靈氣療法對成人疼痛和焦慮的影響：對效應大小計算的隨機試驗的深入文獻綜述。

Effect of Reiki therapy on pain and anxiety in adults: an in-depth literature review of randomized trials with effect size calculations. 
靈氣療法對成人疼痛和焦慮的影響：對效應大小計算的隨機試驗的深入文獻綜述。 

Thrane S1, Cohen SM2. Author information 1University of Pittsburgh School of Nursing, Research in Cancer Survivorship, Pittsburgh, Pennsylvania. Electronic address: sut11@pitt.edu. 
匹茲堡大學護理學院. 癌症倖存者研究，匹茲堡，賓夕法尼亞州。 電子地址 sut11@pitt.edu. 2University of Pittsburgh School of Nursing, Research in Cancer Survivorship, Pittsburgh, Pennsylvania. 匹茲堡大學護理學院 癌症倖存者研究，匹茲堡，賓夕法尼亞州 

Abstract The objective of this study was to calculate the effect of Reiki therapy for pain and anxiety in randomized clinical trials. A systematic search of PubMed, ProQuest, Cochrane, PsychInfo, CINAHL, Web of Science, Global Health, and Medline databases was conducted using the search terms pain, anxiety, and Reiki. The Center for Reiki Research also was examined for articles. Studies that used randomization and a control or usual care group, used Reiki therapy in one arm of the study, were published in 2000 or later in peer-reviewed journals in English, and measured pain or anxiety were included. After removing duplicates, 49 articles were examined and 12 articles received full review. Seven studies met the inclusion criteria: four articles studied cancer patients, one examined post-surgical patients, and two analyzed community dwelling older adults. Effect sizes were calculated for all studies using Cohen's d statistic. Effect sizes for within group differences ranged from d = 0.24 for decrease in anxiety in women undergoing breast biopsy to d = 2.08 for decreased pain in community dwelling adults. The between group differences ranged from d = 0.32 for decrease of pain in a Reiki versus rest intervention for cancer patients to d = 4.5 for decrease in pain in community dwelling adults. Although the number of studies is limited, based on the size Cohen's d statistics calculated in this review, there is evidence to suggest that Reiki therapy may be effective for pain and anxiety. Continued research using Reiki therapy with larger sample sizes, consistently randomized groups, and standardized treatment protocols is recommended. 

摘要 本研究的目的是在隨機臨床試驗中計算靈氣療法對疼痛和焦慮的效果。PubMed，ProQuest，Cochrane， PsychInfo，CINAHL，Web of Science，Global Health 和 Medline 數據庫是使用搜索術語 pain，anxiety 和 Reiki 進行的。靈氣研究中心也進行了文章審查。使用隨機化和對照組或常規護理組的研究，使 用靈氣療法在研究的一個臂，在 2000 年或以後出版在同行評審的英文期刊，包括測量的疼痛或焦 慮。刪除重複項目後，審查了 49 篇文章，12 篇文章得到全面審查。七項研究符合納入標準：四篇 文章研究癌症患者，一個檢查了手術後的患者，以及兩個分析的社區居住的老年人。使用 Cohen's 統計量計算所有研究的效應大小。在群體差異內的效應大小範圍從 d = 0.24（對於經歷乳房活檢的 婦女的焦慮減少）到 d = 2.08（對於社區居住成年人的減輕的疼痛）。組間差異範圍從 d = 0.32，將 Reiki 疼痛減輕與癌症患者休息干預 d = 4.5，減少社區居住成年人的疼痛。雖然研究的數量是有限 的，根據本次評估計算的 Cohen 統計的大小，有證據表明，靈氣療法可能對疼痛和焦慮有效。使 用更大樣本量的靈氣療法繼續研究，持續隨機分組，建議標準治療方案。 

Objective To calculate the effect of Reiki therapy for pain and anxiety in randomized clinical trials. 
目的 在隨機臨床試驗中計算靈氣療法治療疼痛和焦慮的效果 

Data Sources A systematic search of PubMed, ProQuest, Cochrane, PsychInfo, CINAHL, Web of Science, Global Health, and Medline databases was conducted using the search terms pain, anxiety, and Reiki. The Center for Reiki Research was also examined for articles. 數據源 系統搜索 PubMed, ProQuest, Cochrane, PsychInfo, CINAHL 
資料庫之檢索平台，全球健康和資料庫 數據庫使用搜索術語疼痛進行，使用搜索術語痛苦，焦慮和靈氣進行。靈氣研究中心也進行了審查 的文章。 Study 

Selection 研究選擇 
Studies that used randomization and a control or usual care group, used Reiki therapy in one arm of the study, published in 2000 or later in peer-reviewed journals in English, and measured pain or anxiety were included. 使用隨機化和對照組或常規護理組的研究，在研究的一個組中使用了靈氣療法， 出版於 2000 年或以後的英文同行評審雜誌，包括測量的疼痛或焦慮。 

Results After removing duplicates, 49 articles were examined and 12 articles received full review. Seven studies met the inclusion criteria: four articles studied cancer patients; one examined post-surgical patients; and two analyzed community dwelling older adults. Effect sizes were calculated for all studies using Cohen’s d statistic. Effect sizes for within group differences ranged from d=0.24 for decrease in anxiety in women undergoing breast biopsy to d=2.08 for decreased pain in community dwelling adults. The between group differences ranged from d=0.32 for decrease of pain in a Reiki versus rest intervention for cancer patients to d=4.5 for decrease in pain in community dwelling adults. 刪除重複之後，審查了 49 篇文章，12 篇文章得到全面審查，七項研究符合納入標準: 四篇文章研 究癌症患者，一個檢查手術後患者；和兩個分析社區居住老年人。使用 Cohen's d 統計量計算所有 研究的效應大小。組內差異的效應大小範圍從 d = 0.24，在接受乳房活檢的婦女中焦慮減少到社區 居住成年人疼痛減輕為 2.08 減少社區居住成年人的疼痛，組間差異範圍從 d = 0.32，為減少癌症患者的靈氣與休息的干預，至 d = 4.5，以減少社區居住成年人的疼痛。

 Conclusions While the number of studies is limited, based on the size Cohen’s d statistics calculated in this review, there is evidence to suggest that Reiki therapy may be effective for pain and anxiety. Continued research using Reiki therapy with larger sample sizes, consistently randomized groups, and standardized treatment protocols is recommended. 
結論 雖然研究的數量是有限的，基於這個評論中計算的 Cohen's 統計量，有證據表明，靈氣療法可能對 疼痛和焦慮有效，繼續研究使用，靈氣療法更大的樣本量，一貫隨機分組，並建議標準治療方案。 

