病人期望影响针刺疗效的相关性研究进展  

Development of Studies on Influence of Patients' Expectations on Therapeutic Effects of Acupuncture and Moxibustion Interventions

作　　者：徐倩[1] 石广霞[1] 李兆鑫[2] 王麟鹏[1] 刘存志[1] 

机构地区：[1]首都医科大学附属北京中医医院,北京100010 [2]天津中医药大学,天津300193

出　　处：《针刺研究》2014年第3期256-258,共3页Acupuncture Research

基　　金：北京市卫生系统高层次卫生技术人才培养计划(2011-3-055)

摘　　要：期望效应对针刺疗效的影响是目前针灸临床研究中的热点和难点,如何客观量化评估病人期望的大小是当前研究中亟须解决的问题。本文对期望的机制研究和临床研究进行总结,并介绍了期望的评价方法及影响因素。通过对针刺期望效应及其在针灸临床试验中应用的探讨,明确了针刺期望效应的重要性,对于今后优化临床试验设计,降低针刺临床研究由于期望不同造成的评价结果偏倚具有一定的意义。The patient＇s expectations （placebo effects） refer to the anticipation or the belief about what is to be encountered in a consultation in the healthcare system. Currently, it is a hot-spot for researching its influence on clinical outcomes of acupuncture and moxibustion interventions. How to evaluate the magnitude of patients＇ expectations is a problem needing to be solved urgently at the moment. The authors of the present paper make a summary about researches on the mechanism of expectations. For example, placebo analgesia was related to decreased brain activity in pain-sensitive brain regions （thalamus, insula, and anterior cingulate cortex）, and to the increased activity of the prefrontal cortex showed by fMRI, and to the release of endogenous opioids. In addition, the authors also introduce some methods （psychological scales） for assessing expectations and related influencing factors （physicians or acupuncturists, and medical environment） for future research in this area. In the coming clinical trials on acupuncture or moxibustion treatment of clinical disorders, we should further better our experimental design, and try our best to exclude placebo effect-associated or expectation-induced bias of clinical outcomes for confirming the therapeutic effects in the treatment of different clinical problems.

关 键 词：针灸 期望 疗效 影响因素 机制 评价方法 综述 

分 类 号：R245-0[医药卫生—针灸推拿学]