1.天津中医药大学第一附属医院/国家中医针灸临床医学研究中心,天津市南开区鞍山西道314号,300193
2.国家中医药管理局推拿手法生物效应三级实验室
收稿:2024-10-30,
修回:2025-03-27,
纸质出版:2025-06-02
移动端阅览
王金贵,张海宁,范顺等.推拿临床试验中安慰推拿手法的现状和设计思路[J].中医杂志,2025,66(11):1128-1132.
WANG Jingui,ZHANG Haining,FAN Shun,et al.Research Status and Design Ideas of Placebo Manipulation in Clinical Trial Design of Tuina[J].Journal of Traditional Chinese Medicine,2025,66(11):1128-1132.
王金贵,张海宁,范顺等.推拿临床试验中安慰推拿手法的现状和设计思路[J].中医杂志,2025,66(11):1128-1132. DOI: 10.13288/j.11-2166/r.2025.11.008.
WANG Jingui,ZHANG Haining,FAN Shun,et al.Research Status and Design Ideas of Placebo Manipulation in Clinical Trial Design of Tuina[J].Journal of Traditional Chinese Medicine,2025,66(11):1128-1132. DOI: 10.13288/j.11-2166/r.2025.11.008.
推拿临床试验中对照的合理设置是验证推拿疗法有效性的基础。梳理当前推拿临床试验中安慰推拿手法的研究现状,指出推拿临床试验中安慰推拿设置的必要性,分析安慰推拿手法设置的难点,认为安慰推拿尚存在安慰效应的影响、推拿手法多样化但缺乏标准化、公众对推拿认知度较高而实施盲法较困难等问题。总结脊柱整复手法、穴位按摩、小儿推拿三种类型推拿临床试验中安慰手法的研究设计,提出控制安慰效应、制定安慰推拿手法操作标准、确保盲法实施的严密性、应用新技术提高安慰推拿手法标准化和可盲性的四种安慰推拿手法设计思路,以期提升推拿临床试验设计的方法学质量,促进推拿临床试验设计的规范性和科学性。
The rationale for the design of control groups in tuina clinical trial is the foundation for rigorously validating the effectiveness and safety of this therapy. This article reviewed the current state of the design of tuina placebo in control groups of clinical trials, pointed out the necessity of setting up tuina placebo in clinical trials of tuina, analyzed the challenges in implementing blinding of tuina manipulation, and concluded that tuina placebo is still challenged by the placebo effect, the diversification of tuina manipulation but the lack of standardization, and the difficulty of implementing blinding due to the high level of public awareness of tuina. This article also summarized the design of placebo manipulation in three types of clinical trials, including spinal manipulation, acupressure, and paediatric tuina, and proposed four strategies for designing placebo tuina manipulation-controlling placebo effects, developing operational standards for placebo tuina manipulation, ensuring the rigor of blinding implementation, and applying new technologies to enhance the standardization and blinding capacity of placebo tuina methods. So the article is aimed at improving the methodological quality of tuina clinical trial designs, and promoting the standardization and scientificity of tuina clinical trial design.
房敏 , 王金贵 . 推拿学 [M]. 5版 . 北京 : 中国中医药出版社 , 2021 : 107 .
艾民 . 推拿疗法与“治未病” [J]. 中医杂志 , 2010 , 51 ( 7 ): 668 - 669 .
李美玲 , 路桃影 , 王立新 , 等 . 小儿推拿临床研究设计的方法学思考 [J]. 中医杂志 , 2018 , 59 ( 17 ): 1474 - 1479 .
ALI A , KAHN J , ROSENBERGER L , et al . Development of a manualized protocol of massage therapy for clinical trials in osteoarthritis [J]. Trials , 2012 , 13 : 185 . doi: 10.1186/1745-6215-13-185 http://dx.doi.org/10.1186/1745-6215-13-185 .
ROSSETTINI G , TESTA M . Manual therapy RCTs: should we control placebo in placebo control? [J]. Eur J Phys Rehabil Med , 2018 , 54 ( 3 ): 500 - 501 .
WEBER P , KLINGLER W , SCHLEIP R , et al . The influence of a single instrument-assisted manual therapy (IAMT) for the lower back on the structural and functional properties of the dorsal myofascial chain in female soccer players: a randomised, placebo-controlled trial [J]. J Clin Med , 2022 , 11 ( 23 ): 7110 .
PERLMAN A , DREUSICKE M , KEEVER T , et al . Perceptions of massage therapists participating in a rando-mized controlled trial [J]. Int J Ther Massage Bodywork , 2015 , 8 ( 3 ): 10 - 15 .
