1.Assessing the adequacy of acupuncture in clinical trials: current status and suggestions.
Wei-Juan GANG ; Xing MENG ; Xiang-Hong JING
Chinese Acupuncture & Moxibustion 2019;39(3):229-233
In recent years, some large rigorous acupuncture randomized controlled trials (RCTs) frequently draw the conclusion that the therapeutic effects of acupuncture is equivalent to placebo effect, which has aroused wide attention and controversy. Thus, some studies attempted to assess the adequacy of acupuncture regimen in clinical trials. In this study, the concept of acupuncture regimen adequacy in clinical trials is clarified and the research status and limitations are summarized. Moreover, the suggestions in the future researches are proposed in association with clinical practice characteristics of acupuncture, i.e. classifying assessment according to different types of acupuncture; conducting the assessment according to the treatment characteristics of different types of acupuncture; assessing the maturity of acupuncture regimens; evaluating the rationality of the control group according to the purpose of the study; and focusing on domains evaluation.
Acupuncture Therapy
;
Clinical Trials as Topic
;
Placebo Effect
2.The therapeutic effect of silver nanocrystalline ointment on TMJ capsulitis.
Chang Hoon CHAE ; Jwa Young KIM ; Mi Ja KIM ; Hoon CHUNG ; Seung Ho KIM ; Hyun Woo OH ; Young Nam KIM ; Young Il KIM ; Byung Ho YANG ; Seong Gon KIM
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2006;32(3):262-266
The silver nanocrystalline is widely used for biological field because of its biocompatibility and anti-microbial effect. The objective of this study was to evaluate the therapeutic efficacy of the silver nanocrystalline ointment on the temporomandibular joint (TMJ) capsulitis. Total 39 patients were included in this study and all patients were received single topical application of the silver nanocrystalline ointment (group A, n=30) or placebo ointment (group B, n=19). Measured variables were maximum mouth opening (MMO), visual analog scale (VAS) for pain, and VAS for function. In results, we could not assess any therapeutic efficacy of single application in the chronic TMJ capsulitis (p>0.05). However, the single application of silver nanocrystalline ointment showed significant improvement in MMO and VAS for pain compared to placebo effect in the acute TMJ capsulitis (p<0.05). We could not find any complications related to ointment application in both groups. In conclusion, the single application of silver nanocrystalline ointment was effective in improving patient's symptom in acute TMJ capsulitis without any noticing complications.
Humans
;
Mouth
;
Placebo Effect
;
Silver*
;
Temporomandibular Joint*
;
Visual Analog Scale
3.Reflections into the latent contradictions between the "placebo" concept and traditional Chinese medicine.
Chinese Acupuncture & Moxibustion 2013;33(3):269-272
The correspondence of modern western medicine efficacy research basis and traditional Chinese medicine are discussed through analysis of differences in treatment pattern that modern western medicine and traditional Chinese medicine are based on. At the same time, the true meaning of "placebo" concept is re-analyzed and the latent contradiction of this concept when applied to traditional Chinese medicine studies is given in-depth reflection. It turns out that conflicts exist in treatment pattern between the two medicine theories and efficacy research basis of the two medicine theories lack correspondence. The "placebo" and "placebo effect" concepts have a different meaning when applied to traditional Chinese medicine. The "placebo" concept is applicable to just a small field of modern western medicine experimental studies. The research results and conclusions drawn from traditional Chinese medicine studies based on this concept should be given the necessary discretion and criticism.
Humans
;
Medicine, Chinese Traditional
;
Placebo Effect
;
Research Design
;
Treatment Outcome
4.Psychiatric Applications of Placebos.
Korean Journal of Psychopharmacology 2014;25(2):37-42
As the placebo effect is inevitable in almost all types of treatment implemented in the context of the doctor-patient relationship, it would be a wise strategy to try to enhance the treatment effect by understanding its mechanism and applying it clinically. However, for various reasons there is resistance to therapeutical application of placebos. The main reason for this resistance comes from the confusion about the concept of the placebo, and it is necessary to differentiate the placebo response and the placebo effect and understand them clearly. Meta-analytical reviews of clinical studies showed that the placebo effect accounts for part of clinical effect of drugs. Authors reviewed meta-analytic studies dealing with the placebo effect on depression, sleep disorders, dementia, anxiety and addiction. In addition, we discussed the current state of placebo use and also the way to promote the placebo effect.
Antidepressive Agents
;
Anxiety
;
Dementia
;
Depression
;
Effect Modifier, Epidemiologic
;
Placebo Effect
;
Placebos*
;
Sleep Wake Disorders
5.Biofeedback Therapy in Patients with Functional Evacuation Disorders.
