[Discussion on existing problems of placebo acupuncture design based on acupuncture analgesia].

In the present article, the authors made an overview about the existing problems of placebo acupuncture design in accordance with the neurological basis of acupuncture analgesia. The neuron-segmental and systemic mechanisms initiated by local somesthetic stimuli at different intensities are involved in acupuncture analgesia. When the local pain locus and the stimulated point are in the same spinal segmental region, stimuli of either higher intensity or lower intensity may produce an obvious anaIgesia effect. If the stimulation site is far from the pain locus (in remote spinal segment region), only higher intensity stimulation works. From this viewpoint, the placebo acupuncture design in current clinical trials for pain treatment exists some unreasonable aspects. Both pain focus and intensity of acupuncture stimulation should be taken into consideration together. The optimal placebo acupuncture design for the treatment of pain conditions is that lower intensity acupuncture stimulation is given for longer distance between the pain origin locus and the stimulated acupoint.

[Thinking on controlled setting of plarebo acupuncture in clinical trial of acupuncture and moxibustion].

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.