Introduction 介紹 
The use of complementary and alternative medicine (CAM) techniques is growing in popularity with the public. CAM modalities are often either lauded or debunked in the popular press and the scientific community based on the evidence of one study. Reiki therapy, a form of biofield energy has been examined with community dwelling older adults, specific disease conditions such as cancer, chronic fatigue, diabetic neuropathy, surgical patients, and others. The objective of this review is to determine if Reiki therapy is effective for pain and anxiety in adults and to calculate the effect sizes for Reiki therapy in randomized clinical trials. Moreover, this review considers the use of Reiki therapy for pain and anxiety in adults and seeks to discover if Reiki therapy is effective for these conditions based on current evidence. 
補充和替代醫學（CAM）技術的使用越來越受到公眾的歡迎，在大眾媒體和科學界，CAM 模式往 往被稱讚或揭穿，基於一項研究的證據。靈氣療法，一種生物能量的形式已經與居住在老年人群體 的社區進行了審查，特定的疾病如癌症，慢性疲勞，糖尿病性神經病，手術患者等。本綜述的目的 是確定靈氣療法是否對成人的疼痛和焦慮有效，併計算隨機臨床試驗中靈氣療法的療效大小。此外， 本綜述考慮了使用靈氣療法治療成人的疼痛和焦慮，並根據目前的證據尋求發現靈氣療法是否對這 些情況有效。

 There is a lot of confusion around what Reiki therapy is. From a practical standpoint, Reiki therapy is a way for the practitioner to guide energy to the recipient, to assist the innate healing energy of the recipient and facilitate self-healing (National Center for Complementary and Alternative Medicine, 2012a). The practitioner does not cause the healing, nor are they the source of the energy. The practitioner is a channel for the energy, much like a garden hose is a channel for water. Many call this energy universal, but some say it is from God, Buddha, or a sacred source. A common interpretation for the word Reiki is spiritually guided life force energy (Rand, 2005). 
靈氣療法是什麼讓人困惑，從實際的角度來看，靈氣療法是一種練習者引導能量給接受者的方式， 協助接受者的固有的癒合能量並且促進自我修復(（國家補充和替代醫學中心，2012a），醫生不會 導致治療，從業者是能源的渠道很像一個花園軟管是一個水渠，許多人把這種能量稱為普遍的，但 有人說這是來自上帝，佛陀或神聖的來源。靈氣這個詞的共同解釋是精神上引導生命力的能量(德 蘭 2005).。 

There are several versions regarding the origins of Reiki therapy. It is generally accepted that Reiki therapy began with Dr. Mikau Usui, a spiritual seeker who undertook a 21 day penance and fast on Mount Kurama in Japan (Miles, 2008). Usui experienced the Reiki energy on the 21st day and was healed. He brought the technique to his family and subsequently opened a clinic in order to treat the public. Usui taught Reiki therapy level one to many people and taught several students the master/teacher level (Rand, 2005). Usui taught Reiki therapy as part of a spiritual practice, but not as a religion (Miles, 2008). As Reiki therapy evolved and came to the West, the hands-on healing practices came to the fore and the spirituality piece of the practice faded. There are three degrees or levels of Reiki practice. First degree practitioners are able to treat themselves or others through light touch (Miles & True, 2003). This level of Reiki is suitable for anyone from school aged children to the very old. Second degree Reiki expands practice to the use of distance healing: the practitioner may send Reiki energy to the next room or around the world (Rand, 2005). Third degree or master level Reiki expands Reiki practice to teaching and initiating others into Reiki and involves extensive practice. 
關於靈氣療法的起源有幾個版本，人們普遍認為，靈氣療法開始於日本 Mik 山博士，一位在日本 進行曠日苦苦修 21 天的精神追求者(Miles, 2008)，臼井在 21 日經歷了靈氣能量，並得到了治愈。 他把這項技術帶到了家裡，隨後開了一家診所來對待公眾。臼井教了靈氣療法水平一對多人，並教 幾個學生的主/教級（蘭德，2005 年）臼井教靈氣治療作為一個精神實踐的一部分，但不是一個宗 教（邁爾斯，2008 年）。當靈氣療法演變而來到西方時，動手治療實踐脫穎而出，實踐的靈性片斷 消失。靈氣練習有三度或三級。一級學員能夠通過輕觸來對待自己或他人（Miles＆True，2003）。 這個級別的靈氣適合從學齡兒童到老年人。第二度靈氣擴展練習使用距離癒合：從業者可能會發送 靈氣能量到下一個房間或世界各地（蘭德，2005 年）。三級或大師級靈氣擴大靈氣實踐教學，並啟 動他人進入靈氣，涉及廣泛的實踐。 

A typical Reiki therapy session may last from 30 to 90 minutes. Ideally, the recipient lies comfortably on a massage table fully clothed and the practitioner places their hands lightly on the body in a set sequence of hand positions. Most people leave a Reiki therapy session feeling very relaxed. A qualitative study found that during a Reiki treatment participants felt “dreamy,” “safe,” “secure,” and “more grounded” (Ring, 2009, p. 255). A study of nurses who use Reiki therapy for self-care found that the nurses used Reiki therapy during their workday to feel more calm, centered, and more able to care for others (Vitale, 2009). 典型的靈氣療法可持續 30 到 90 分鐘。理想情況下，收件人舒適地躺在按摩桌上，穿著整齊的衣服， 醫生將手輕輕地放在身體上，收件人舒適地躺在按摩桌上，穿著整齊的衣服，醫生按照一系列手的位置輕輕地將手放在身體上。大多數人離開靈氣治療會議感覺很輕鬆，一項定性研究發現，在靈氣 治療期間，參與者感覺“夢幻”，“安全”，“安全”和“更多接地”（Ring，2009，p。255）。 對使用靈氣療法進行自我護理的護士進行的一項研究發現，護士在工作日期間使用靈氣療法來感到 更加冷靜，集中，更能夠照顧他人（Vitale，2009）。 

The National Center for Complementary and Alternative Medicine (NCCAM) places Reiki therapy in the in the category of biofield energy. Biofield energy is any electrical or magnetic field produced by a biological organism, e.g. a human. The human body produces measurable electrical and magnetic fields. The heart produces an electrical field to regulate its beat: This electrical signal is measured through an electrocardiogram (ECG or EKG), a common medical test. The brain also produces an electrical field but at a much lower level than the heart. In fact, every cell in the human body produces minute amounts of electricity, a magnetic field, has a positive charge on the outer cell wall, and a negative charge on the inner cell wall (Dale, 2009). Electrical fields produce magnetic fields with a stronger electrical field producing a stronger magnetic field (Rae, 2005; Thomas, 2012). A magnetic resonance imaging (MRI) scan uses the body’s own magnetic field (along with a strong magnet and radio waves that are emitted from the machine) to produce sharp images of soft tissue within the body (Berger, 2002). Classic Newtonian physics experiments have shown how waves interact with each other: Depending on the pattern, some waves are enhanced and some are cancelled (Figure 1). The interference pattern between two human magnetic fields may explain some of the results that any touch therapy creates. Wave interference pattern. “A” and “B” are two people standing near each other. The black lines are peaks and the grey lines are troughs. The circles indicate areas where the two waves enhance one another (either higher ... 
國家補充和替代醫學中心（NCCAM）將靈氣療法納入生物能源範疇。 Biofield 能量是由生物有機 體產生的任何電場或磁場，例如，一個人。國家補充和替代醫學中心（NCCAM）將靈氣療法納入 生物能源範疇。 Biofield 能量是由生物有機體產生的任何電場或磁場，例如，一個人。人體產生 可測量的電場和磁場。心臟產生一個電場來調節它的節拍：該電信號通過心電圖（ECG 或 EKG） 測量，一個常見的醫學測試。大腦也產生電場，但比心臟低得多。事實上，人體內的每個細胞都會 產生微量的電力，一個磁場，在細胞外壁上有一個正電荷，在細胞內壁上有一個負電荷（Dale，2009）， 電場產生具有更強電場的磁場，產生更強的磁場（Rae，2005; Thomas，2012）。磁共振成像（MRI） 掃描利用人體自身的磁場（以及從機器發出的強大的磁體和無線電波）在人體內產生軟組織的清晰 圖像（Berger，2002）。經典的牛頓物理實驗已經顯示了波如何相互作用：根據模式，一些波被增 強，一些被取消（圖 1）。兩個人類磁場之間的干涉模式可能解釋了任何觸摸療法產生的一些結果。 科學實驗已經證明這種現像在一段時間內是真實的（Rae，2005）。人造生物磁能如靈氣療法和裝 置產生的電磁場治愈之間的相似性似乎很清楚。人類生物能量的測量表明人類生物磁能的存在。量 子粒子的行為與靈氣能量的相似性需要更多的研究，然而，重複的物理實驗與思想驅動的粒子與人 類生物場能量的測量相結合表明，靈氣能量可能由量子粒子組成，這可能導致經過驗證的靈氣療法 理論。 

