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NTIS 바로가기大韓鍼灸學會誌= The journal of Korean Acupuncture & Moxibustion Society, v.28 no.5, 2011년, pp.29 - 38
장진영 (경희대학교 강남경희한방병원 침구과) , 김소정 (경희대학교 강남경희한방병원 침구과) , 김남식 (경희대학교 강남경희한방병원 침구과) , 남상수 (경희대학교 강남경희한방병원 침구과) , 김용석 (경희대학교 강남경희한방병원 침구과)
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 ...
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핵심어 | 질문 | 논문에서 추출한 답변 |
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거짓침의 대조군으로 진행한 임상연구들의 결과를 볼 때 침치료가 효과적이라는 긍정적인 연구 결과와 부정적인 연구 결과는 무엇이 있는가? | 그런데 거짓침을 대조군으로 진행한 임상연구들의 결과를 보면 침치료가 효과적이라는 긍정적인 연구결과도 있지만 대체로 거짓침과 유의한 차이가 없다는 부정적인 연구결과도 보고되었다. 의료분야의 객관적이고 양질의 연구근거를 종합해 체계적 고찰을 통해 근거를 제공하고 있는 Cochrane review를 비롯한 대부분의 메타분석에서 침치료는 특정효과가 없는 플라시보 효과라고 결론내리거나 질 높은 연구들이 아직까지 많지 않기 때문에 명확한 결론을 내릴 수 없다고 보고하였다. 그러나 침치료의 임상적 효과는 기존치료에 비해 우월한 경우가 많고 심지어 거짓침도 기존치료에 비해 좋은 효과를 나타내고 있으므로 거짓침이 플라시보 대조군으로서 적절한지에 대한 의문이 제기되어 왔다. 또한 거짓침이 생리적 활성이 있을 것으로 추측하는 보고도 있어왔다3). | |
침치료는 어떤 치료방식인가? | 치료효과에 대한 기대감, 환자와 의사와의 믿음, 긴밀한 신뢰관계 등 현대 임상연구에서는 플라시보 효과로 보는 요소들을 침치료의한 부분으로 보는 것이다. 즉 침치료는 득기와 다양한 자극법 및 보사법을 이용한 물리적 측면과 위와 같은 정신적인 측면을 동시에 포함하는 복합적인 치료방식이다. 이와 관련해서 IBS 환자를 대상으로 시행한 플라시보 효과에 대한 연구47)에서 흥미로운 결과를 보여주었다. | |
거짓침은 무엇을 만족해야 하는가? | 1998년 Streitberger부터 2001년 Fink에 이르기까지 피부를 뚫지 않는 형태의 거짓침 도구가 개발되었으며 이에 대한 타당도 연구도 함께 진행되었다. 거짓침은 두 가지 조건을 만족해야 하는데 첫 번째는 피험자에게 눈가림이 가능해야 하고, 두 번째는 생리적 활성이 없어야 한다2). 현재까지 눈가림에 대해서는 많은 타당성 검증이 이루어지고 있으나, 생리적 활성에 대해서는 득기를 확인하는 것 외에는 검증이 이루어지지 않고 있다. |
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