慢性疼痛假的差异性安慰剂效应:随机对照试验的网络元分析
Renhong Wan1, Qianhua Zheng1, Xiaorui Zeng1
1Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
BMC complementary medicine and therapies
|September 1, 2025
概括
假针具有显著的安慰剂效应, 这项研究为慢性疼痛临床试验中选择安慰剂对照提供了指导,尽管需要更多的直接比较.
科学领域:
- 整合和补充医学
- 疼痛管理研究
- 临床试验方法
背景情况:
- 针的临床效果经常被低估,
- 有多种假针方法,但缺乏对比试验使选择最佳安慰剂对照方法变得复杂.
- 这一系统性审查解决了对假干预的基于证据的指导的需要.
研究的目的:
- 为了比较各种假干预的不同安慰剂效应.
- 为在临床实践和研究中选择最佳安慰剂对照提供基于证据的指导.
- 为未来针研究中随机对照试验 (RCT) 的设计提供信息.
主要方法:
- 在PubMed,Embase,Cochrane和Web of Science系统搜索与慢性非癌症疼痛中针与假针进行比较的RCT.
- 使用频率主义随机效应模型进行间接治疗比较的元分析.
- 使用网络元分析 (CINeMA) 的证据水平评估.
主要成果:
- 分析了45项涉及8287名参与者的RCT和7种假针方法.
- 与手动针相比,等待治疗组的疼痛变化差异最为明显.
- 与其他方法相比,无透假针 (针点或非针点) 显示出较低的安慰剂效应,并具有相似的不良事件率和成功失明.
结论:
- 假针具有显著的安慰剂效应,而无透技术的影响最小.
- 这些发现为针研究中选择安慰剂对照提供了指导.
- 进一步的对比试验是产生假针疗效的直接比较证据的必要条件.
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