The theory of quantum physics may hold promise in the future explanation of the mechanisms of Reiki. Although no verified theory exists that explains how Reiki therapy (or any biofield energy therapy) works, there may be a scientific explanation for Reiki therapy to be found in quantum physics, a branch of physics that was first discovered in the 1800’s and studies extremely small particles (electrons, photons, and the like) that do not behave in a predictable way. Quantum physics studies these particles and attempts to describe the interactions of energy and matter. Physicists have found that very tiny particles have some very curious properties: Not only can these tiny particles be in more than one place at once, some theorists say they have to be in more than one place at the same time (Rosenblum & Kuttner, 2006). The Nobel Prize in Physics for 2012 was won by two scientists who were each able to detect a particle being in two places at the same time (Nobelprize.org, 2012). Biofield energy may be gathered and directed by the practitioner to the recipient as explained by quantum physics, e.g., thought produces change in how the particles work (Rosenblum & Kuttner, 2006). Distance healing may be explained by energy particles being simultaneously present at the location and time of the Reiki practitioner and the location and time of the recipient through the intention of the Reiki practitioner. 
量子物理理論可能在未來對靈氣機制的解釋方面有希望。雖然沒有證實理論可以解釋靈氣療法（或 任何生物場能量療法）是如何工作的，量子物理學中可能會有一個科學的解釋，它是在 19 世紀首 次發現的物理學的一個分支，它研究的是非常小的粒子（電子，光子等），這些粒子的行為並不可 預測。量子物理研究這些粒子，試圖描述能量與物質的相互作用。物理學家發現，非常微小的粒子 有一些非常好奇的特性：這些微小的粒子不僅可以同時在一個以上的地方，一些理論家說他們必須 同時在一個以上的地方（Rosenblum＆Kuttner，2006）。距離癒合可以通過能量微粒同時出現在靈 氣醫師的位置和時間以及通過靈氣醫師的意圖的接收者的位置和時間來解釋。

 These particles by definition are difficult to measure but beginning in the 1960’s scientists began measuring the biomagnetic field coming from the human heart that is believed to extend beyond the body (see Figure 2). In the 1990’s Dr. John Zimmerman was able to measure a biomagnetic field coming from a healing practitioner’s hands (see Figure 3) with a device called a superconducting quantum interference device (SQUID). A few years later a Japanese team measured a biomagnetic field emanating from the hands of practitioners of yoga, meditation, Qigong and similar modalities (Oschman, 2000). These electromagnetic signal pulses varied from 0.3 to 30 Hertz (cycles per second). Device-generated pulsed electromagnetic fields (PEMF) have been effective for bone stimulation, stroke rehabilitation, decreased postoperative pain, and other applications (Abo et al., 2012; Heden & Pilla, 2008; Kondo et al., 2013). Transcutaneous electrical nerve stimulation (TENS) units are a well-known example of an adjustable pulsed electromagnetic field that is used to decrease chronic pain. Although it may be difficult to imagine tiny particles that react to human thought, scientific experiments have shown this phenomenon to be true for some time now (Rae, 2005). The similarities between human-generated biomagnetic energy such as Reiki therapy and device-generated electromagnetic fields for healing seem clear. The measurement of human biofield energy demonstrates the existence of human-generated biomagnetic energy. The similarities in the behavior of quantum particles and Reiki energy require more study, however repeated physics experiments with thought-driven particles united with the measurement of human biofield energy suggests that Reiki energy may consist of quantum particles that may lead to a validated theory of Reiki therapy.
這些粒子的定義很難測量，但是從二十世紀六十年代開始，科學家們開始測量來自人體心臟的生物 磁場，這個磁場被認為會延伸到身體之外（見圖 2）。 在二十世紀九十年代，John Zimmerman 博士用一種稱為超導量子乾涉儀（SQUID）的裝置測量了 一位來自修復醫生手中的生物磁場（見圖 3）。 在二十世紀九十年代，John Zimmerman 博士用一種稱為超導量子乾涉儀（SQUID）的裝置測量了 一位來自修復醫生手中的生物磁場（見圖 3）。 幾年後，日本的一個團隊測量了瑜伽，冥想，氣功和類似模式練習者手中的生物磁場（Oschman， 2000）。這些電磁信號脈衝從 0.3 到 30 赫茲（每秒週期）變化。 設備產生的脈衝電磁場（PEMF）對於骨刺激，中風康復，減少的術後疼痛和其他應用已經有效（Abo et al。，2012; Heden＆Pilla，2008; Kondo et al。，2013）。 經皮電神經刺激（TENS）單位是用於減少慢性疼痛的可調脈衝電磁場的眾所周知的例子。雖然可能 很難想像對人類思維有反應的微小粒子，科學實驗已經證明這種現像在一段時間內是真實的（Rae， 2005）。人造生物磁能如靈氣療法和裝置產生的電磁場治愈之間的相似性似乎很清楚。人類生物能 量的測量表明人類生物磁能的存在。量子粒子的行為與靈氣能量的相似性需要更多的研究，然而， 重複的物理實驗與思想驅動的粒子與人類生物場能量的測量相結合表明，靈氣能量可能由量子粒子 組成，這可能導致經過驗證的靈氣療法理論。 