Journal of the Korean Society of Coloproctology 2003;19(4):260-269
Biofeedback therapy has emerged as a useful adjunct for patients with functional evacuation disorders over the past decade. The goals of biofeedback retraining may vary and could depend on the underlying dysfunction. In patients with obstructive defecation, the goals are to relax the anal sphincter, improve rectoanal coordination, and improve sensory perception. Methods of biofeedback therapy varied widely between centers. However, no difference was described when EMG-based biofeedback was compared to manometry-based biofeedback, or when visual or auditory feedback was given. In regards to biofeedback adjuncts, including sensory retraining with either an intrarectal balloon, a portable home-training unit or both can be practicable. There are inconsistencies in the literature regarding the patient selection criteria for biofeedback treatment. The patient group is not homogeneous. Different case selection, different regimens and different methods of biofeedback may explain the variability in success rate. Quality research that would assist in predicting outcome is still lacking. Although no specific denominator could possibly be assigned to correctly predict the overall outcome of therapy, biofeedback is not successful in all patients with outlet obstructed constipation. Results with success rates is ranging from 8.3 percent to 100 percent. The treatment of constipation by biofeedback has been viewed with some skepticism as the low success rate may simply be a placebo effect. The majority of scepticism to therapeutic outcome are derived from entry criteria for treatment. Lower success rates have been described when entry criteria were broadened. Prebiofeedback clinical findings which are presupposed to prognostic relevance are age, gender, duration of symptoms and presence of rectal pain, lower motor neuron disease, and psychiatric problems. I feel strongly that informations about the predictive factors are vital to all physicians either performing or recommending biofeedback to their patients. If biofeedback could be undertaken according to specific criteria, we, colorectal surgeon will save a fruitless endeavour, one would expect more improvements in more patients. Additional well-designed controlled trials are needed to establish the clinical and physiologic factors.
Anal Canal
;
Biofeedback, Psychology*
;
Constipation
;
Defecation
;
Humans
;
Motor Neuron Disease
;
Patient Selection
;
Placebo Effect
6.Efficacy of terazosin for overactive bladder symptoms and sexual function in patients with overactive bladder and symptomatic benign prostatic hyperplasia: a prospective multicenter trial.
Chin Kyung DOO ; Myung Soo CHOO ; Kyu Sung LEE ; Moon Kee CHUNG ; Kwang Sung PARK ; Jae Seung PAICK ; Tae Kon HWANG
Journal of the Korean Continence Society 2008;12(1):36-41
OBJECTIVE: This study is to evaluate the efficacy of terazosin in the treatment of overactive bladder (OAB) symptoms and sexual dysfunction in patients with symptomatic benign prostatic hyperplasia (BPH) and OAB. METHODS: Of 200 men aged 50-80 years with symptomatic BPH, an International Prostatic Symptom Score (IPSS) > or =8 accompanied by OAB symptoms, 185 patients completed treatment with terazosin 2-5 mg once daily for 8 weeks. Patients were asked to complete a voiding diary, the International Index of Erectile Function (IIEF) questionnaire, and the IPSS at baseline, 4 and 8 weeks. RESULTS: 8-week terazosin treatment improved OAB symptoms as well as reducing IPSS (19.8 to 12.7) and IIEF (34.4 to 37.4) scores. OAB symptoms improved significantly, irrespective of symptom severity by the IPSS, but the IIEF score only increased in patients with severe symptoms. CONCLUSIONS: Additional studies are needed to further evaluate the placebo effect. However, terazosin monotherapy is effective in patients with symptomatic BPH and OAB, and may increase sexual function in patients with severely symptomatic BPH.
Adrenergic alpha-Antagonists
;
Humans
;
Male
;
Placebo Effect
;
Prospective Studies*
;
Prostatic Hyperplasia*
;
Surveys and Questionnaires
;
Urinary Bladder, Overactive*
7.Maintenance Therapy of Facial Seborrheic Dermatitis with 0.1% Tacrolimus Ointment.
Hye One KIM ; Yoon Seok YANG ; Hyun Chang KO ; Gyung Moon KIM ; Sang Hyun CHO ; Young Joon SEO ; Sang Wook SON ; Jong Rok LEE ; Joong Sun LEE ; Sung Eun CHANG ; Jae We CHE ; Chun Wook PARK
Annals of Dermatology 2015;27(5):523-530
BACKGROUND: Topical calcineurin inhibitors (TCIs) have been successfully used to treat seborrheic dermatitis (SD) patients. Meanwhile, treatment of atopic dermatitis (AD) with low-dose, intermittent TCI has been proved to reduce disease flare-ups. This regimen is known as a maintenance treatment. OBJECTIVE: The aim of this trial was to investigate the efficacy and tolerability of a maintenance treatment with tacrolimus ointment in patients with facial SD. METHODS: During the initial stabilization period, patients with facial SD or AD applied 0.1% tacrolimus ointment twice daily for up to 4 weeks. Clinical measurements were evaluated on either in the whole face or on separate facial regions. When an investigator global assessment score 1 was achieved, the patient applied tacrolimus twice weekly for 20 weeks. We also compared our results with recent published data of placebo controlled study to allow an estimation of the placebo effect. RESULTS: The time to the first relapse during phase II was similar in both groups otherwise significantly longer than the placebo group. The recurrence-free curves of two groups were not significantly different from each other; otherwise the curve of the placebo group was significantly different. There were no significant differences between the 2 groups in the number of DEs, and treatment days for disease exacerbations (DEs). The adverse event profile was also similar between the 2 groups. During the 20 weeks of treatment, the study population tolerated tacrolimus ointment well. CONCLUSION: The results of this study suggest that maintenance treatment with tacrolimus may be effective in preventing the occurrence of facial SD exacerbations.
