Matthias Fink
Hochschule Hannover Klinik fur Psysik. Medizin, OE 8300, D-30625 Hannover, Germany
Introduction
Credibility is a main factor of placebo effects, also in acupuncture treatment. In placebo controlled trials the credibility therefore must be equalised in placebo and treatment group. To effectively assess placebo effects in acupuncture a procedure must be noninvasive as well as credible to the patients. Streitberger and Kleinheinz (1998) developed a method for placebo acupuncture that is very demanding and difficult, thus limiting the feasibility of placebo studies. We have developed a new placebo acupuncture that is much simpler, allowing clinical scientists a broader application of such studies. The present study investigates the credibility of this new method in a randomized clinical trial on a sample of patients with tension.
Method
69 patients were randomly assigned to two groups (34 verum. 35 placebo acupuncture). Credibility was assessed with a modified credibility score (Borcovec, 1972) after the first treatment session and after 10 treatments.
Treatment
All patients were treated twice a week for an overall number of 10 treatments.
Placebo-grup: The tip of the acupuncture needle is blunt, and when it touches the skin a sensation similar to a puncture of the skin is felt by the patient. A cubio-shaped elastic foam was used to fixate the needle and make the contact patch invisible for the patient. Credibility was enhanced by the elasticity of the foam making the needle appear to be shortened.
Verum-grup: Local and distal points were chosen for treatment of tension headache, the points were chosen according to the patients’ symptoms. Needles were inserted regularily and while twitching the needles the ‘deQi’ sensation was elicited.
Results
After the first treatment there was no difference in credibility between study groups in any of the 12 credibility score items. After 10 sessions the result was the same except for one item: a deQi sensation was felt significantly more frequently in the verum acupuncture group.
Discussion
Credibility of treatment is a key factor in placebo controlled studies. The goal of the present study was the development of a simple and easily applicable placebo acupuncture method with a placebo effect equivalent to verum acupuncture. Our placebo treatment shows a credibility equivalent to verum acupuncture over up to 10 treatment sessions; it might be a useful and simple method to assess placebo effects of acupuncture treatment.