The theory of quantum physics may hold promise in the future explanation of the mechanisms of Reiki. Although no verified theory exists that explains how Reiki therapy (or any biofield energy therapy) works, there may be a scientific explanation for Reiki therapy to be found in quantum physics, a branch of physics that was first discovered in the 1800’s and studies extremely small particles (electrons, photons, and the like) that do not behave in a predictable way. Quantum physics studies these particles and attempts to describe the interactions of energy and matter. Physicists have found that very tiny particles have some very curious properties: Not only can these tiny particles be in more than one place at once, some theorists say they have to be in more than one place at the same time (Rosenblum & Kuttner, 2006). The Nobel Prize in Physics for 2012 was won by two scientists who were each able to detect a particle being in two places at the same time (Nobelprize.org, 2012). Biofield energy may be gathered and directed by the practitioner to the recipient as explained by quantum physics, e.g., thought produces change in how the particles work (Rosenblum & Kuttner, 2006). Distance healing may be explained by energy particles being simultaneously present at the location and time of the Reiki practitioner and the location and time of the recipient through the intention of the Reiki practitioner. 
量子物理理論可能在未來對靈氣機制的解釋方面有希望。雖然沒有證實理論可以解釋靈氣療法（或 任何生物場能量療法）是如何工作的，量子物理學中可能會有一個科學的解釋，它是在 19 世紀首 次發現的物理學的一個分支，它研究的是非常小的粒子（電子，光子等），這些粒子的行為並不可 預測。量子物理研究這些粒子，試圖描述能量與物質的相互作用。物理學家發現，非常微小的粒子 有一些非常好奇的特性：這些微小的粒子不僅可以同時在一個以上的地方，一些理論家說他們必須 同時在一個以上的地方（Rosenblum＆Kuttner，2006）。距離癒合可以通過能量微粒同時出現在靈 氣醫師的位置和時間以及通過靈氣醫師的意圖的接收者的位置和時間來解釋。

 These particles by definition are difficult to measure but beginning in the 1960’s scientists began measuring the biomagnetic field coming from the human heart that is believed to extend beyond the body (see Figure 2). In the 1990’s Dr. John Zimmerman was able to measure a biomagnetic field coming from a healing practitioner’s hands (see Figure 3) with a device called a superconducting quantum interference device (SQUID). A few years later a Japanese team measured a biomagnetic field emanating from the hands of practitioners of yoga, meditation, Qigong and similar modalities (Oschman, 2000). These electromagnetic signal pulses varied from 0.3 to 30 Hertz (cycles per second). Device-generated pulsed electromagnetic fields (PEMF) have been effective for bone stimulation, stroke rehabilitation, decreased postoperative pain, and other applications (Abo et al., 2012; Heden & Pilla, 2008; Kondo et al., 2013). Transcutaneous electrical nerve stimulation (TENS) units are a well-known example of an adjustable pulsed electromagnetic field that is used to decrease chronic pain. Although it may be difficult to imagine tiny particles that react to human thought, scientific experiments have shown this phenomenon to be true for some time now (Rae, 2005). The similarities between human-generated biomagnetic energy such as Reiki therapy and device-generated electromagnetic fields for healing seem clear. The measurement of human biofield energy demonstrates the existence of human-generated biomagnetic energy. The similarities in the behavior of quantum particles and Reiki energy require more study, however repeated physics experiments with thought-driven particles united with the measurement of human biofield energy suggests that Reiki energy may consist of quantum particles that may lead to a validated theory of Reiki therapy. 
這些粒子的定義很難測量，但是從二十世紀六十年代開始，科學家們開始測量來自人體心臟的生物 磁場，這個磁場被認為會延伸到身體之外（見圖 2）。 在二十世紀九十年代，John Zimmerman 博士用一種稱為超導量子乾涉儀（SQUID）的裝置測量了 一位來自修復醫生手中的生物磁場（見圖 3）。 在二十世紀九十年代，John Zimmerman 博士用一種稱為超導量子乾涉儀（SQUID）的裝置測量了 一位來自修復醫生手中的生物磁場（見圖 3）。 幾年後，日本的一個團隊測量了瑜伽，冥想，氣功和類似模式練習者手中的生物磁場（Oschman， 2000）。這些電磁信號脈衝從 0.3 到 30 赫茲（每秒週期）變化。 設備產生的脈衝電磁場（PEMF）對於骨刺激，中風康復，減少的術後疼痛和其他應用已經有效（Abo et al。，2012; Heden＆Pilla，2008; Kondo et al。，2013）。經皮電神經刺激（TENS）單位是用於減少慢性疼痛的可調脈衝電磁場的眾所周知的例子。雖然可 能很難想像對人類思維有反應的微小粒子，科學實驗已經證明這種現像在一段時間內是真實的 （Rae，2005）。人造生物磁能如靈氣療法和裝置產生的電磁場治愈之間的相似性似乎很清楚。人 類生物能量的測量表明人類生物磁能的存在。量子粒子的行為與靈氣能量的相似性需要更多的研 究， 

Figure 2 Human biofield as it extends outside the body. Reprinted from Energy Medicine: The Scientific Basis, Oschman, J. L Polarity, therapeutic touch, magnet therapy, and related methods, p. 77, Copyright Elsevier Limited (2000), with permission from Elsevier ... Figure 3 Signal recorded from the hands of a therapeutic touch practitioner on the SQUID device. Reprinted from Energy Medicine: The Scientific Basis, Oschman, J. L. Polarity, therapeutic touch, magnet therapy, and related methods, p. 87, Copyright Elsevier Limited ... 
圖一波形干涉圖案。 “A”和“B”是兩個站在一起的人。黑線是峰值，灰線是谷值。圓圈表示兩個波互相 增強的區域（或者更高... 圖二 人體生物場，因為它延伸到身體之外。轉載自能源醫學：科學基礎，奧斯曼，J.L 極性，治療觸摸， 磁療和相關的方法，頁。 77，版權 Elsevier 有限公司（2000 年），經 Elsevier 許可... 圖三 在 SQUID 設備上從治療觸摸醫生的手中記錄的信號。轉載自能源醫學：科學基礎，奧斯曼，J.L. 極性，治療觸摸，磁療和相關的方法，p.87，Copyright Elsevier Limited ... 

Significance Pain is a very common symptom. Approximately 100 million Americans suffer from chronic pain (Institute of Medicine, 2011). Additionally, millions of people suffer from acute pain (pain that lasts for 6 months or less) such as people with cancer, trauma or surgical patients, and other everyday events such as a sprained ankle or a stubbed toe. Anxiety is a state that may accompany many of the conditions that cause pain such the diagnosis of a serious illness like cancer or heart disease. Very few high-quality studies have been done exploring Reiki therapy for pain and anxiety. Despite the lack of evidence, articles are published in peer reviewed journals giving anecdotal evidence for the effectiveness of Reiki therapy citing the few studies that have been published (Hurvitz, Leonard, Ayyangar, & Nelson, 2003; Rand, 2011). While there have been a total of four review articles published examining Reiki therapy in clinical trials (Jain & Mills, 2010; Lee, Pittler, & Ernst, 2008; vanderVaart, Gijsen, de Wildt, & Koren, 2009; Vitale, 2007), none have focused exclusively on pain and anxiety and none report effect sizes for study variables. 
意義 疼痛是一個非常常見的症狀。大約有 1 億美國人患有慢性疼痛（2011 年，醫學研究所）。此外， 數百萬人患有急性疼痛（疼痛持續 6 個月或更少），如患有癌症，創傷或手術病人的人，此外，數 百萬人患有急性疼痛（疼痛持續 6 個月或更少），如患有癌症，創傷或手術病人的人，和其他日 常事件，如扭傷的腳踝或腳趾。焦慮是一種可能伴隨許多導致疼痛的疾病的狀態，例如癌症或心髒 病等嚴重疾病的診斷。 很少有高質量的研究探索靈氣療法治療疼痛和焦慮。儘管缺乏證據，文章發表在同行評審的雜誌上， 引用少數已發表的研究（Hurvitz，Leonard，Ayyangar，＆amp; Nelson，2003; Rand，2011），為 靈氣療法的有效性提供軼事證據。 儘管在臨床試驗中發表了四篇綜述性文章（Jain＆Mills，2010; Lee，Pittler 和 Ernst，2008; vanderVaart， Gijsen，de Wildt，＆Koren，2009; Vitale，2007） 沒有人專注於疼痛和焦慮，沒有報告研究變量的效應量。 

