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| Item | Detail |
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| (1) Acupuncture Rationale | (1a) Style of acupuncture |
| (i) MA and IA using PTN based on traditional meridian theory |
| (1b) Reasoning for treatment provided, based on historical context, literature sources, and/or consensus methods, with references where appropriate |
| (i) Partially individualized MA treatment and IA treatments based on the traditional meridian theory, clinical experience, and consensus by the experts in acupuncture and AD |
| (1c) Extent to which treatment was varied |
| MA: Partially individualized, that is, 6 fixed points plus optional points according to individual symptoms |
| IA: Fixed treatment |
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| (2) Details of Needling | (2a) Number of needle insertions per subject per session (mean and range where relevant)
MA: 6 to 19 body acupoints per participant per session
IA: 2 body acupoints and 1 auricular acupoint per participant per session
(2b) Names (or location if no standard name) of points used (uni/bilateral)
MA: |
| (i) fixed points: PC6, LI11, ST36 bilaterally |
| (ii) optional points: ST43, GB11, LI2, TE3, TE6, SI2, SI3, BL66, LR3, SP3 contralaterally (GB41, TE3, SI3 can be applied bilaterally according to the signs or symptoms of the patient) |
| IA: LI11 bilaterally and auricular shenmen contralaterally |
(2c) Depth of insertion, based on a specified unit of measurement or on a particular tissue level
MA: From 5 to 30 mm, perpendicular to skin surface
IA: 1.5 mm, perpendicular to skin surface
(2d) Response sought (e.g., de qi or muscle twitch response)
MA: “de qi” sensation
IA: None
(2e) Needle stimulation (e.g., manual, electrical)
MA: Manual stimulation, needle rotation with thumb and index fingers for the first 10-15 seconds
IA: Participants will be educated to press PTNS at LI11 for more than 3 minutes when they feel severe itching
(2f) Needle retention time
MA: 15 minutes
IA: 1-2 days until PTN falls off
(2g) Needle type (diameter, length, and manufacturer or material)
MA: A sterilized stainless steel needle (0.25 x 40 mm, Dongbang Acupuncture Inc., Bundang, Seongnam, Korea)
IA: A hypoallergic PTN (1.5 mm, 10 x 10 mm adhesive tape, Haeng Lim Seo Won Medical Co., Korea) |
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| (3) Treatment Regimen | (3a) Number of treatment sessions |
| (i) 8 sessions |
| (3b) Frequency and duration of treatment sessions |
| (i) Twice a week for 4 weeks, 15 minutes for each session |
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| (4) Other Components of Treatment | (4a) Details of other interventions administered to the acupuncture group (e.g. moxibustion, cupping, herbs, exercises, lifestyle advice) |
| (i) Lifestyle advice will be given to all participants |
| (ii) Any other interventions will be prohibited during study period |
| (4b) Settings and context of treatment, including instructions to practitioner and information and explanations to patients |
| (i) Participants will be informed about acupuncture treatment in the study as follows: “In this study, you will be randomly allocated to VA group or SA group. Acupoints will be selected based on traditional Korean medicine textbook and AD-related reports. Also, additional acupoints can be used according to individual conditions, if needed.” |
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| (5) Practitioner Background | (5) Description of participating acupuncturists (qualification or professional affiliation, years in acupuncture practice, other relevant experience) |
| (i) KMD who has clinical experience in Korean Medicine dermatology more than 2 years. The practitioner KMD will have undergone more than 10 hours of training and simulation workshop to ensure that he is able to provide identical acupuncture treatment in accordance with a predefined protocol. |
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| (6) Control and Comparator Interventions | (6a) Rationale for the control or comparator in the context of the research question, with sources that justify this choice |
| (i) A control group (SA) will be treated with sham acupuncture using Park sham acupuncture needles and nonpenetrating sham PTNs |
| (6b) Precise description of the control or comparator. If sham acupuncture or any other type of acupuncture-like control is used, provide details as for items (1) to (3) above |
| MA: Park sham acupuncture needles and devices will be used in same environment as in the VA group. However, fixed acupoints will be different: a point 1 to 2 cm proximal and 1 cm medial to LI7, a point 1 cm proximal and 1 cm medial to LI11, and a point 1 cm proximal and 1 cm lateral to ST36, each bilaterally |
| IA: Nonpenetrating sham PTNs, which were designed and validated for blinding for our study, will be used as a control in same environment as in the VA group. The same sized stainless steel rings without needles will be attached to three control points: a point 1 cm proximal and 1 cm medial to LI11, bilaterally, and finger point in the ear contralaterally. |
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