Anotações
GLOSSÁRIO
- Minimal acupuncture: an acupuncture treatment that is not lege artis and a form that was clearly suboptimal according to traditional acupuncture theory: puncturing a location that was expected to be irrelevant in the treatment of the tested diagnosis, for example, a location about 2 cm or more off the classically described “meridian.” In addition, the needles were inserted only superficially and were not twisted or otherwise stimulated to avoid generating de qi (a range of sensations that include tingling, aching, heaviness, dull pain, numbness, soreness, warmth, and coolness felt at the site of needle insertion) that is believed to be indicative of successful acupuncture treatment. As stated above, minimal acupuncture cannot be viewed as placebo acupuncture, but must be defined as sham acupuncture: a form of acupuncture does not follow the classical theory but has certain physiological effects (Ots T et al., 2020 <https://pubmed.ncbi.nlm.nih.gov/32026725/>)
- Sham acupuncture: needling of non-acupuncture points. (Lund and Lundeberg, 2006 <https://pubmed.ncbi.nlm.nih.gov/16618044/>)
- Placebo acupuncture needles: a blunt tip of a needle touches the skin without penetrating it. Therefore, neither minimal, superficial, sham acupuncture nor ‘placebo‘ needles may be regarded as placebo as they are not inert.
- Inert placebo controls (Lund and Lundeberg, 2006 <https://pubmed.ncbi.nlm.nih.gov/16618044/>)
- Sham Vs. Placebo: A minority of researchers suggested that the so-called placebo needling had not been inert, but had produced physiological effects, and therefore should be reconceptualized as sham rather than placebo acupuncture. (Ots T et al., 2020 <https://pubmed.ncbi.nlm.nih.gov/32026725/>)
- Microsystems acupuncture, for example, ear acupuncture, hand acupuncture, or Yamamoto new scalp acupuncture. Microsystems acupuncture cannot be explained by means of segmental anatomy. Its functional
principles are not yet understood. (Ots T et al., 2020 <https://pubmed.ncbi.nlm.nih.gov/32026725/>) - wrong points or non-speficic points (points not indicated for the condition).
- non-points (locations that are not known acupuncture points).
- Sham acupuncture (SA) is divided into roughly two categories: penetrative SA (PSA; at sham acupoints) and nonpenetrative SA (NPSA; at real or sham acupoints). NPSA was defined as a sham insertion at real and sham acupoints. Sham insertion was defined as needling without penetrating the skin, normally with the use of an auxiliary device. Sham acupoints referred to both nonacupoints and acupoints without specificity for pain management. PSA was defined as the use of all needling methods penetrating the skin at sham acupoints, including deep insertion, minimal insertion, superficial insertion, and quick needle insertion without retention. Non-acupuncture (NA) included groups of waiting list controls, usual care, or no treatment. SA acts as a non-inert control (vs. inert controls) with some physiological and psychological responses, and this can result in false-negative results in RCTs with SA controls. (Zhou R et al., 2022. DOI: 10.1093/pm/pnac126).
EFFECT SIZE
- Acupuncture was superior to sham acupuncture for multiple pain conditions: OA had an effect size of 0.20–0.30. When acupuncture is compared with more noninvasive controls or a wait list, the effect size of acupuncture for OA increases to 0.50–0.60, which is of clinical importance (DOI: 10.1002/art.41583).
- SA is more effective for pain than a placebo pill. This suggests that not all placebos are equal (for example placebo pills may have less analgesic action than placebo surgery), resulting in potentially more invasive placebo maneuvers producing more clinical action. (doi: 10.1136/bmj.38726.603310.55).
DERMÁTOMOS
- Ots T et al. The selection of dermatomes for sham (placebo) acupuncture points is relevant for the outcome of acupuncture studies: a systematic review of sham (placebo)-controlled randomized acupuncture trials. Acupunct Med. 2020 Aug;38(4):211-226. <https://pubmed.ncbi.nlm.nih.gov/32026725/>
BOOKS
- Wiseman N and Ellis A (eds) Fundamentals of Chinese medicine. Brookline, MA: Paradigm Publications, 1985.
- Nanjing College of Traditional Chinese Medicine (ed.) Essentials of Chinese acupuncture. Beijing, China: Foreign Language Press, 1980.
DESFECHOS
- Global Rating of Change Scale <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762832/> The EQ-5D questionnaire also includes a Visual Analog Scale (VAS), by which respondents can report their perceived health status with a grade ranging from 0 (the worst possible health status) to 100 (the best possible health status).
ESTÍMULO
- In most verum acupuncture arms, after having achieved de qi the needles were stimulated according to the classical Chinese theories of “tonification” (Bufa: weak stimulation) for states of deficiency
and “sedation” (Xiefa: strong stimulation) for states of excess. (Ots T et al., 2020 <https://pubmed.ncbi.nlm.nih.gov/32026725/>)