Search Strategy and Inclusion Criteria A systematic search was conducted using PubMed, ProQuest, Cochrane, PsychInfo, CINAHL, Web of Science, Global Health, and Medline databases in addition to the Center for Reiki Research (The International Center for Reiki Training, 2012). The following keywords were used: pain, anxiety, and Reiki. The last search was run on April 4, 2012. After removing duplicates there were 49 articles: 17 review articles, 6 informational articles, 1 study that reported on the prevalence of CAM use that included Reiki, 6 qualitative studies, 1 dissertation, and 18 studies of any type, any year. Studies that include Reiki therapy as an intervention are scarce. To present the best evidence, articles were included in the review if they (a) used Reiki therapy as one arm of the study, (b) used randomization with a control or usual care group, (c) were published in peer-reviewed journals, (d) measured either pain or anxiety, (e) published in 2000 or later, and (e) were published in English. After evaluating the 18 studies against inclusion criteria, 12 studies remained for full review (see Figure 4). 
搜索策略和包含標準 搜索策略和包含標準，採用 PubMed，ProQuest，Cochrane，PsychInfo，CINAHL， Web of Science，Global Health 和 Medline 數據庫，以及靈氣研究中心（2012 年國際靈氣培訓中心）。 使用以下關鍵字：痛苦，焦慮和靈氣。最後一次搜索是在 2012 年 4 月 4 日進行的。刪除重複項目 後，共有 49 篇文章：17 篇評論文章，6 篇信息文章，1 篇關於 CAM 使用流行的研究，包括靈氣， 6 項定性研究，1 項研究報導了 CAM 使用的流行，包括靈氣，6 項定性研究，1 篇論文和 18 項任 何類型的研究，任何一年。 包括靈氣療法在內的研究很少。為了提供最好的證據，文章被納入評論，如果他們（a）使用靈氣 療法作為研究的一個手臂，（b）與對照或常規護理組一起使用隨機化，（c）在同行評審期刊上發 表，（d）測量疼痛或焦慮，和（e）以英文出版。在評估了 18 項針對納入標準的研究之後，仍有 12 項研究需要全面審查（見圖 4）。 

Method of Review and Data Extraction Each of the 12 studies selected for full text review was carefully evaluated by both authors against the inclusion criteria. 兩個作者對選擇的全部 12 個研究中的每一個都進行了仔細的評估 second used a convenience sample with no randomization or control (Birocco et al., 2011), a third used a semi-randomized patient preference design (Hulse, Stuart-Shor, & Russo, 2010), a fourth used a four-group design with a combination of Reiki and sham Reiki and no control (Assefi, Bogart, Goldberg, & Buchwald, 2008) and the fifth included a control group that was different from the stated design and the two experimental groups (Park, McCaffrey, Dunn, & Goodman, 2011). The remaining seven studies met the inclusion criteria for review as determined by both authors (Beard et al., 2011; Gillespie, Gillespie, & Stevens, 2007; Olson, Hanson, & Michaud, 2003; Potter, 2007; Richeson, Spross, Lutz, & Peng, 2010; Tsang, Carlson, & Olson, 2007; Vitale & O’Connor, 2006) (see Table 1). Table 1 Summary of Reiki studies Data were extracted from each study including: (a) sample population (disease process, gender, mean age, and race if available), (b) study design, (c) outcome measures for anxiety or pain or both and (d) statistical significance for within group and between group differences including p values, means, standard deviations, and z values for calculating Cohen’s d statistic for effect sizes. 
回顧和數據提取的方法 兩個作者對選擇的全部 12 個研究中的每一個都進行了仔細的評估，三分之一使用半隨機患者偏好 設計（Hulse，Stuart-Shor，＆Russo，2010），第四個使用了四組設計，結合了靈氣和假靈氣，沒 有控制（Assefi，Bogart，Goldberg，＆Buchwald，2008），第五個包括一個對照組，它與所述設 計和兩個實驗組不同（Park，McCaffrey，Dunn，＆Goodman，2011），其餘七項研究符合兩位作 者確定的納入標準(Beard et al., 2011; Gillespie, Gillespie, & Stevens, 2007; Olson, Hanson, & Michaud, 2003; Potter, 2007; Richeson, Spross, Lutz, & Peng, 2010; Tsang, Carlson, & Olson, 2007; Vitale & O’Connor, 2006) (see Table 1). 表一 靈氣研究綜述 數據從每項研究中提取，包括： （a）樣本人口（疾病過程，性別，平均年齡和種族，如果有的話），（b）研究設計，（C）焦慮 或疼痛的結果措施或兩者兼而有之，（d）組內和組間差異的統計學顯著性，包括用於計算效應大 小的 Cohen's d 統計量的 p 值，平均值，標準偏差和 z 值。 

Findings Sample sizes for the seven studies included in this review ranged from 16 to 160 participants (median = 24) for a total of 328 participants. There were 48% women and the mean age for the overall sample was 63 years old. Only two studies mentioned race. Beard et al. (2011) had 91% white participants but did not say how the remaining 9% of the participants identified themselves. Tsang et al. (2007) reported 75% white, 13% Asian, and 12% other participants. The seven studies (see Table 1) included in the review examined a variety of populations: three studied cancer patients (Beard et al., 2011; Olson et al., 2003; Tsang et al., 2007), two tested Reiki therapy in a surgical setting (Potter, 2007; Vitale & O’Connor, 2006), and two looked at Reiki therapy in adults living in the community (Gillespie et al., 2007; Richeson et al., 2010). The results from each individual study may be found in Table 2. Table 2 Summary of Results: Reiki therapy and control groups 
本研究納入的 7 項研究的樣本量為 16〜160 人（中位數= 24），總共 328 名參與者。有 48％的女 性，整體樣本的平均年齡為 63 歲。只有兩項研究提到種族。 納入研究的七項研究（見表 1）檢查了多種人群：三名研究過的癌症患者（Beard 等，2011; Olson 等，2003; Tsang 等，2007）; Beard et al. (2011)有 91％的白人參與者，但沒有說明剩餘的 9％的參 與者如何確定他們自己。Tsang 等人（2007 年）報告了白人 75％，亞洲 13％，其他參與者 12％。 每個研究的結果可以在表 2 中找到。 表二 結果總結：靈氣療法和對照組 

