• Korean Journal of Acupuncture
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• v.23 no.1
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• pp.95-109
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• 2006

Objectives : There has been a considerable debate about how to best control for placebo effects in clinical trials of acupuncture. Recently several sham needles were developed and validated. This study aimed at summarising the validation studies of these needles and evaluating the outcomes of the randomised controlled trials (RCTs) using them. Methods : Computerised literature searches were performed using 'acupuncture' AND 'placebo OR sham' with a limitation of the results to RCTs in Medline via PubMed and the Cochrane Library. Only formally validated sham needle controlled studies were included. Data were extracted regarding study design, condition, sample size, credibility testing, intervention and outcomes. Methodological quality was assessed using a modified Jadad scale. Results : Three validated sham needles by Streitberger, Park, and Fink, were identified. Acupuncture's effectiveness for various conditions was tested using these needles in 12 RCTs. Real acupuncture was superior to sham acupuncture for rotator cuff tendonitis and hypertension. No significant differences between real acupuncture and sham acupuncture emerged for chemotherapy-related nausea and vomiting, postoperative nausea and vomiting, menstrually related migraine, acute stroke rehabilitation, chronic/episodic tension-type headache, neutrophil respiratory burst in healthy volunteers, alcohol withdrawal symptoms and chronic poststroke leg spasticity. Conclusions : The new sham devices have been adequately validated and may be useful tools for investigating specific research question. In spite of the sham needle's limits, the results of RCTs using such devices tend to suggest that the clinical effects of acupuncture are largely due to a placebo response.

• Korean Journal of Acupuncture
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• v.23 no.4
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• pp.85-99
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• 2006

Objectives : Proper acupuncture stimulation is associated with a characteristic set of sensation usually referred to as 'De-Qi'. In order to develop the appropriate sham acupuncture, various sensations to each stimulation should be considered through analysis of the profiles of acupuncture sensation. It was therefore investigated to compare the acupuncture sensation scale (ASS) of two types of sham acupuncture to that of the real acupuncture. Methods : Ninety-four participants (mean age 26.4, range 26-49) were asked to complete five point-Likert scale ASS developed by Vincent et al. after real or two-kinds of sham acupuncture stimulation: blunted tip sham acupuncture (BT) and round tip sham acupuncture (RT). Needling was done at LI4 acupoint on non-dominant hand and stimulated for 30 seconds with real or two-kinds of sham needle. Finger withdrawal latency (FWL) of each group was also measured to evaluate the pain sensitivity to noxious heat stimuli. Results : BT acupuncture significantly less produced penetrating, numb, intense, hurting, pulling, shock, tingling, throbbing sensation than real acupuncture stimulation. RT acupuncture significantly less produced penetrating, burning, electric, numb, intense, hurting, pulling, aching, shasharp, shock, stinging, tingling, throbbing sensation than real acupuncture. Each group did not demonstrate the differences of pain sensitivity to noxious stimuli. Conclusions : These results indicated that types of tip of acupuncture produced different kinds of acupuncture sensation. Our finding provides a general information of sensations to two kinds of sham acupuncture for development of ideal placebo sham needle.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.1
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• pp.107-112
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• 2014

This study aimed to prove the effects of acupuncture treatment on acupoint Joksamni(ST36) related to gastrointestinal movement. Electrogastrogram (EGG) data were obtained in 11 healthy subjects treated by real or sham needle in single-blinded condition for 40 min, including before, during acupuncture treatment, and after removing needle. According to frequency analysis of EGG, median frequency(MF) was increased by real needle in 4 subjects, MF for another 2 subjects were increased by real and sham needle and no trend shift in MF showed in other 5 subjects. Our result showed that acupuncture treatment on Joksamni has some effects on gastrointestinal movement. In this study we have applied both real acupuncture and sham acupuncture on the same subjects. So its blinding was regarded as good but was effective in about 36%~55%. Two subjects were assumed that they showed placebo effects on both real and sham acupuncture. Therefore it is necessary to perform further study on case-control and a larger number of subjects with functional dyspepsia, in order to confirm our findings.