DEVEREAUX PJ , YUSUF S . The evolution of the randomized controlled trial and its role in evidence-based decision making [J]. J Intern Med , 2003 , 254 ( 2 ): 105 - 113 .
周航 , 王丽琼 , 屠建锋 , 等 . 针刺随机对照试验中盲法评价现状与方法学思考 [J]. 中医杂志 , 2024 , 65 ( 19 ): 1978 - 1982,1987 .
肖侠 , 燕翔琳 , 章冰 , 等 . 推拿对正常儿童生长发育影响的系统评价 [J]. 山东中医杂志 , 2020 , 39 ( 8 ): 801 - 808 .
MOLINA-ÁLVAREZ M , ARRIBAS-ROMANO A , RODRÍGUEZ-RIVERA C , et al . Manual therapy effect in placebo-controlled trials: a systematic review and meta-analysis [J]. Int J Environ Res Public Health , 2022 , 19 ( 21 ): 14021 .
张艳宏 , 艾艳珂 , 杨金洪 , 等 . 安慰剂效应及临床试验中针刺安慰效应的设计思路 [J]. 中医杂志 , 2024 , 65 ( 9 ): 904 - 908 .
ABEDIAN Z , ESKANDARI L , ABDI H , et al . The effect of acupressure on sleep quality in menopausal women: a randomized control trial [J]. Iran J Med Sci , 2015 , 40 ( 4 ): 328 - 334 .
ROSSETTINI G , PELLICCIARI L , TUROLLA A . " Do Not Mix Apples with Oranges" to avoid misinterpretation of placebo effects in manual therapy: the risk is resulting in a fruit basket [J]. Int J Environ Res Public Health , 2023 , 20 ( 15 ): 6444 .
INJEYAN HS , BUDGELL BS . Mitigating bias in the measurement of heart rate variability in physiological studies of spinal manipulation: a comparison between authentic and sham manipulation [J]. J Manipulative Physiol Ther , 2022 , 45 ( 2 ): 104 - 113 .
ASPINALL SL , JACQUES A , LEBOEUF-YDE C , et al . Pressure pain threshold and temporal summation in adults with episodic and persistent low back pain trajectories: a secondary analysis at baseline and after lumbar manipulation or sham [J]. Chiropr Man Ther , 2020 , 28 ( 1 ): 1 - 12 .
陈牮阁 , 王为民 . 关节弹响与推拿所致“咔哒”声响的研究进展 [J]. 按摩与康复医学 , 2020 , 11 ( 6 ): 16 - 18 .
CHAIBI A , ŠALTYTĖ BENTH J , BJØRN RUSSELL M . Validation of placebo in a manual therapy randomized controlled trial [J]. Sci Rep , 2015 , 5 : 11774 . doi: 10. 1038/srep11774 http://dx.doi.org/10.1038/srep11774 .
AMJAD I , NIAZI IK , KUMARI N , et al . The effects of chiropractic adjustment on inattention, hyperactivity, and impulsivity in children with attention deficit hyperactivity disorder: a pilot RCT [J]. Front Psychol , 2024 , 15 : 1323397 . doi: 10.3389/fpsyg.2024.1323397 http://dx.doi.org/10.3389/fpsyg.2024.1323397 .
韩玉清 , 邓宝华 , 王敖庚 , 等 . 中药熏洗加穴位按摩治疗脾虚气滞型妊娠蛋白尿57例临床观察 [J]. 中医杂志 , 2011 , 52 ( 21 ): 1843 - 1845 .
NIEH HC , WU PO , OU SF , et al . Effect of acupressure on alleviating constipation among inpatients with stroke during the acute phase: a randomized controlled trial [J]. Complement Ther Clin Pract , 2023 , 53 : 101801 . doi: 10.1016/j.ctcp.2023.101801 http://dx.doi.org/10.1016/j.ctcp.2023.101801 .
LU T , YIN L , CHEN R , et al . Chinese pediatric Tuina on children with acute diarrhea: a randomized sham-controlled trial [J]. Health Qual Life Outcomes , 2021 , 19 ( 1 ): 4 .
李旭豪 , 李金玲 , 杨继国 . 艾灸临床试验中安慰灸的设计方法与思路 [J]. 中医杂志 , 2022 , 63 ( 19 ): 1834 - 1839 .
张锡玮 , 侯德才 . 骨关节炎中医传统疗法评价的设计与实施 [J]. 辽宁中医杂志 , 2018 , 45 ( 7 ): 1394 - 1395 .
0
浏览量
1
下载量
0
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号