Study Design and Comparison Groups All studies in this review used randomization as specified in the inclusion criteria. Three studies used a two group design with the control group utilizing either usual care (Potter, 2007; Vitale & O’Connor, 2006) or wait list control (Richeson et al., 2010). Olson et al. (2003) used a rest period equal to the Reiki therapy intervention as the control group and Tsang et al. (2007) used a random crossover design. Two studies used a three group design. Beard et al. (2011) explored Reiki therapy as compared to Relaxation Response Therapy (RRT) and a wait list control while Gillespie, et al. (2007) explored Reiki and sham Reiki compared to usual care. In sham Reiki, an actor performs the same treatment sequence as the real Reiki practitioner, but with no Reiki energy. 
研究設計和比較組 本評價中的所有研究都採用了納入標準中規定的隨機分組。三項研究使用兩組設計與對照組一起使 用常規護理(Potter, 2007; Vitale & O’Connor, 2006) 或等待列表控制(Richeson et al., 2010). Olson et al. (2003)，採用與靈氣療法干預相當的休息期作為對照組，Tsang 等（2007 年）使用了一個隨機交 叉設計。兩項研究使用三組設計。Beard 等人（2011）探討了靈氣療法與放鬆反應療法（RRT）和 等候名單控制相比，而 Gillespie 等。（2007 年）探索靈氣和假靈氣比平常的照顧。在假靈氣，一 個演員執行相同的治療順序作為真正的靈氣練習者，但沒有靈氣能源。

Variables and Measures Three of the studies examined both pain and anxiety (Richeson et al., 2010; Tsang et al., 2007; Vitale & O’Connor, 2006). Two studies considered just pain (Gillespie et al., 2007; Olson et al., 2003) and two only evaluated anxiety (Beard et al., 2011; Potter, 2007). There were a variety of validated measures used. AnxietyThree studies chose the Spielberger State Anxiety Inventory (STAI) (Spielberger, Gorsch, Lushene, Vagg, & Jacobs, 1983) to measure anxiety (Beard et al., 2011; Potter, 2007; Vitale & O’Connor, 2006). The STAI scale was originally created to measure anxiety in adolescents with cancer but has been well validated in adults. Tsang et al. (2007) used the Edmonton Symptom Assessment System (ESAS) questionnaire (Chang, Hwang, & Feuerman, 2000) a validated nine symptom visual analog scale to measure anxiety. Potter also used the Hospital Anxiety and Depression Scale (HADS) (Zigmund & Snaith, 1983), because it recognizes anxiety in populations suffering from physical symptoms as a result of their disease. Richeson et al. (2010) used the HAM-A rating scale which exhibits high reliability and internal consistency (Cronbach’s alpha = .85, r=.23, p<.05) (Diefenbach et al., 2001). 
變量和度量 其中三項研究檢查了疼痛和焦慮（Richeson 等，2010; Tsang 等，2007; Vitale＆O'Connor，2006）。 兩項研究僅考慮疼痛（Gillespie 等，2007; Olson 等，2003），另外兩項研究僅評估了焦慮（Beard 等，2011; Potter，2007）。有各種經過驗證的措施。 焦慮三項研究選擇了斯皮爾伯格狀態焦慮量表（STAI）（Spielberger，Gorsch，Lushene，Vagg 和 Jacobs，1983）來衡量焦慮（Beard 等，2011; Potter，2007; Vitale＆O'Connor，2006）。STAI 量表 最初是為了測量患有癌症的青少年的焦慮而設計的，但在成年人中得到了很好的驗證。 Tsang 等 人（2007 年）使用埃德蒙頓症狀評估系統（ESAS）問卷(Chang, Hwang, & Feuerman, 2000) 驗證九 個症狀視覺模擬量表來衡量焦慮，波特還使用了醫院焦慮和抑鬱量表（HADS）（Zigmund＆Snaith， 1983），因為它承認由於疾病而患有身體症狀的人群的焦慮。 Richeson 等人（2010 年）使用 HAM-A 評分量表，該量表具有高可靠性和內部一致性（Cronbach'sα= .85，r = .23，p <.05）（Diefenbach et al。，2001）。 

PainTwo studies used an 11-point Visual Analog Scale (VAS) (Olson et al., 2003; Vitale & O’Connor, 2006) to measure pain. Olson also used an unspecified “Likert” scale to measure pain. Tsang et al. also employed the ESAS questionnaire mentioned above to evaluate pain. Gillespie et al. (2007) used The McGill Pain Questionnaire (Melzack, 1975) to evaluate pain in patients with painful diabetic neuropathy. Richeson et al. utilized the faces pain scale originally developed for children but has been shown to be effective in older adults as well (A. G. S. Panel on Persistent Pain in Older Persons, 2002). 
疼痛兩項研究使用 11 點視覺模擬量表（VAS）（Olson 等，2003; Vitale＆O'Connor，2006）來測量 疼痛。奧爾森還用一個不明的“李克特”量表來衡量疼痛。 Tsang 等人也採用上述 ESAS 問卷評 估疼痛。Gillespie 等人（2007）使用 McGill 疼痛問卷（Melzack，1975）評估疼痛性糖尿病神經病 變患者的疼痛。 Richeson 等人，利用了最初為兒童開發的面部疼痛量表，但也顯示在老年人中也 是有效的（A.G.S。老年人持續性疼痛小組，2002 年）。 

Outcomes and Effect Sizes All but one study included in this review achieved at least one statistically significant result on the outcome variables of interest for the Reiki therapy intervention. Effect sizes were calculated using standard equations and were measured using the Cohen’s dstatistic. Effect sizes for the Reiki therapy intervention ranged from small (d=.28) to very large (1.82). 
成果和影響規模 除了一項研究外，本次回顧中至少有一項關於靈氣療法干預的結局變量的統計學意義的結果。使用 標準方程計算效應大小，並使用 Cohen's dstatistic 進行測量。 

Effect sizes for the Reiki therapy intervention ranged from small (d=.28) to very large (1.82). Discussion Reiki therapy has been explored in a variety of populations including cancer patients, community dwelling adults, surgical patients and more.. The studies included in this review exhibit design flaws common to research involving complementary therapies. The most obvious difficulty is sample size. The median number of study participants was 24 (range of 16 to 160 participants). It is difficult to make generalizations to a population, even a limited one such as adults with cancer utilizing such small sample sizes. Moreover, acquiring these samples may take months to years. For example, Beard et al. took 22 months to recruit 54 subjects and Potter required 15 months to recruit 32 subjects. The length of recruitment time creates difficulties if a longitudinal design would be more appropriate. Olson et al. and another that did not meet the inclusion criteria had difficulty recruiting subjects and in fact took two years to recruit 24 adults because the subjects stated they would not participate unless they could be in the Reiki therapy group. Gillespie et al. also had to limit the control group due to high attrition. 
結論 靈氣療法已經在各種人群中被探索，包括癌症患者，社區居住成年人，手術患者和更多.. 納入本次 審查的研究表明，共同研究涉及補充療法的設計缺陷。最明顯的困難是樣本量。研究參與者的中位 數為 24（16 到 160 人參加），對一個人口進行概括是困難的，即使是有限的人群，例如使用如此 小的樣本量的癌症成年人。而且，獲取這些樣本可能需要幾個月到幾年時間。例如，Beard 等人花 了 22 個月的時間來招募 54 個科目，而波特則需要 15 個月來招募 32 個科目。如果縱向設計更合適， 招聘時間的長短會造成困難。奧爾森等。而另一個不符合納入標準的人招募受試者很困難，實際上 花費了兩年的時間招募了 24 名成年人，因為受試者聲稱他們不會參加，除非他們可能在靈氣療法 組。Gillespie 等人也由於高摩擦而限制了對照組。 

