摘要
Acupuncture therapy is widely used in the clinic,and its therapeutic effects have been proven by numerous studies.The dose–effect relationship of acupuncture is a fundamental aspect of the acupuncture research system.Recent studies found that different acupuncture dosages altered study results directly,indicating the importance of screening the optimal stimulation dosage.However,the system for studying the acupuncture dose–effect relationship is still in its infancy,and the methodology of the system needs to be improved.This review aimed to define the factors impacting acupuncture“dosage”and“effect,”and to improve the methodological system for research on the dose–effect relationship of acupuncture.By summarizing the current findings of acupuncture dose–effect studies,we discussed the vital acupuncture parameters and methodological problems that influence the relationship between acupuncture dosage and its effects.These factors consist of specific influencing factors(acupoint selection,acupuncture manipulation parameters,de qi response)and nonspecific influencing factors(comparison selection,blinding procedure,patient expectancy).Our perspectives offer suggestions for the design of acupuncture dosage–effect trials.Further studies need to be conducted to establish the methodological system and provide systematic evidence of the acupuncture dose–effect relationship.
针刺疗法在临床中应用广泛,大量研究已证实针刺治疗的有效性。针刺的量效关系是针刺研究体系的基本要素。近年来,研究发现针刺刺激量的改变直接影响到针刺治疗的研究结果,说明了筛选最佳针刺刺激量的重要性。然而,针对针刺量效关系的研究体系尚未成熟,其研究方法学仍需完善。本综述旨在阐明影响针刺“量”与“效”关系的关键因素,进一步完善针刺量效关系研究的方法学体系。结合目前针刺量效研究相关文献,本文探讨了影响针刺量效关系的关键针刺参数及研究中的方法学问题,主要包括特异性因素(穴位选取、针刺手法参数、得气反应)与非特异性因素(对照组设置、盲法实施、患者期望)等。基于此,文章为针刺量效研究提供了切实可行的建议。在今后的研究中仍需进一步完善针刺量效关系研究的方法学体系,提供针刺量效关系的研究证据。
基金
funded by the Ministry of Science and Technology of the People’s Republic of China
National Key Research and Development Program(2010CB530506,2018YFC1706001,2019YFC0840709)
Tianjin Municipal Science and Technology Bureau
Tianjin Science and Technology Plan Project(18PTLCSY00060)
the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Exploration and Innovation Project(YB202112)
