the efficacy and safety of manual acupuncture for PD. In addition, the results of this study will help to identify the efficacy of acupuncture due to the specific effects of acupuncture or placebo effects of acupuncture ritual.Trial registrationClinical Trials.gov NCT02783534. Registered on 26 May 2016

The placebo effects of acupuncture and moxibustion

The role of placebo effect in acupuncture and moxibustion efficacy was explored. Through the analysis of multiple factors including trust, expectation, understanding, doctor-patient relationship and social cultural environment, etc. in the literature at home and abroad, it was found the placebo effects, including patient's cognition, expectation, attention, preference and communication with doctor as well as doctor's suggestion, expectation and indirect regulation of diagnosis and treatment environment on patient's psychology, were essential factors for acupuncture efficacy. Therefore, it was concluded that the placebo effect was an inseparable part of acupuncture efficacy.

Discussion on several basic issues of acupuncture-moxibustion science

Nine basic issues on acupuncture-moxibustion science are discussed in this paper. The author believes those include the universal property of acupoints,the placebo effect of acupuncture and moxibustion,the continuous transmission of acupuncture information,the factors of the effects such as growth as well as acquired shape and properties,the classification evidence of acupoint function,the compatibility of acupoints,the change of functional state of acupoint and deqi. The universal property of acupoints means whether there is identical position of acupoint among different ethnic groups. The continuous transmission of acupuncture information is seen as whether the delivery which mainly shows as diffusion maintains active in special region and situation. The classification evidence of acupoint function refers to if there exists universal biological basis.

A Case Report on the Effect of Sham Acupuncture

When nausea, an extremely unpleasant symptom, is experienced during dental treatment, it generates disorders and obstacles for both the patient and the professional, compromising the good quality of dental care. Clinical studies have confirmed the antiemetic action of acupuncture and shown its use for the treatment of nausea and vomiting. In the scientific literature there are several recent studies that address the placebo effect of acupuncture. The aim of this manuscript is to present a case report of a 46-year-old Caucasian male patient, who had severe symptoms of nausea while undergoing dental care. Treatment with sham acupuncture (acupuncture simulation) obtained a positive result of nausea prevention. We will discuss three possible hypotheses concerning this result: (1) there was action of Deqi; (2) high expectations of the patient; and (3) association with specific learned response. The patient in this case report received nonpenetrating sham acupuncture at acupoint Neiguan (PC6), which resulted in the complete remission of nausea during an intra-oral impression-taking procedure, but it is unclear whether the placebo effect was triggered by the action of Deqi, the high expectations of the patient, an association with a learned response, or by the interaction of all these factors.

족저근막염의 침치료에 대한 국내외 연구동향 분석

Objectives Plantar fasciitis is one of the most common causes of heel pain. Plantar fasciitis can be managed with acupuncture, but the evidence for its effectiveness is uncertain. The aim of this review was to assess the effectiveness of acupuncture for plantar fasciitis. Methods I searched specific Korean and foreign electronic databases (KCI, RISS, NDSL, OASIS, KTKP, National Assembly Library, KMbase, PubMed, The Cochrane Library and China National Knowledge Infrastructure). The key search terms were `heel pain`, `plantar fasciitis` and `acupuncture`. Twenty-seven trials were included; eleven case reports, fourteen randomized controlled trials (RCTs) and two non-randomized controlled trials (NRCTs). Results Twenty-seven studies reported that acupuncture treatment reduced plantar fasciitis pain. However, the evidence provided by the case reports was regarded as weak because the methodological quality was poor, and the placebo effect of acupuncture was not accounted for in the RCTs and NRCTs. Overall, the methodological quality of the RCTs and NRCTs was weak. Conclusions There is some evidence for the effectiveness of acupuncture for plantar fasciitis. However, in order to reinforce the evidence for acupuncture`s effectiveness, additional placebo-controlled trials with well-designed methodologies are required.

Target dIsease-Guided placEbo-contRolled (TIGER) design: a novel method for clinical trials of acupuncture

