The impact of placebo, psychopathology, and expectations on the response to acupuncture needling in patients with chronic low back pain.
The impact of placebo, psychopathology, and expectations on the response to acupuncture needling in patients with chronic low back pain.
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DOI：
10.1016/j.jpain.2009.09.013
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发表时间：
2010-06
期刊：
影响因子：
--
通讯作者：
Gollub RL
中科院分区：
文献类型：
--
作者：
Wasan AD;Kong J;Pham LD;Kaptchuk TJ;Edwards R;Gollub RL
Comorbid psychopathology is a variable not explored in the acupuncture RCTs that could explain whether subgroups of patients with chronic low back pain have differential responses to acupuncture or placebo treatments. This was a controlled, blinded, crossover trial of verum acupuncture and validated sham acupuncture in 40 CLBP patients, with a Low or High level of psychiatric comorbidity. They completed a 0–10 rating scale for pain at the beginning and end of each treatment session, and rated their expectations for change in pain. Verum acupuncture was performed at Large Intestine 4 on the dorsal right hand for 30 minutes by a licensed acupuncturist. Data analysis used percent improvement in pain as the primary outcome for each of the treatment sessions. Both groups (21 Low and 19 High) reported significant analgesia with verum acupuncture needling, mean 33%, p=.90 for difference between groups; and with placebo, 26%, p=.09. In both groups expectations were only a significant predictor of verum acupuncture response, p=.002, such that those with greater expectations had greater pain relief. Psychiatric comorbidity does not significantly impact acupuncture or placebo acupuncture analgesia in CLBP. It does not affect the positive impact of expectations on reported pain relief from real acupuncture.
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