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

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

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

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

Through clinical practice and theory of acupuncture, three aspects are expounded in this article, namely whether the sham acupuncture is in reality as well as in name or not, whether the topics assigned as real and sham acupuncture exists or not, and whether the effect of acupuncture equals to placebo or not. It is held that the research method which separates the biological availability and psychological effect does not confirm to the theory of integration of the physical and the psychological in Chinese medicine. It also does not meet the new medical model of biology-psychology-society of the modern society. Therefore, the western research module which separates the physical and psychological should not be repeated. Sham acupuncture as a control method is still immature, which is not appropriate to be taken as a standard model for acupuncture research. If the research method which takes modern medicine as the control method in Chinese Acupuncture and Moxibustion can be promoted, and the most effective and the most advanced methods and results which are general accepted can be taken as the control, the differences and the advantages of acupuncture-moxibustion can be discovered directly with greater value
Acupuncture Therapy ; instrumentation ; methods ; standards ; Biomedical Research ; instrumentation ; methods ; standards ; Humans ; Placebo Effect

INTRODUCTIONThe management of psychogenic movement disorders is fraught with difficulties. Empathy and a non-judgmental manner are essential in dealing with patients, and a neurobiological explanation of the symptoms may help to foster trust, acceptance, understanding and recovery.

CLINICAL PICTUREWe report a 17-year-old Chinese girl with psychogenic blepharospasm. Her parents refused psychotherapy and pharmacotherapy.

TREATMENT AND OUTCOMEPlacebo therapy (with parental consent) was prescribed with favourable results.

CONCLUSIONWe examine the ethical considerations for and against placebo therapy, and explore the role of placebo therapy in the management of psychogenic movement disorders.

Adolescent ; Blepharospasm ; psychology ; therapy ; Female ; Fraud ; Humans ; Placebo Effect ; Placebos ; therapeutic use

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*

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

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

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 difference 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.
Acupuncture Therapy ; psychology ; Controlled Clinical Trials as Topic ; methods ; psychology ; Humans ; Placebo Effect ; Research Design ; Treatment Outcome