BackgroundAt present, the design of an ideal placebo control in acupuncture studies challenges researchers. Previously devised sham acupuncture techniques have reported various imperfections; therefore, the specific effects of acupuncture cannot be accurately examined in clinical trials primarily because of interferences from the placebo effects.MethodGuided by evidence-based medicine (EBM) theories, we have made an initial attempt to establish a set of control methods for use in acupuncture studies, which is named the target disease-guided placebo-controlled (TIGER) design. In a trial using the TIGER design, participants suffering simultaneously from a predefined target disease and a pseudo target disease will be recruited and randomized to receive identical acupuncture intervention measures. As a result, the interventions not only appear the same but also produce the same stimulations in both groups. The patients in the treatment group will be informed of the actual target disease that the treatment aims for, whereas patients in the control group will be informed that the treatment is for the pseudotarget disease. It is speculated that no psychological response will be aroused in the control group. During data analysis, changes in the outcome measures of the patients in the control groupreveal the real therapeutic effect of acupuncture, and those of patients in the treatment group show both the real and placebo acupuncture effect. In this article, we explain how to put this design into use in a planned randomized clinical trial of acupuncture for the treatment of migraine.ResultsThis approach can eliminate the acupuncture placebo effect in the control group that may confound trial results. It is possible to observe the specific and placebo effects of acupuncture for the target disease separately using the TIGER design.ConclusionsThe proposed TIGER design has limitations. It is designed for clinical studies focusing on the specific effects of acupuncture, and it needs to be tested and verified for practicality and feasibility in various clinical research settings.

Time Course of Placebo Effect of Acupuncture on Pain: A Systematic Review.

Objectives. Our objective was to investigate the time course of the placebo effect of acupuncture on pain and the factors affecting the placebo effect. Methods. Previously we retrieved three-armed randomized acupuncture trials including sham and no-treatment groups which were published until October 2009. We searched electronic databases again to identify additional trials from October 2009 to December 2011. After a screening of trials, fifteen three-armed acupuncture trials for pain were included in the analysis. Standardized mean differences between the sham and no-treatment groups were calculated for placebo effect. We then plotted the magnitude of the placebo effect over time. Results. The placebo effect gradually has increased for 12 weeks with a standardized mean difference of 0.74 (95% CI: 0.54 to 0.94). Then it decreased after 12 weeks as time passed. When the placebo effects were compared for factors including methodological qualities, they were not affected by all factors, except patient blinding. Trials with sufficient patient blinding showed a larger placebo effect at 8 weeks than those with insufficient patient blinding (P = 0.0009). Conclusion. The placebo effect of acupuncture showed a unique pattern, which was affected by insufficient patient blinding.

Review: Acupuncture Analgesia in Clinical Trials

Acupuncture treatment has been accepted worldwide. Many clinical trials have been conducted especially in analgesia. The present review includes almost all the important trials since 1970. Among all the pain conditions, postoperative pain, lower back pain, osteoarthritis of the knee and chronic headache are the most popular topics. We found that there are diverse conclusions in each condition; however, most trials agree that acupuncture is an effective therapeutic strategy for analgesia. As with regard to the placebo effect, there is no consensus. In chronic headache treatment, the placebo effect of acupuncture seems to be large. However, in osteoarthritis, the placebo effect is minimal. Another issue is the non-specific physiologic response to piercing the skin. We believe that this effect produces analgesia in some heterogeneous syndrome such as lower back pain. However, this effect is not superior to the specific therapeutic effect of acupuncture based on TCM theory in all the pain conditions reviewed here. We also notice that the design of the sham acupuncture or the placebo has great impact on the result. Rigorous design can minimize the non-specific and placebo effects of acupuncture. Therefore, the real effect of acupuncture can be investigated well. We conclude that acupuncture is a proven treatment for relieving pain. This conclusion is based on specific effects of acupuncture rather than placebo.

The Effect of Real and Sham Acupuncture on Thermal Sensation and Thermal Pain Thresholds

Downs NM, Kirk K, MacSween A. The effect of real and sham acupuncture on thermal sensation and thermal pain thresholds. Arch Phys Med Rehabil 2005;86:1252–7. Objective To compare the effect of real and sham acupuncture and a control intervention on thermal sensation and thermal pain thresholds. Design Single-blind, randomized controlled, repeated-measures trial. Setting Laboratory. Participants Eighteen acupuncture naive, healthy subjects with no history of upper-limb pathology or acupuncture contraindications. Intervention Subjects were randomly assigned (blind card allocation) to 1 of 6 possible orders of application of the interventions, which consisted of 25 minutes each of control, real, and sham acupuncture. Main Outcome Measures Thermal sensation and thermal pain thresholds measured with a thermal sensory analyzer before and after each intervention. Results There were increases in cold and hot pain and cold sensation thresholds with real acupuncture. The level of increase did not differ significantly from the changes that occurred with sham acupuncture and control interventions. Conclusions Although we observed a trend toward a decreased sensitivity to thermal pain and thermal sensation with real acupuncture, this trend did not differ significantly from the changes with control or sham interventions. Therefore, no support was provided for analgesic or placebo effects of acupuncture. The trend, combined with the relatively low power of the inferential tests applied does, however, suggest that further research is merited.