Could acupuncture needle sensation be a predictor of analgesic response? Acupuncture in Medicine, 27, 65-67

Faculty of Health, Leeds Metropolitan University, Leeds, UK.
Acupuncture in Medicine (Impact Factor: 1.5). 07/2009; 27(2):65-7. DOI: 10.1136/aim.2008.000174
Source: PubMed


During acupuncture some patients experience distinct sensations which are often referred to as needle sensation. Needle sensation may be related to treatment outcome, although what constitutes adequate acupuncture needle sensation is not known. In this paper, we debate the possibility of using the self-report of the overall intensity of needle sensation as a predictor of analgesic outcome to acupuncture. We describe how our approach to establish criteria to determine adequacy of transcutaneous electrical nerve stimulation interventions in clinical trials has been used to inform our search for markers of adequacy of procedural technique for acupuncture. We describe previous research which has focused on developing tools to capture the nature of the descriptors used by patients when they self-report needle sensation and reveal that little attention has been given to its role in outcome. We demonstrate that needle sensation is a complex phenomenon with subjects using multiple descriptors to report their experience. We argue that the intensity of the overall experience of needle sensation may prove useful as a gross marker of the adequacy of acupuncture. We briefly describe our research which isolates individual components of needling technique, such as depth of needle penetration and bidirectional needle rotation, in order to assess their contribution to overall needle sensation intensity.

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    • "Therefore, the intensity of needling in most present acupuncture studies might not be enough for achieving therapeutic effects. It may help some confounders to have biased findings toward a negative outcome [15, 16]. These views support that Deqi is a key to the treatment efficacy. "
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    ABSTRACT: Although it is difficult in fully clarifying its mechanisms and effects, Deqi still can be considered as an instant "sign" of acupuncture response of the patient and acupuncturist, which has a significant value in clinic and research. This paper aims to take a history trace to the development of Deqi theory, understand the connotation of Deqi based on Chinese medicine theory, and establish an evaluation methodology accordingly. We believe that Deqi is not only the needling sensation, but also the perception of changes of qi (') flowing of the patient elicited by needling on acupoints. The signs of Deqi include the patient's subjective perception (needling sensation), the objective physiological changes (common referred to the skin redness around the acupoints and the response of brain), and the acupuncturists' perception. Although Deqi is essential for attaining the effect, it may not be the necessary sign of the ideal efficacy. It is found that the characteristics of Deqi sensations, Deqi's intensity, time duration, and the propagation will all affect the efficacy. Thus, acupuncturists should pay attention to elicit and control Deqi state, which is also the key point in modern research on the therapeutic implications of Deqi.
    Evidence-based Complementary and Alternative Medicine 11/2013; 2013:639302. DOI:10.1155/2013/639302 · 1.88 Impact Factor
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    • "It is described as a sensory perception of varying character and is mostly ascribed to metal needle acupuncture. The importance of Deqi has been investigated on the modern biological and medical framework in recent years [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14]. Such work was started a couple of years ago by Kou et al. [15]. "
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    ABSTRACT: Acupuncture as an essential component of complementary and alternative medicine is gradually recognized and accepted by the mainstream of contemporary medicine. For obtaining preferable clinical effectiveness, Deqi is commonly regarded as efficacy predictor and parameter which is necessary to be achieved. Influential factors for acupuncture efficacy, like Deqi sensation as well as propagated sensation along channels (PSCs), enjoyed a long history in acupuncture basic research. Concerning this study, taking into account different positions on acupuncture Deqi sensation and PSCs, we would like to attest whether different body positions for subjects during needling procedure yield differed acupuncture Deqi sensation, particularly in terms of intensity, and PSCs. Methods. We used self-controlled method and selected 30 healthy subjects to perform needle insertion at Futu point (ST32) bilaterally. Then they were instructed to record the value of intensity of acupuncture sensation and the length and width of PSCs after removing the needle. Results. In regard to intensity of Deqi, kneeling seat position is stronger than supine position, accounting for 90% of the total number of subjects. In length of PSCs, kneeling seat position is greater than supine position, accounting for 56.7%. In width of PSCs, kneeling seat position is greater than supine position, accounting for 66.7%. Conclusion. Our findings show that needle inserting at Futu point (ST32) in kneeling seat position achieve better needle sensation and provide reference for clinical.
    Evidence-based Complementary and Alternative Medicine 10/2013; 2013:897048. DOI:10.1155/2013/897048 · 1.88 Impact Factor
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    • "De Qi is believed to be essential to the therapeutic effectiveness of acupuncture and is often used as a signal to acupuncturists that the proper amount of needle stimulation is being performed [4–8]. It is also proposed that the patient's response (De Qi) served as a basis for “dose” of acupuncture needling, which calls for a better understanding of both the qualitative and quantitative characterization of the De Qi sensation [9, 10]. One recent report investigated the characteristics of the “De Qi” response in acupuncture at different acupoints (ST36, LI4, LV3) and its association with distinct nerve fibers, compared with the conventional somatosensory or noxious stimuli. "
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    ABSTRACT: Acupuncture has been widely used for treating stroke and De Qi may play an important role. In spite of its acceptance, the neural mechanism underlying acupuncture for motor recovery is still elusive. Particularly, by what extent De Qi sensations can reliably predict the therapeutical acupuncture effect on the mediating recovery from stroke is urgent to investigate. Nine stroke patients were assessed by De Qi, neurological examination, and scanned with acupuncture stimuli across two time points at an interval of two weeks. And we adopted multivariate Granger causality analysis to explore the interregional influences within motor executive brain network during post-acupuncture resting state. Our findings indicated that acupuncture at GB34 can enhance the recovery of stroke mainly by strengthening causal influences between the ipsilesional and contralesional motor cortex. Moreover, centrality of some motor-related regions correlated with clinical variables and thus served as a predictor of stroke recovery. Along the same line, the centrality of these motor-related regions has also high relations with the De Qi sensation. Our findings suggest that De Qi having relatively stable reliability may be essential and used as a predictor to the therapeutic effectiveness of acupuncture for stroke recovery.
    Evidence-based Complementary and Alternative Medicine 06/2013; 2013(3):197238. DOI:10.1155/2013/197238 · 1.88 Impact Factor
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