Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medical Center, 10098, Berlin, Germany,
Chin J Integr Med. 2011 Mar;17(3):166-72. doi: 10.1007/s11655-011-0662-x. Epub 2011 Feb 27.
Over the last few years a number of large acupuncture trials have been carried out in western countries. carried out in western countries. The following article draws on the experience from these recent large-scale trials on acupuncture to outline the way randomized trials could be used to answer questions on efficacy, effectiveness and efficiency. It will provide guidance, firstly on the underlying concepts of both efficacy and effectiveness and secondly on designing both types of trials. In addition, the controversy over specific and non-specific effects of acupuncture, emerging from the results of the above-mentioned trials, will be highlighted. Suggestions for future clinical research on acupuncture include: greater reflection on the complex approach of Chinese medicine, and transparent and detailed reporting according to CONSORT and STRICTA guidelines. The current data on acupuncture point-specific effects do indeed have relevance, however for valid decision-making on acupuncture, further clinical trials on effectiveness and cost-effectiveness are required to provide realistic benefit estimates for future health care.
在过去的几年中，许多西方国家都开展了大型针灸临床试验。本文借鉴了这些最新大型针灸试验的经验，概述了如何使用随机试验来回答疗效、有效性和效率方面的问题。它将首先提供关于疗效和有效性的基本概念的指导，其次是关于设计这两种类型的试验。此外，上述试验结果中出现的针灸的具体和非特异性效应的争议也将被强调。对未来针灸临床研究的建议包括：更多地思考中医药的复杂方法，并根据 CONSORT 和 STRICTA 指南进行透明和详细的报告。目前关于穴位特异性效应的数据确实具有相关性，然而，为了对针灸进行有效的决策，需要进一步进行有效性和成本效益的临床试验，为未来的医疗保健提供现实的效益估计。
