Acupressure as a non-pharmacological treatment for neurological insult and stress reduction: Theory, mechanisms, and efficacy.

摘要

Acupressure is a form of complementary and alternative medicine (CAM) that involves stimulation of acupoints using fingertip pressure. Acupoints are areas of skin designated as such by Traditional Chinese Medicine, with stimulation thought to elicit distinct effects from stimulation of non-acupoints. As such, the studies in this thesis compare effects of active acupressure treatments (with stimulation of acupoints) to those of placebo acupressure treatments, which control for all aspects of active acupressure treatments, but stimulate non-acupoints rather than acupoints. Specifically, the effects of acupressure on cognitive function following traumatic brain injury (TBI) were investigated, as well as the efficacy of acupressure for stress reduction in healthy college students. A series of eight acupressure treatments were found to improve cognitive function and reduce perceived stress over and above improvements seen following placebo acupressure in TBI survivors. The cognitive benefits seen could be a result of active acupressure-associated stress reduction, possibly mediated via the autonomic nervous system. No group differences in stress response reduction were found after a single administration of active acupressure, placebo acupressure or a relaxation CD in the stress study, possibly due to insufficient "dosing". As attitudes can contribute to placebo effects in both active and placebo interventions, the impact of attitudes towards CAM and conventional medicine on treatment outcome in both studies were assessed, to further delineate possible placebo effects. Although having less of an influence on outcome than hypothesized, attitudes towards both CAM and conventional medicine did affect a number of outcome measures, as well as measures at baseline and during the intervention itself, suggesting that attitudes towards CAM and conventional medicine should be taken into account both in clinical studies and regular clinical practice. These studies highlight the importance of rigorous scientific research of CAM therapies, incorporating randomization, blinding procedures, and appropriate control conditions.