Calcineurin
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Dermatitis, Atopic
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Dermatitis, Seborrheic*
;
Humans
;
Placebo Effect
;
Recurrence
;
Research Personnel
;
Tacrolimus*
8.Maintenance Therapy of Facial Seborrheic Dermatitis with 0.1% Tacrolimus Ointment.
Hye One KIM ; Yoon Seok YANG ; Hyun Chang KO ; Gyung Moon KIM ; Sang Hyun CHO ; Young Joon SEO ; Sang Wook SON ; Jong Rok LEE ; Joong Sun LEE ; Sung Eun CHANG ; Jae We CHE ; Chun Wook PARK
Annals of Dermatology 2015;27(5):523-530
BACKGROUND: Topical calcineurin inhibitors (TCIs) have been successfully used to treat seborrheic dermatitis (SD) patients. Meanwhile, treatment of atopic dermatitis (AD) with low-dose, intermittent TCI has been proved to reduce disease flare-ups. This regimen is known as a maintenance treatment. OBJECTIVE: The aim of this trial was to investigate the efficacy and tolerability of a maintenance treatment with tacrolimus ointment in patients with facial SD. METHODS: During the initial stabilization period, patients with facial SD or AD applied 0.1% tacrolimus ointment twice daily for up to 4 weeks. Clinical measurements were evaluated on either in the whole face or on separate facial regions. When an investigator global assessment score 1 was achieved, the patient applied tacrolimus twice weekly for 20 weeks. We also compared our results with recent published data of placebo controlled study to allow an estimation of the placebo effect. RESULTS: The time to the first relapse during phase II was similar in both groups otherwise significantly longer than the placebo group. The recurrence-free curves of two groups were not significantly different from each other; otherwise the curve of the placebo group was significantly different. There were no significant differences between the 2 groups in the number of DEs, and treatment days for disease exacerbations (DEs). The adverse event profile was also similar between the 2 groups. During the 20 weeks of treatment, the study population tolerated tacrolimus ointment well. CONCLUSION: The results of this study suggest that maintenance treatment with tacrolimus may be effective in preventing the occurrence of facial SD exacerbations.
Calcineurin
;
Dermatitis, Atopic
;
Dermatitis, Seborrheic*
;
Humans
;
Placebo Effect
;
Recurrence
;
Research Personnel
;
Tacrolimus*
9.Application of placebo acupuncture in randomized controlled trials in the past 10 years in foreign countries.
Lu JU ; Xiaoliang WU ; Dake XU ; Lixia PEI ; Houxu NING ; Jianhua SUN
Chinese Acupuncture & Moxibustion 2016;36(2):203-206
The application of placebo acupuncture in randomized controlled trials in the past 10 years (2004-2014) in foreign countries was systematically reviewed to summarize the design of placebo acupuncture; according to category of diseases, advantages and disadvantages were analyzed to explore an ideal placebo acupuncture set. By retrieval in PubMed, EMBASE and OVID databases, the clinical study literature which met the inclusion criteria was searched, and the category of diseases, design of placebo acupuncture and clinical efficacy were analyzed. Totally 29 articles were included. The pain was the leading disease in category of diseases; the most commonly used application of placebo acupuncture design was telescopiform sliding blunt needle, accounting for 45. 16%; the treatment locations were non-acupoints mostly; in the needling depth, approximately 60. 00% selected non-penetrating needling and 26. 67% selected superficial needling; 28 articles indicated that acupuncture and placebo acupuncture had clinical effects, accounting for 96. 55%; 37. 93% of articles indicated acupuncture was superior to placebo acupuncture and 37. 93% of articles indicated acupuncture was not superior to placebo acupuncture. It is concluded that the design of placebo acupuncture should consider multiple factors, including main symptoms, operability, security, blinding and specific effects, and the objective indices should be selected for outcome evaluation.
Acupuncture Therapy
;
instrumentation
;
methods
;
standards
;
Humans
;
Internationality
;
Needles
;
Placebo Effect
;
Randomized Controlled Trials as Topic
;
standards
10.Re-discussion on bias.
Chinese Acupuncture & Moxibustion 2013;33(11):1043-1047
The reasons of bias that is caused in the design of randomized controlled trial are analyzed in this article. It is emphasized that the design of randomized controlled trial in TCM acupuncture should follow its basic concepts and cores and make clear normative standards of placebo acupuncture. The concept of real-time control is proposed and focusing on activating the nerve cells process in threshold field is advised, which will make profound influence on development of medical science of acupuncture and moxibustion.
Acupuncture Therapy
;
standards
;
Humans
;
Placebo Effect
;
Randomized Controlled Trials as Topic
;
standards
;
Research Design
;
Treatment Outcome