• Journal of Acupuncture Research
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• v.25 no.6
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• pp.77-93
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• 2008

Objectives : Though there were many clinical studies of acupuncture effects they didn't have appropriate control group or use another therapy for control group. So, we didn't say it was true acupuncture effect, though subjects in clinical study improved. Recently several sham needles for control group were developed and validated. This study aimed at summarizing the validation studies of these needles and evaluating the control group of the acupuncture clinical study. Methods : Computerized literature searches were performed using 'acupuncture' and 'placebo or sham' with a limitation of the results to RCTs in Pubmed, Sciencedirect, NDSL, KISS, RISS. Data were extracted regarding study design, sample size, acupuncture point, stimulation form, credibility testing. And We have examined 106 acupuncture clinical studies published by Pubmed from January 1, 2005 to April 30, 2008. Data were extracted author's country, subject of study, type of study groups, type of control groups, type of blinding, difference between the results in the control groups. Results : Streitberger's placebo needle, Fink's sham needle, Park sham needle, Kim sham needle were developed. They were validated at domestic and abroad. But the results were deviation depending on the each of the researcher. They has shown that sample, acupuncture points, experiences or knowledge of acupuncture dependent on the results. Recent three years, acupuncture clinical trial had different results. Significant differences between Study group and control group emerged from using other therapy or non-treatment for control group. Many study has no significant differences using sham acupuncture for control groups. Conclusions : Acupuncture clinical studies need to meet several requirements. First of all, they require the basics of randomized controlled clinical studies such as blinding and the accurate implementation and description of randomization. And also need to research the unique circumstances of these studies such as the development of sham acupuncture and blinding method which differs from other clinical trials.

• Journal of Acupuncture Research
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• v.28 no.5
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• pp.29-38
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• 2011

Objectives : Recent well-designed randomized controlled trials(RCTs) and their meta-analysis have been published on the efficacy of acupuncture in different condition. In most of them, real acupuncture is compared with sham acupuncture including invasive and non-invasive sham methods. But it is not clear how active sham methods are. These results tend to lead the conclusion that acupuncture has no more effective than sham acupuncture. In order to investigate that sham acupuncture is appropriate as a control, we reviewed several acupuncture trials using different sham acupuncture as a control. Methods : We searched Cochrane researches of acupuncture, reviewed and analyzed 25 RCTs in 42 Cochrane reviews. And especially we compared the effect of acupuncture according to the type of sham acupuncture. Results : Invasive sham acupunctures are used in 12 RCTs and non-invasive types are used in the rest. The majority of studies(19 RCTs) fail to show effects beyond a sham acupuncture. Streitberger's sham needle is a validated sham acupuncture of non-invasive type that was used in 8 trials and also no significant group differences are shown except one trial. Conclusions : Acupuncture is a complex intervention. Clinical trials of acupuncture need to be reexamined and redesigned to remove several bias. Especially, sham acupuncture as a control might be investigated for physiological effects as well as validation test including patient-blinding and de qi sensation. Other research need to be investigated and developed for acupuncture trials.

• Journal of Acupuncture Research
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• v.25 no.5
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• pp.139-149
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• 2008

Objectives : The aim of this study was to compare the effect of needle retention(NR) and electro-acupuncture of low(EA(L)) and high(EA(H)) frequencies at $SP_6$ and Sham point in rats. Methods : Intestinal hypermotility was induced by feeding carbachol and experimental groups divided mainly into 7 groups which were normal, holder, control, acupuncture in normal state of rats, pre-treatment of acupuncture(NR, EA) in hypermotility, post-treatment of acupuncture(NR, EA) in hypermotility. We fed charcoal to them after the treatment and measured the travel rate of charcoal in the gastrointestinal track so that which treatment affected more in intestinal hypermotility. Results : As the following study, each acupuncture ways of EA(L) had significant effect of decreasing travel rate on intestinal hypermotility than EA(H) and NR. The comparison between pre-treatment and post-treatment, pre-treatment had slight more effect than post-treatment but not significantly. There was more affected at $SP_6$ than Sham point on this study. Conclusions : There were 21 groups to find out which treatment was best to slow down the intestinal motility and $SP_6$-EA(L)-C had significant effect compared with control group at the figure than any other groups. That meant $SP_6$ had effect on gastric disorder such as intestinal hypermotility and its' effect had more prevention than cure. Further study was needed to have more precise effect of EA and $SP_6$.

• The Journal of Korean Medical History
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• v.33 no.1
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• pp.59-78
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• 2020

The Summary Handbook of Acupuncture and Moxibustion (鍼灸要覽) (SHAM) was written by an unknown folk healer who learned acupuncture about 100 years ago in Korea. The book discusses 79 acupoints and includes a table of contents, a text, and a pair of acupoint charts. The acupoints in the book are classed under two headings, 49 acupoints of 14 meridians and 33 acupoints. A number of the acupoints such as Gichoong (氣忠), Eumheobong (陰虛峰), Goowa (口卧), Cheonryang (天良) did not fit the then existing meridian system and were newly uncovered by the authors. The book also discusses needle insertion depth in a way that is quite different from how insertion depth is understood by clinicians today. Books such as SHAM that record new acupoints and treatments are rare among Korea's existing medical and clinical books and can be said to be very important in terms of medical history.