Length of intervention may have been problematic for some study outcomes. Although Olsen et al. was able to show a significant reduction in pain and a medium effect size for the Reiki treatment group (p=.035, d=.64) on day one and significant reduction in pain and a large effect size on day four (p=.002, d=.93), the intervention consisted of only two Reiki treatments four days apart. It seems possible that if the study had lasted several weeks they may have seen the decrease in medication usage that they were looking for. Another study that may have benefitted from a longer intervention time was Gillespie et al. when they examined Reiki therapy for reduction in pain in diabetic subjects with painful diabetic neuropathy (PDN). Although this was one of the longer interventions (12 weeks total), PDN is not an easy condition to treat and does not respond well to medications. While the intervention did achieve a statistically significant decrease in pain for the Reiki group (p=.002, d=.36), the effect sizes were not very different for the sham Reiki group (p=.039, d=.26) leading the authors to question the clinical significance. Possibly if the intervention had run 26 weeks or longer, the authors may have been able to detect a difference between the Reiki group and the sham Reiki group. 干預的時間長度對於一些研究結果可能是有問題的。儘管 Olsen 等人在第一天能夠顯示出靈氣治療 組顯著減少疼痛和中等效果的大小（p = .035，d = .64），並且在第四天顯著減少疼痛和大的效果 大小（p =。 002，d = .93），干預包括相隔四天的兩次靈氣療法。如果這項研究持續了幾個星期， 他們可能已經看到他們正在尋找的藥物使用減少。另一項可能受益於較長干預時間的研究是 Gillespie 等人。當他們審查了靈氣療法減輕疼痛糖尿病受試者疼痛糖尿病神經病變（PDN）。雖然 這是較長的干預措施之一（總共 12 週），但是 PDN 並不是治療的一個容易的條件，並且對藥物治 療反應不佳，儘管干預確實可以顯著降低 Reiki 組疼痛（p = 0.002，d = 0.36），但是，對於假靈氣 組（p = 0.039，d = .26），效應大小差異不大，導致作者質疑其臨床意義。可能如果乾預已經運行 了 26 週或更長時間，作者可能已經能夠檢測到靈氣組和假靈氣組之間的差異。 

Timing of interventions can also be important to success. For example in the Reiki therapy intervention for breast biopsy, the pre-biopsy intervention was given within seven days prior to the biopsy and the post-biopsy intervention was given within seven days post biopsy. The study author admitted that the timing was for subject convenience and that an intervention “within the clinical setting might more effectively mitigate a crisis response” (Potter, 2007, p. 246). In contrast, Vitale et al. timed the Reiki therapy intervention around abdominal hysterectomy in a way that makes more sense: just prior to surgery, then 24 and 48 hours post-surgery. This timing resulted in a significant decrease in both pain and medication usage. 
干預的時間對成功也很重要。例如在用於乳房活檢的靈氣療法干預中，活檢前 7 天內進行活檢前干 預，活檢後 7 天內進行活檢後乾預。研究作者承認，時機選擇是為了方便患者，“在臨床環境中進 行干預可能會更有效地減輕危機的反應”（Potter，2007，p。246）相反 Vitale 等人圍繞腹式子宮 切除術定時進行靈氣療法干預，使之更有意義：就在術前，術後 24 小時和 48 小時。這個時間導致 疼痛和藥物使用的顯著下降。 

Most studies included in this review used a standardized protocol of timing and hand positions. However, these protocols differed significantly from study to study. Reiki treatment times varied from 25 minutes in the diabetic neuropathy study (Gillespie et al., 2007) to 90 minutes in the Reiki therapy plus opioid use in cancer patients study (Olson et al., 2003). The average treatment length was 48 minutes. All but one study used a set protocol for treatment hand positions. Richeson et al. allowed the treatments to be patient specific rather than follow a particular hand placement and timing protocol, making it difficult to compare subjects to each other much less compare between studies. 
大多數研究納入本次審查使用時間和手位置的標準化協議。然而這些協議差異顯著，從研究。在糖 尿病神經病變研究中，靈氣治療時間從 25 分鐘變化（Gillespie et al。，2007）到 90 分鐘的 Reiki 療法加上阿片類藥物用於癌症患者的研究（Olson et al。，2003）。平均治療時間是 48 分鐘。除了 一項研究外，所有研究都使用了一套治療方案。 Richeson 等人允許治療是特定患者的，而不是遵 循特定的手部安置和時間協議，使得難以比較研究之間的對象相互比較。 

Suggestions for Future Research Based on the findings of this review it may be helpful if future Reiki therapy studies consider the following design strategies. First, in order to be able to conform to scientific research standards, a three arm design which includes a Reiki intervention, a sham Reiki intervention (placebo), and a non-intervention control group seems most effective. Having a sham Reiki group allows for investigators to take into account and control for the therapeutic effect of attention and potential effect of human interaction. It has been shown that any touch therapy, even a sham intervention produces an effect on subjects as demonstrated by several of the studies in this review. Reiki interventions need to show significantly better results than the sham group in order to overcome the “placebo effect.” It is suggested that effect sizes be calculated and reported in articles so that readers may understand and compare the effect of the interventions. Second, in order to combat the reluctance of subjects to participate in complementary research, a crossover design is suggested. In this way, control subjects know that they will receive the intervention either now, or in the near future. Studies that use a crossover design seem to have fewer issues with control groups (Post-White et al., 2009; Tsang et al., 2007). Third, a standardized protocol of intervention length and hand positions seems essential. It is difficult to compare subjects who have not utilized the same treatment protocol. Fourth, researchers need to consider whether Reiki therapy is appropriate for a particular condition, and what the optimal timing of the intervention may be. For example, the timing of the Reiki treatments used in the abdominal hysterectomy study (Vitale & O’Connor, 2006) consisting of immediately before surgery then 24 and 48 hours after surgery was well considered and makes sense. 
對未來研究的建議 根據這次審查的結果，如果將來的靈氣療法研究考慮以下設計策略可能會有所幫助。首先，為了能 夠符合科學研究標準，三臂設計包括靈氣乾預，假靈氣介入（安慰劑），而一個不干預的對照組似 乎是最有效的。具有假的靈氣組允許調查人員考慮和控制注意力的治療效果和人類互動的潛在影響。 已經表明，任何觸摸療法， 即使是一個假的干預產生的影響主題，由本研究中的幾個研究表明。為了克服“安慰劑效應”，靈 氣乾預需要顯示出比假手術組顯著更好的結果。建議在文章中計算和報告效應大小，以便讀者可以 理解和比較乾預措施的效果。第二，為了對抗科目參與互補性研究的不情願，提出了一種交叉設計。 這樣，控制主體知道現在他們會接受干預，或在不久的將來。使用交叉設計的研究似乎與對照組相 比較少（Post-White 等，2009; Tsang 等，2007）。第三，干預長度和手位置的標準化協議似乎是必 不可少的。比較沒有使用相同治療方案的受試者是困難的。第四， 研究人員需要考慮靈氣療法是否適合某一特定情況，以及乾預的最佳時機可能是什麼。例如，腹部 子宮切除術研究（Vitale＆O'Connor，2006）所使用的靈氣療法的時間安排在手術前 24 小時和術後 24 小時，這是很有意義的。

