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KMID : 0615720110280050029
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Jouranl of Korean Acupuncture and Moxibustion society
2011 Volume.28 No. 5 p.29 ~ p.38
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Review and Analysis of Sham Acupuncture in Acupuncture Clinical Trials
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Jang Jin-Young
Kim So-Jung
Kim Nam-Sik
Nam Sang-Su
Kim Yong-Suk
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Abstract
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Objectives:Recent well-designed randomized controlled trials(RCTs) and their meta-analysis have been published on the efficacy of acupuncture in different condition. In most of them, real acupuncture is compared with sham acupuncture including invasive and non-invasive sham methods. But it is not clear how active sham methods are. These results tend to lead the conclusion that acupuncture has no more effective than sham acupuncture. In order to investigate that sham acupuncture is appropriate as a control, we reviewed several acupuncture trials using different sham acupuncture as a control.
Methods: We searched Cochrane researches of acupuncture, reviewed and analyzed 25 RCTs in 42 Cochrane reviews. And especially we compared the effect of acupuncture according to the type of sham acupuncture.
Results:Invasive sham acupunctures are used in 12 RCTs and non-invasive types are used in the rest. The majority of studies(19 RCTs) fail to show effects beyond a sham acupuncture. Streitberger’s sham needle is a validated sham acupuncture of non-invasive type that was used in 8 trials and also no significant group differences are shown except one trial.
Conslusions: Acupuncture is a complex intervention. Clinical trials of acupuncture need to be reexamined and redesigned to remove several bias. Especially, sham acupuncture as a control might be investigated for physiological effects as well as validation test including patient-blinding and de qi sensation. Other research need to be investigated and developed for acupuncture trials.
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KEYWORD
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acupuncture, placebo, sham, randomized controlled trial
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