A Method for Evaluating Acupuncture Therapy in Pain Management

评估针灸治疗疼痛的方法

• 批准号: 8294798
• 负责人: Lucy L. Chen
• 金额: $ 43.37万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8294798
• 关键词: Acupuncture Points; Acupuncture Therapy; Acupuncture procedure; Affect; Alternative Medicine; Americas; Analgesics; Belief; Biological; Biological Markers; Clinical; Clinical Assessment Tool; Clinical Research; Clinical effectiveness; Complementary and alternative medicine; Effectiveness; Endorphins; Equipment and supply inventories; Face; Individual; Interleukins; Measures; Medicine; Methods; Modality; Nociception; Outcome; Outcome Assessment; Outcome Measure; Pain; Pain Measurement; Pain intensity; Pain management; Patients; Physician-Patient Relations; Physiological; Protocols documentation; Psychophysiology; Research; Research Project Grants; Role; Sensory; Symptoms; System; Tail; Testing; Therapeutic Effect; Treatment Protocols; Treatment outcome; United States; Visual; analog; base; clinical practice; clinically relevant; conventional therapy; gabapentin; novel strategies; preclinical study; public health relevance; research study; response; theories; tool

DESCRIPTION (provided by applicant): Acupuncture has been increasingly used as a modality of complementary and alternative medicine for treating clinical conditions including pain. However, the clinical effectiveness of acupuncture therapy remains difficult to assess. In search for informative and clinically relevant outcome measures for acupuncture therapy, it is important to make a distinction between clinical outcome measures and those measures reflective of the acupuncture's effect on biological (e.g., biomarkers) and/or physiological responses. A translational tool useful to assess the effectiveness of acupuncture therapy should be expected to bridge the gap between preclinical and clinical studies of acupuncture as well as between conventional medicine and alternative medicine. In this regard, quantitative sensory testing (QST) is a well-recognized psychophysical outcome measure that has been extensively used to assess the effect of conventional medicine on clinical pain. QST provides valuable information on both pain intensity and pain affect and, when combined with other clinical tools (e.g., pain inventory), can be used as a standard research and clinical tool. To date, QST has rarely been used as an outcome measure for clinical acupuncture therapy. In this application, we propose to develop a new approach to evaluating the effectiveness of acupuncture therapy by integrating the unique psychophysical features of QST responses (QST responders) with clinical evidence for pain symptom relief (clinical responders). This approach will be used to differentiate between the acupuncture's physiological and biological effect and its effect on clinical pain symptom relief. This proposed approach will be examined through a set of integrated and complementary experiments as outlined in four specific aims: (1) To evaluate QST as an assessment tool for the effect of acupuncture versus "sham" acupuncture on clinical pain; (2) To explore the role of QST in acupuncture outcome measures between "acupuncture believers" and "acupuncture non-believers"; (3) To compare the effect of acupuncture versus conventional medicine on clinical pain using a standard QST protocol; and (4) To compare changes in QST responses and biomarkers for nociception (e.g., interleukins) and antinociception (e.g., ¿-endorphin) in pain subjects before and after acupuncture therapy. This research project will yield valuable information on a research and clinical assessment tool that could be used to compare the therapeutic effect on clinical pain between acupuncture (other forms of alternative medicine as well) and conventional medicine. PUBLIC HEALTH RELEVANCE: In recent years, acupuncture has gained its popularity in the United States of America as a modality of complementary and alternative medicine for treating many clinical conditions including pain. However, the clinical effectiveness of acupuncture therapy remains difficult to assess. In this project, a new approach will be developed to evaluate the effectiveness of acupuncture therapy. This new approach could be used to compare the therapeutic effects on clinical pain between acupuncture (other forms of alternative medicine as well) and conventional medicine.

描述（由申请人提供）：针灸越来越多地被用作治疗包括疼痛在内的临床疾病的补充和替代医学。然而，针灸治疗的临床效果仍然难以评估。在寻找针灸治疗的信息和临床相关的结果测量时，重要的是要区分临床结果测量和那些反映针灸对生物（如生物标志物）和/或生理反应的影响的测量。一种有助于评估针灸治疗有效性的转化工具有望弥合针灸临床前和临床研究之间的差距，以及传统医学和替代医学之间的差距。在这方面，定量感觉测试（QST）是一种公认的心理物理结果测量，已广泛用于评估常规医学对临床疼痛的影响。QST提供了关于疼痛强度和疼痛影响的宝贵信息，当与其他临床工具（如疼痛清单）结合使用时，可作为标准研究和临床工具。迄今为止，QST很少被用作临床针灸治疗的结果测量。在这项应用中，我们建议开发一种新的方法，通过将QST反应（QST响应者）独特的心理物理特征与疼痛症状缓解（临床响应者）的临床证据相结合，来评估针灸治疗的有效性。这种方法将用于区分针灸的生理和生物效应及其对临床疼痛症状的缓解作用。该方法将通过一系列综合和互补的实验进行检验，具体目标如下：(1)评估QST作为针刺与“假”针刺对临床疼痛影响的评估工具；(2)探讨QST在“信针者”和“不信针者”针灸疗效测量中的作用；(3)采用标准QST方案比较针刺与常规药物对临床疼痛的影响；(4)比较针刺治疗前后疼痛受试者QST反应及痛觉生物标志物（如白细胞介素）和抗痛觉生物标志物（如内啡肽）的变化。这一研究项目将为研究和临床评估工具提供有价值的信息，可用于比较针灸（以及其他形式的替代医学）和传统医学对临床疼痛的治疗效果。