A Crossover Study on the Blinding Effect of a New Pragmatic Placebo Needle

Overview

Placebo needle is a useful tool to assess the efficacy of acupuncture. Investigators have applied a new kind of placebo needle in large scale acupuncture clinical trials, which named as pragmatic placebo needle. Compared with other placebo needles used in acupuncture trials, this pragmatic placebo needle shows several advantages: the outlook closer to traditional acupuncture needles, no restriction to needle depth of true needle, simple to manipulate and more economical. However, its blinding effect is not yet validated. The primary objective of this trial is to validate the blinding effect of the new pragmatic placebo needle; the secondary objective is to explore factors influencing the blinding effect of the placebo needles.

Full Title of Study: “Effect of Blinding With a New Pragmatic Placebo Needle: a Crossover Study”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Crossover Assignment
    • Primary Purpose: Other
    • Masking: Single (Participant)
  • Study Primary Completion Date: December 2013

Detailed Description

blinding refers to subject blinding

Interventions

  • Device: real needle- placebo needle
    • All acupoints were needled through the pad but just pressed against the skin without penetration by pragmatic placebo needle, while through the pad and into the skin 15 mm by real needle. For each intervention, LI4 and RN12 are needled first in a supine position for 15 minutes; BL36 and BL25 are needled secondly in a prone position for another 15 minutes. After withdrawal of the needle, participants were asked to give answers on perception of skin penetration, needle sensation and acupuncture pain. Acupuncture was given every other day, three sessions for one kind of needle, six sessions in total for each subject. There was a two-day interval between the applications of two kinds of needles.
  • Device: placebo needle – real needle
    • All acupoints were needled through the pad but just pressed against the skin without penetration by pragmatic placebo needle, while through the pad and into the skin 15 mm by real needle. For each intervention, LI4 and RN12 are needled first in a supine position for 15 minutes; BL36 and BL25 are needled secondly in a prone position for another 15 minutes. After withdrawal of the needle, participants were asked to give answers on perception of skin penetration, needle sensation and acupuncture pain. Acupuncture was given every other day, three sessions for one kind of needle, six sessions in total for each subject. There was a two-day interval between the applications of two kinds of needles.

Arms, Groups and Cohorts

  • Experimental: real needle- placebo needle
    • Participants received acupuncture with real needle in the first period, and with pragmatic placebo acupuncture needle in the second period.
  • Experimental: placebo needle – real needle
    • Participants received acupuncture with pragmatic placebo needle in the first period, and with real acupuncture needle in the second period.

Clinical Trial Outcome Measures

Primary Measures

  • Proportion of Volunteers’Perception of Needle Penetration Between the Pragmatic Placebo Needle and Real Needle.
    • Time Frame: in the third acupuncture session in each period
    • The primary outcome was the proportion of volunteers’perception of needle penetration between the placebo needle and the real needle in the third acupuncture session in each period. LI4, on the dorsum of the hand, between the first and second metacarpal bones, approximately in the center of the second metacarpal bone; RN12, on the upper abdomen,4 cun above the umbilicus,on the anterior midline; BL36, on the back of the thigh,on the midpoint of the inferior gluteal crease; BL25, on the loin, 1.5 cun lateral to the lower border of the spinous process of the fourth lumbar vertebra.

Secondary Measures

  • Southampton Needle Sensation Questionnaire-Type of Needle Sensation
    • Time Frame: in the third acupuncture session in each period
    • This questionnaire is used to collect the types and degree of needle sensation experienced by participants. Information is collected after the third acupuncture session in each period. The difference between two kinds of needles is to be analyzed.
  • Southampton Needle Sensation Questionnaire-Degree of Needle Sensation
    • Time Frame: in the third acupuncture session in each period
    • The degree of needle sensation between the placebo needle and the real needle were compared. The data of degree of needle sensation of the placebo needle included rows 1-4,i.e,, rows of “placebo needle:no”, “placebo needle: mild”, “placebo needle: moderate” and “placebo needle: severe”. The data of degree of needle sensation of the real needle included rows 5-8, i.e., rows of “real needle: no”, ‘real needle: mild”, “real needle: moderate”, and “real needle: severe”.
  • Degree of Acupuncture Pain
    • Time Frame: in the third acupuncture session in each period
    • The pain of acupuncture is assessed using visual analogue scale (VAS), where 0 means no pain, and 10 means the imaginable severest pain. The VAS value of each period is used to compare the difference of acupuncture pain between the placebo needle and the real needle. A lower value represented a better outcome, which indicated that needles used induced less pain.
  • Acceptability of the Acupuncture Needle
    • Time Frame: in the third acupuncture session in each period
    • After the third acupuncture of each period, participants are asked to show their acceptance toward the needles with a 5-point scale: very difficult to accept, a little difficult to accept, acceptable, easy to accept, very easy to accept. The needle acceptability between the placebo needle and real needle are compared. Data of the acceptability of the placebo needle included rows 1-5, i.e., rows of “placebo needle: very difficult to accept”, “placebo needle: a little difficult to accept”, “placebo needle: acceptable”, “placebo needle: easy to accept” and “placebo needle: very easy to accept”. Data of the acceptability of the real needle included rows 6-10, i.e., rows of “real needle: very difficult to accept”, “real needle: a little difficult to accept”, “real needle: acceptable”, “real needle: easy to accept” and “real needle: very easy to accept”.

Participating in This Clinical Trial

Inclusion Criteria

  • 18-74 years old; – with a basic capacity of listening, speaking, reading and writing in Chinese; – volunteer to join this research and sign the informed consent. Exclusion Criteria:

  • with acute or chronic pain; – taking analgesics or drugs inducing abnormal sensation; – with diseases of sensory disturbance or sensory loss; – with alcohol or drug abuse history; – serious cardiovascular, cerebral, hepatic, renal, hematopoietic, hemorrhagic or psychiatric diseases; – diabetes mellitus or dermatological disease; – women in pregnancy or lactation period; – cardiac pacemaker carrier, metal allergy or severe needle phobia.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 74 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Guang’anmen Hospital of China Academy of Chinese Medical Sciences
  • Provider of Information About this Clinical Study
    • Principal Investigator: Liu Zhishun, professor – Guang’anmen Hospital of China Academy of Chinese Medical Sciences
  • Overall Official(s)
    • Zhishun Liu, Study Director, Guang’an Men Hospotal Affiliated to China Academy of Chinese Medical Sciences

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