• Journal of Acupuncture Research
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• v.25 no.4
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• pp.11-29
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• 2008

Objectives : The purpose of this study was to observe the effects of acupuncture and electro-acupuncture at $LI_4$ on intestinal motility in rat. Methods : We made over-activated state of intestinal motility with carbachol and suppressed state of intestinal motility with loperamide in rat and carried out needle retention acupuncture, low frequency electro-acupuncture and high frequency electro-acupuncture at $LI_4$ or sham point in rat devided into pre-treatment group and post-treatment group. and we resulted as follow for measuring charcoal travel rate to observe intestinal motility. Results : 1. Any of needle retention acupuncture, low frequency electro-acupuncture and high frequency electro-acupuncture at $LI_4$ have no significant influences on intestinal motility of rat in normal state. 2. All of the pre-treatment and post-treatment of needle retention acupuncture, low frequency electro-acupuncture and high frequency electro-acupuncture didn't significantly decrease intestinal motility in rat which over-activated with carbachol. 3. Pre-treatment of needle retention acupuncture and high frequency electro-acupuncture significantly increased intestinal motility in rat which suppressed with loperamide. 4. Post-treatment of needle retention acupuncture, low frequency electro-acupuncture and high frequency electro-acupuncture significantly increased intestinal motility in rat which suppressed with loperamide. Conclusions : These results suggest that acupuncture on $LI_4$ have preventive effect and therapeutic effect on suppressed intestinal motility, and especially high frequency electro-acupuncture is more effective.

• Journal of Acupuncture Research
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• v.26 no.2
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• pp.79-89
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• 2009

Objectives : The aim of this study was to observe the effect of acupuncture and high frequency electroacupuncture at $ST_{39}$ on intestinal motility in rats. Methods: We made over-activated state of intestinal motility with carbachol and suppressed state of intestinal motility with loperamide in rat and carried out needle retention acupuncture and high frequency electroacupuncture at $ST_{39}$ or sham point in rat divided into pre-treatment group and post-treatment group. We fed charcoal to them after the treatment and measured the travel rate of charcoal in the gastrointestinal tract to observe intestinal motility. Results : Examining intestinal motility of normal rat treated with needle retention acupuncture at $ST_{39}$ significantly suppressed intestinal motility. Pre-treatment of needle retention acupuncture significantly suppressed intestinal motility in rat which over-activated with carbachol. Pre-treatment and post-treatment of high frequency electroacupuncture significantly suppressed intestinal motility in rat which over-activated with carbachol. All of the pre-treatment and post-treatment of needle retention acupuncture, high frequency electroacupuncture showed no significant effect than control group on intestinal motility of rat which was suppressed with loperamide. Conclusions : These results suggest that acupuncture and high frequency electroacupuncture at $ST_{39}$ have preventive and therapeutic effects on over-activated intestinal motility, and high frequency electroacupuncture is more effective.

• Journal of Acupuncture Research
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• v.33 no.1
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• pp.9-21
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• 2016

Objectives : The aim of this study was to investigate the effect of low frequency electro-acupuncture at ST39 on intestinal motility in rats. Methods : Intestinal hypermotility and hypomotility in rats were induced by oral carbachol ingestion and loperamide injection. Rats were divided into seventeen experimental groups including the normal and holder groups. The rats were induced with intestinal hypermotility and hypomotility and divided into pre and post-treatment groups. I also carried out acupuncture (needle retention) and low frequency electro-acupuncture at ST39 or the sham point. I fed charcoal to rats after the treatment and calculated its distance travelled in the gastrointestinal tract, which was compared by groups so as to determine which treatment was more effective in increasing or decreasing intestinal motility. Results : 1. In normal rats, low frequency electro-acupuncture at ST39 showed no significant effect on intestinal motility. 2. Pre-treatment with acupuncture (needle retention) at ST39 on intestinal motility over-activated with carbachol significantly decreased intestinal motility in rats. 3. Pre-treatment with low frequency electro-acupuncture at ST39 on intestinal motility over-activated with carbachol significantly decreased intestinal motility in rats. 4. Pre-treatment with acupuncture (needle retention and low frequency electro-acupuncture) at ST39 showed no significant effect on intestinal hypomotility in rats that was induced by loperamide injection. Conclusions : These results suggest that acupuncture (needle retention) and low frequency electro-acupuncture at ST39 have preventive effects on intestinal hypermotility. Regardless of the stimulation method, ST39 showed an effect on intestinal motility. Further study is required to confirm other effects of ST39.