关于针灸临床研究中安慰针刺对照设置的思考  

Thinking on controlled setting of plarebo acupuncture in clinical trial of acupuncture and moxibustion

作　　者：毛文超[1] 刘保延[2] 何丽云[1] 刘志顺[3] 

机构地区：[1]中国中医科学院中医临床基础医学研究所,北京100700 [2]中国中医科学院,北京100700 [3]中国中医科学院广安门医院针灸科

出　　处：《中国针灸》2013年第4期367-371,共5页Chinese Acupuncture & Moxibustion

基　　金：国家"十二五"科技支撑计划项目:2012BAI 24B02

摘　　要：从影响针刺效应的因素出发,系统辨析了针刺效应与假针刺效应的区别与联系。认为假针刺效应并不能够完全等同于安慰剂效应,不论治疗针刺还是假针刺,其产生的效应均由特异效应和非特异效应组成,通过盲法、随机等手段可以将治疗针刺与假针刺的非特异效应的差异最大程度地降低,因而治疗针刺与假针刺的效应差异主要取决于特异效应差异的大小。当针刺的特异效应最小时,其效应也最小,才可作为理想的安慰针刺。因此在进行安慰针刺设置时应综合考虑影响针刺特异效应的因素(机体状态,刺激部位,刺激参数),使其产生的特异效应相对最小。Differences and relations between effects of acupuncture therapy and sham acupuncture are systematically analyzed in this article through the influential factors of acupuncture effect. And it is held that sham acupuncture effect is not exactly equal to placebo effect. The effects of both acupuncture and sham acupuncture are composed by specific effects and non-specific effects, and the differences of non-specific effects between acupunc- ture and sham acupuncture can be minimized furthest with blinding and randomized method. Therefore, the diffe- rence of acupuncture and sham acupuncture treatment rests with the degree of differences of the specific effects. Only when both of the specific effect of acupuncture and the effect of acupuncture are minimized, can it be applied as the ideal placebo control. Consequently when placebo acupunture are setted up, factors such as the body condition, site of stimulation and stimulation parameters which can influence the specific effect of acupuncture should be taken into consideration to produce the relatively minimum specific effect.

关 键 词：假针刺 对照研究 特异效应 非特异效应 

分 类 号：R245[医药卫生—针灸推拿学]