Abstract
BackgroundDeqi is defined in relation to acupuncture needling as a sensory perception of varying character. In a recently published sham laser validation study, we found that subjects in the verum and the sham laser group experienced deqi sensations. Therefore, we aim to further analyze whether the perceptions reported in the two study arms were distinguishable and whether expectancy effects exhibited considerable impact on our results.MethodsA detailed re-analysis focusing on deqi sensations was performed from data collected in a previously published placebo-controlled, double-blind, clinical cross-over trial for a sham laser evaluation. Thirty-four healthy volunteers (28 ± 10.7 years; 16 women, 18 men) received two laser acupuncture treatments at three acupuncture points LI4 (hégu), LU7 (liéque), and LR3 (táichong); once by verum laser and once using a sham device containing an inactive laser in randomized order. Outcome measures were frequency, intensity (evaluated by visual analogue scale; VAS), and quality of the subjects' sensations perceived during treatments (assessed with the "acupuncture sensation scale").ResultsBoth, verum and the sham laser acupuncture result in similar deqi sensations with regard to frequency (p-value = 0.67), intensity (p-value = 0.71) and quality (p-values between 0.15 - 0.98). In both groups the most frequently used adjectives to describe these perceptions were "spreading", "radiating", "tingling", "tugging", "pulsing", "warm", "dull", and "electric". Sensations reported were consistent with the perception of deqi as previously defined in literature. Subjects' conviction regarding the effectiveness of laser acupuncture or the history of having received acupuncture treatments before did not correlate with the frequency or intensity of sensations reported.ConclusionsSince deqi sensations, described as sensory perceptions, were elicited without any cutaneous sensory input, we assume that they are a product of non-specific effects from the overall treatment procedure. Expectancy-effects due to previous acupuncture experience and belief in laser acupuncture do not seem to play a major role in elicitation of deqi sensations. Our results give hints that deqi might be a central phenomenon of awareness and consciousness, and that its relevance should be taken into account, even in clinical trials. However, further research is required to understand mechanisms underlying deqi.
Highlights
Deqi is defined in relation to acupuncture needling as a sensory perception of varying character
Differentiation of the laser devices In this more detailed data analysis, we found that the two study groups did neither differ in how often the laser device was identified correctly nor in how often the laser device was assumed to be active
When one looks at what happens during an acupuncture treatment - in our case during laser acupuncture - we find a unique physician patient interaction characterized by attention paid on the acupuncture point
Summary
Deqi is defined in relation to acupuncture needling as a sensory perception of varying character. Deqi is defined as a sensation that occurs during positioning of an acupuncture needle during treatment, which can be felt by the patient, the therapist, or both [1,2,3]. Later textbooks refer to patients’ sensations [3] According to both ancient Traditional Chinese and modern text books patients experience deqi very differently and refer to a feeling of soreness, numbness, distension or heaviness around the acupuncture point and/or along the meridians [6,7]. Acupuncturists’ perception of deqi has been described in terms of a slight pull of the needle downwards into the tissue [4]. The needle adhesion has been shown to be due to fasciae winding around the needle both by ultrasound in humans and microscopically in animal models [9]
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