Immediate analgesic effect of needling acupoints(bilateral De Qi vs unilateral De Qi)on primary dysmenorrhea:a multi-center,randomized,controlled trail

OBJECTIVE: To analyze the effect of needling acupoints(bilateral vs unilateral) with De Qi using data collected from 501 primary dysmenorrhea(PD) patients participating in multi-center, randomized,controlled trail.METHODS: De Qi was defined as at least one of the feelings in soreness, numbness, fullness or heaviness at the acupoints when stimulated with needles. The 501 patients were grouped in 3 groups in terms of De Qi or not De Qi in one side(unilateral)or both sides(bilateral) of the body: bilateral De Qi group, unilateral De Qi group, and non-De Qi group. The abdominal pains were measured using visual analog scale(VAS).RESULTS: In 501 patients, 472 acquired De Qi at unilateral acupoints, 24 De Qi at bilateral acupoint,and 5 had no De Qi at any acupoint. The data of non-De Qi group was excluded as the sample was less than 5% of that in the bilateral De Qi group.There was significant difference in the VAS before and after treatment between unilateral and bilateral De Qi group(P < 0.01). After stratified by acupoints, for the patients needled at Sanyinjiao(SP 6)and Xuanzhong(GB 39), VAS scores in the bilateral De Qi group were larger than those in the unilateral De Qi group(P < 0.05).CONCLUSION: Bilateral De Qi was possibly superior to unilateral De Qi in enhancing the immediate analgesic effect of needling the acupoints, but no statistical significance was observed on the pa-tients of needling at non acupoint, which preliminarily suggested this immediate analgesic effect was perhaps along meridians.

A review of the methods used for subjective evaluation of De Qi

De Qi refers to a series of sensations experienced when acupuncture is performed at acupoints. De Qi comprises needling sensations felt by the patient, and the sensations perceived by the acupuncturist. Classical Traditional Chinese Medicine theory states that De Qi is closely related to curative effect.In modern studies, the main index that researchers have used to evaluate De Qi was the needling sensation reported by the patient. Between 1 st Aug and 31 st Oct 2014, we conducted an electronic database search of all fields in Chinese and English to select literature assessing acupuncture needle sensations. We then reviewed the methods used within these studies to evaluate De Qi. The methods included simple evaluation, and the use of a De Qi scale/questionnaire. The simple evaluation, a qualitative evaluation, was judged by typical sensations felt by the patient after needling at acupoints, such as soreness, numbness, fullness, and heaviness.This method was easy and practicable, and had been adopted widely by Chinese researchers. In contrast, the De Qi scale/questionnaire, a quantitative evaluation, had multiple compiling methods available for evaluating the intensity of De Qi. The standardization and objectification of the De Qi scale/questionnaire effectively improved the quality of studies on De Qi, thereby these scales/questionnaires have been acknowledged and applied by most researchers. The present review analyzed and compared the scales/questionnaires used to evaluate De Qi; furthermore, we provided suggestions for the development and improvement of these questionnaires through integration with classical De Qi theory.

Capillary blood flow in patients with dysmenorrhea treated with acupuncture

OBJECTIVE: To observe capillary blood flow at acupoints during acupuncture treatment of primary dysmenorrhea and gain new insights into its analgesic mechanism. METHODS: Patients with primary dysmenorrhea were enrolled and randomly assigned to a treatment or control group. Subjects' symptoms were differentiated into variousTraditional Chinese Medicine(TCM) syndromes and treated for 10 sessions with puncturing acupuncture or self-pressing right-hand Hegu(LI 4), adding other acupoints based on syndrome. Laser speckle was used to compare the change in the vasomotor amplitude and perfusion of the capillaries in Hegu(LI 4) before and during the treatment. Each subject was required to finish the period pain symptoms observation form, verbal rating scales, numerical rating scale, pain rating index, face rating scale, Zung self-rating depression scale, Zung self-rating anxiety scale, and numerical rating scale before and after treatments. RESULTS: After 10 sessions, the symptom scores, pain index(PI), and visual analog scale(VAS) decreased significantly in treatment group. The volume of blood flow in Hegu(LI 4) declined slightly. No significant evidence supported that needling caused capillary contraction, but the capillary vasomotor amplitude at Hegu(LI 4) increased remarkably. CONCLUSION: Acupuncture can increase the capillary blood flow, thus promoting the flow of Qi and blood in terms of TCM theory, which facilitates pain relief.