Another possible avenue of research would be to teach first degree Reiki to subjects and have them practice Reiki therapy as a self-healing strategy. This could be combined with weekly or periodic Reiki treatments by a Reiki therapy professional. The reasons for this suggestion are two-fold. First, a preliminary report using this method with an HIV population showed a decrease in pain and anxiety using self-Reiki (Miles, 2003). Second, when considering the study using Reiki versus RRT for men with prostate cancer, the RRT arm showed a larger decrease in anxiety (Beard et al., 2011). This may be because the men using RRT were encouraged to practice daily while the Reiki therapy intervention was only twice per week. It would be interesting to discover whether daily Reiki self-treatment would produce a larger decrease in pain or anxiety than a once or twice weekly session given by a Reiki therapy professional. 
另一個可能的研究途徑是教一級靈氣科目，讓他們練習靈氣療法作為一種自我修復的策略。這可以 與靈氣療法專家每週或定期的靈氣治療相結合。這個建議的原因是雙重的。第一，使用這種方法與 艾滋病毒人口的初步報告顯示疼痛和焦慮減少使用自我靈氣（邁爾斯，2003 年）。其次，當考慮使用靈氣與 RRT 治療男性前列腺癌的研究時，RRT 組表現出更大的焦慮減少（Beard et al。，2011）。 這可能是因為鼓勵使用 RRT 的人每天練習，而靈氣療法干預每週只有兩次。這可能是因為鼓勵使 用 RRT 的人每天練習，而靈氣療法干預每週只有兩次。發現每日靈氣療法自我療法是否會比靈氣 療法專家給予每週一次或兩次的疼痛或焦慮減少更有意義。 

Limitations Every effort was made to limit bias in study selection. Inclusion criteria were tight and strictly adhered to. Small sample sizes may contribute to some inflation of effect sizes. Only studies that used a reliable randomization scheme were included. There was no requirement on study use of validated measures although most studies included in this review did use validated measures. Only studies published in English were included and no gray literature such as dissertations or conference abstracts were included. Publication bias may of course account for some inflation of results. 限制 盡一切努力來限制學習選擇的偏見。納入標準嚴格並嚴格遵守。小樣本量可能會導致一些效應規模 的膨脹。小樣本量可能會導致一些效應規模的膨脹。只有使用可靠的隨機方案的研究被包括在內。 雖然大多數研究包括在本次審查中，但沒有要求使用經過驗證的措施。只有英文出版的研究被包括 在內，沒有包括論文或會議摘要在內的灰色文獻。發表偏見當然可以解釋一些結果的通貨膨脹。 

Conclusion There are very few high quality studies that explore the use of Reiki therapy for pain or anxiety. Because the number of studies is small, the interventions are dissimilar from each other, and the populations presented are so different, it is difficult to make generalizations or recommendations from these studies. Some of the dissimilarities included length of individual treatments which ranged from 30 to 90 minutes and populations varied from cancer to surgical to community dwelling adults. Design issues included small sample sizes, the timing of interventions in relation to the complaint, and the length of the intervention in relation to the issue being addressed such as painful diabetic neuropathy which is known to be difficult to treat. While it is often difficult to recruit subjects into non-drug related studies, more than one study specifically mentioned the difficulty of recruiting or keeping subjects in the non-Reiki control groups. 
限制 很少有高質量的研究探索使用靈氣療法治療疼痛或焦慮。由於研究的數量較少，干預措施各不相同， 呈現的人群差異較大，這些研究很難作出概括或推薦。一些不同之處包括個體治療的時間長度在 30-90 分鐘之間，並且人群從癌症到手術到社區居住成年人各不相同。設計問題包括樣本量較小， 與投訴有關的干預時機，以及與所涉及的問題有關的干預時間，例如已知難以治療的疼痛性糖尿病 神經病變。雖然將研究對象納入非藥物相關研究通常是困難的，但是多項研究特別提到了在非靈氣 對照組中招募或保持研究對象的困難。 

On the other hand, the majority of studies in this review did achieve statistical significance or near significance on the variable of interest; either pain or anxiety or both. Effect size calculations were performed using Cohen’s d which allows comparison of studies in a standardized way. Effect sizes for most of the studies in this review went from small to very large. Based on statistical significance, the strength of the effect sizes (see Table 1), and public interest in Reiki therapy as a non-invasive even comforting intervention, there is enough evidence to suggest continued research using Reiki therapy. Suggestions for study design and standardization of treatment protocol were proposed in order to increase the potential for positive outcomes in future research. 
另一方面，這次審查的大部分研究在利益變量上的確具有統計意義或接近顯著性; 無論是痛苦還是 焦慮，或者兩者皆有使用 Cohen's d 進行效應量計算，這允許以標準方式比較研究。本評價中大多 數研究的效應大小從小到大。基於統計學意義，效應量的強度（見表 1），以及公眾對於靈氣療法 的興趣作為一種無創甚至舒適的干預措施，有足夠的證據表明繼續使用靈氣療法進行研究。提出了 研究設計和治療方案標準化的建議，以增加未來研究的積極成果的潛力。

 Implications for Nursing Education, Practice, and Research Reiki therapy is a non-invasive, often comforting and relaxing intervention that is within nursing scope of practice in most states. Nurses may easily learn Reiki therapy and use this intervention with patients in day-to-day practice (Whelan & Wishnia, 2003). Additionally, Reiki therapy may be a good self-care tool as suggested by more than one study (Cuneo et al., 2011; Diaz-Rodriguez et al., 2011; Vitale, 2009). Based on this review, there is enough evidence to continue researching Reiki therapy as an intervention for pain and anxiety. Certainly more research is required in order to definitively recommend Reiki therapy as an intervention for decreased pain or anxiety. 
對護理教育，實踐和研究的啟示 靈氣療法是一種非侵入性的，往往是安慰和放鬆的干預，在大多數州的護理範圍內。護士可以很容 易地學習靈氣療法，並在日常練習中使用這種干預（Whelan＆Wishnia，2003）。另外，此外，靈 氣療法可能是一個不錯的自我保健工具，正如一項以上的研究所建議的（Cuneo 等，2011; Diaz-Rodriguez 等，2011; Vitale，2009）。在此基礎上，有足夠的證據繼續研究靈氣療法作為疼痛 和焦慮的干預。 當然需要更多的研究來明確推薦靈氣療法作為減輕疼痛或焦慮的干預措施。 

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References 參考文獻

黃惠玳譯 
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