针灸非特异性效应的影响因素及作用机制

Influential factors and mechanism of non-specific effect in acupuncture

尽管有大量的研究表明了针灸临床的有效性,但仍有研究显示针刺与假(安慰)针无差异,从而对针灸的特异性提出了质疑。原因可能在于针灸为复杂干预,干预实施过程中可产生独特的非特异性效应,且产生这一效应的影响因素众多,常常被忽视,因而无法有效地评估针灸的疗效。而产生针灸非特异性效应的影响因素包括医患沟通、期望效应、医师权威性、患者针灸经历等,可能与期望的生物学效应、霍桑效应和巴普洛夫条件反射等机制有关。

Even though a large amount of researches showing the clinical effectiveness of acupuncture, there are the researches indicating the absent difference between acupuncture and sham-acupuncture （placebo）, which pro- vides the doubts on the specificity of acupuncture. It may be considered that acupuncture intervention is complica- ted and may produce unique non-speciflc effect, which reSultS in the failure to evaluate effectively the acupuncture efficacy. The influential factors of the non-specific effect of acupuncture include the interaction between physician and patient, expectancy, physician authority, acupuncture treatment experiences, etc. It may be also relevant with the anticipated biological effect, Hawthorne effect, Pavlovian conditioned reflex, etc.