Needle Sensation and Personality Factors Influence Therapeutic Effect of Acupuncture for Treating Bell＇s Palsy： A Secondary Analysis of a Multicenter Randomized Controlled Trial

Background： It has not been solved what kind of needle sensation might influence outcomes of acupuncture treatment. Effects of personality factors on the therapeutic effect of acupuncture have not been investigated. This study aimed to find the effects of the traits of personality on the objective outcome when different acupuncture techniques were used in treating patients with Bell＇s palsy. Methods： We performed a secondary analysis of a prospective multicenter randomized controlled trial of acupuncture for Bell＇s palsy. Patients were randomly assigned to the de qi and control groups, respectively. The primary outcome was facial nerve function at month 6. The intensity of each needle sensation was rated by a visual analog scale. Psychosocial thctors were assessed by the pretreatment mediator questionnaire： 16 Personality Factor Questionnaire （16PF） was used tbr assessing personality factors and digit cancellation test for assessing attention. Results： After 6 months, patients in the de qi group had better facial function （adjusted odds ratio [OR]： 4.16, 95% confidence interval [CI]： 2.23-7.78）. Path analysis showed that intensity of needle sensation of fullness had direct effect on House-Brackmann （HB） score at month 6. In de qi group, the low HB score on day I （OR： 0.13, 95% （_7： 0.03-0.45） and the low Social Boldness score （OR： 0.63, 95% CI： 0.41-0.97） in 16PF were associated with better facial function. In control group, low HB score on day 1 （OR： 0.25, 95% CI： 0.13-0.50）, low Vigilance score （OR： 0.66, 95% CI： 0.50-0.88）, and high Tension score （OR： 1.41,95% CI： 1.12 1.77） in 16PF were related to better facial function. Conclusions： The needle sensation of fullness could predict better facial function and personality traits might influence outcomes of acupuncture treatment. Both of them should be considered seriously in acupuncture treatment and research.

Introduction of two novel devices for investigating the influence of non-mechanical components such as therapeutic qi in acupuncture

OBJECTIVE： Acupuncture is a complex intervention consisting of specific and non-specific components. Acupuncture studies more frequently focus on collecting data from the patients＇ perspective and response, but the acupuncturist＇s role remains relatively unclear. In order to investigate potential non-mechanical active factors originating from the acupuncturist and transmitted to the patient during treatment, two novel devices for basic research in acupuncture were designed. The Acuplicator allows the researcher to insert needles without touching the needles themselves, while the Veliusator locks the needle in its place so that no mechanical movement can be transferred. METHODS： The Acuplicator was used to insert needles at Neiguan （PC6） on the right forearm of 23 volunteers. The insertion depth was measured using a depth gauge. The transfer of mechanical movements from the handle to the tip was detected with a precision length gauge with a motoric-tactile sensor. RESULTS： The mean insertion depth was （12.3 ± 1.5） mm （range 9.5 to 15.0 mm）. Even with intense manipulation of the needle handle, no movements within ± 1 μm could be detected at the tip when the needle was locked. CONCLUSION： With these two devices it will be possible to investigate the influence of non- mechanical components such as therapeutic qi in acupuncture.

Effects of Three Needling Manipulations of Zusanli(ST 36) on Deqi Sensations and Surface Myoelectricity in Healthy Participants

Objective:To investigate the effects of different acupuncture manipulations on Deqi sensations and surface myoelectricity,and explore the correlation between Deqi sensations and needling manipulations.Methods:Forty-five healthy participants accepted twirling,lifting-thrusting,and twirling plus lifting-thrusting manipulanions at right Zusanli(ST 36),respectively.The acupuncturist’s and participants’Deqi sensations were collected by MGH Acupuncture Sensation Scale(MASS).The intensity and occurrence rate of soreness,dull pain,pressure,heaviness,fullness,numbness,sharp pain,warmth,coolness,and throbbing feelings of participants,and tightness,smooth,and tangle feelings of acupuncturist were measured.The correlation between the acupuncturist’s and participant’s Deqi sensations was analyzed.Surface electromyogram(EMG)was recorded before,during and after needling in 30 participants.The integrated EMG(iEMG),mean power frequency(MPF)and media frequency(MF)were analyzed.Result:Both fullness and soreness of participants and tightness of acupuncturist were the most frequently occurred ones.A positive correlation between participants’fullness and acupuncturist’s tightness was observed during the three aforementioned needling manipulations(P<0.05,OR>1).Almost all the needling sensations measured in the present study could be induced by the three needling manipulations.However,strength of Deqi sensations was exhibited as lifting-thrusting>twirling plus lifting-thrusting>twirling according to MASS index.The i EMG values were increased and MPF,MF values were decreased during needling compaired to those before needling,especially during lifting-thrusting(P<0.01).Conclusions:The intensity and occurrence rate of the different Deqi sensations induced by different needling manipulations were basically similar.The fullness and soreness were both the most frequently induced Deqi sensations.The strongest Deqi sensation could be induced by lifting-thrusting manipulation.There is a positive correlation between participants’fullness and acupuncturist’s tightness during the three needling manipulations.The myoelectricity around the acupoint is related to Deqi responses.(Registration No.AMCTR-IOR-20000314).

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.