A Longitudinal Study of the Reliability of Acupuncture Deqi Sensations in Knee Osteoarthritis

Rosa B. Spaeth,Ajay D. Wasan,Mark Vangel,Javeria A. Hashmi,Randy L. Gollub,Stephanie Camhi,Robert R. Edwards,Jian Kong

doi:10.1155/2013/204259

Abstract

Deqi is one of the core concepts in acupuncture theory and encompasses a range of sensations. In this study, we used the MGH Acupuncture Sensation Scale (MASS) to measure and assess the reliability of the sensations evoked by acupuncture needle stimulation in a longitudinal clinical trial on knee osteoarthritis (OA) patients. The Knee injury and Osteoarthritis Outcome Score (KOOS) was used as the clinical outcome. Thirty OA patients were randomized into one of three groups (high dose, low dose, and sham acupuncture) for 4 weeks. We found that, compared with sham acupuncture, real acupuncture (combining high and low doses) produced significant improvement in knee pain (P = .025) and function in sport (P = .049). Intraclass correlation analysis showed that patients reliably rated 11 of the 12 acupuncture sensations listed on the MASS and that heaviness was rated most consistently. Overall perceived sensation (MASS Index) (P = .014), ratings of soreness (P = .002), and aching (P = .002) differed significantly across acupuncture groups. Compared to sham acupuncture, real acupuncture reliably evoked stronger deqi sensations and led to better clinical outcomes when measured in a chronic pain population. Our findings highlight the MASS as a useful tool for measuring deqi in acupuncture research.

Highlights

Deqi is a core concept in traditional Chinese acupuncture theory [1, 2] that describes the physiological link between the stimulation of acupuncture needles and the energy meridians running through the body [2,3,4,5]
One challenge in investigating these acupuncture sensations is that perception of deqi is subjective and the specific sensations associated with deqi may vary significantly both between and within individuals, which calls for the development of a systematic measurement of deqi sensation
We longitudinally investigated acupuncture treatment-evoked deqi sensations in a chronic pain population using the Massachusetts General Hospital (MGH) Acupuncture Sensation Scale (MASS) and explored the association between deqi sensations and changes in clinical outcomes related to knee pain

Summary

Introduction

Deqi (obtaining qi) is a core concept in traditional Chinese acupuncture theory [1, 2] that describes the physiological link between the stimulation of acupuncture needles and the energy meridians running through the body [2,3,4,5]. Traditional ancient acupuncturists believed that deqi was comprised of sensations and/or experiences of both the patient receiving the treatment and the acupuncturist administering the treatment [7,8,9]. Modern acupuncturists and researchers have emphasized the patient’s sensations rather than the acupuncturist’s experience during needling [10,11,12,13]. One challenge in investigating these acupuncture sensations is that perception of deqi is subjective and the specific sensations associated with deqi may vary significantly both between and within individuals, which calls for the development of a systematic measurement of deqi sensation. In recent years, investigators have started to use different scales to measure deqi sensation [2, 10,11,12,13,14,15,16] and have investigated the association between deqi sensation and therapeutic effects [13, 17, 18]

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Discussion

Conclusion