Xu Shulian, Song Weizhen, Guo Nianfong, Sun Changhua, Wu Zhenyun (Institute of Psychology, Academia Sinica)
The purpose of this paper is to review our research results during the period from 1974 to 1978, and on the basis of which to put forward some ideas about the role of psychological factors in acupuncture anaesthesia and acupuncture analgesia. The main results are as follows:
1. Among the factors we studied, the patients' emotional state when entering the operation room and the compound sensitivity of cutaneous sensation were best correlated with the effect of acupuncture anaesthesia. The study of the compound sensitivity of cutaneous sensations (106 patients for lung resection and 59 patients for brain resection under acupuncture anesthesia) showed an extremely high correlation between the compound sensitivity of touch and pain sensations and the effect of acupuncture anesthesia and the non-sensitives often had better effect.
2. Sometimes the characteristics of "time estimating" and "discriminative reaction" were correlated with the effect of acupuncture when the clinical conditions were relatively constant.
3. In the experiment on normal subjects in the study of the relationship between the mental readiness and the effect of acupuncture analgesia, it had been observed that the feelings of the subject was rather heavier, and the evoked G.S.R. was larger with the mental non-readiness group than with the other group, especially in the sensitives. But there was no significant difference between the non-sensitives. It seems that the explanation work before operation which our experiment tries to simulate may have some effect on acupuncture anaesthesia.
4. We performed 3 items of experiments in answering the question as to what role does suggestibility play in acupuncture anesthesia. The method of suggestion used is word induction together with amplitude indication on an osilloscope scale as the suggesting stimulus. (i) The patients undergoing lung resection under acupuncture anesthesia were as to whom no statistically significant correlation between suggestibility and acupunctural anesthesia effect has been found (P>0.1), but it appears that there are somewhat more suggestibles in the good effect group. (ii) In the experiment with normal adults as subject (Ss), in which the inhibitory changes of cerebral potentials evoked by painful stimulation during acupuncture were used as the index of the effect of acupuncture analgesia, it has been shown that most of the Ss (21/30) exhibit an inhibitory effect during the short period 2-3' of acupuncture. However, whether inhibitory influence existed or not, no relevance was found either to a person's suggestibility or to his trust in acupuncture analgesia. (iii) In another experiment also using normal adults as Ss. When stimulating the Sanyanglao point manually and after an induction period of 25-30', it had been observed that verbal reports of heavy pain had been very much reduced in number (with an average reduction of 67.8%). And the rate of inhibition of heavy pain showed strong correlation with the Opiate-like Substance (OLS) in Ss' blood after acupuncture, the more the Opiate-like Substance (OLS) the better the effect of analgesia. The rate of inhibition of heavy pain was also correlated with the amount of the blood histamin (HA) after the pain stimuli, Ss with the better effects often showed a smaller increase in the blood HA. After the acupuncture, the sensitivity of pain (d') was significantly decreased, while the response bias (Cx) was significantly increased, the verbal reports of heavy pain and moderate pain were markedly reduced in number, but all these changes were not correlated with the Ss' suggestibility. The result of the above experiments indicates that in acupuncture analgesia there is certain physiological mechanism as its physical basis, and the effect cannot be explained solely by psychological factors such as suggestion and the like.
5. It has been shown that the patients' overconcern about acupuncture and their trust in acupuncture do not significantly affect the acupuncture effect. But better effects are observed in patients less-concerned and more trusted in acupuncture.
From all the results above, it becomes evident that psychological factors, such as mental readiness and others, play a moderate role, but not a dominant one, in accupuncture anaesthesia.
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