Influence of the Intensity, Components, and Spreading of the Deqi Sensation on the Analgesic Effect of SP6 Needling in Primary Dysmenorrhea Patients: A Secondary Analysis of a Randomised Controlled Trial.

Ni-Juan Hu,Shang-Qing Hu,Min-Yi Zhao,Zhuang Zhang,Gui-Wen Wu,Liang-Xiao Ma,Ya-Feng Wang,Pei Wang,Jun-Jun Sun,Yu-Qi Liu,Jiang Zhu

doi:10.1155/2019/6462576

Abstract

Although deqi, the phenomenon whereby excitation of Qi in the meridians occurs with needling, is critical to the practice of acupuncture and its efficacy, it is poorly understood. So we investigate the influence of the deqi sensation on the analgesic effects of acupuncture in patients who were enrolled in a randomised controlled trial for the treatment of patients with primary dysmenorrhea, a painful and common condition, and cold and dampness stagnation. Two groups were assessed: a deqi group (undergoing deep needling with thick needles and manipulation, n=17) and a non-deqi group (undergoing shallow needling with thin needles and no manipulation, n=51). The Sanyinjiao (SP6) was needled for 30 min in both groups. Pain scores at baseline, upon needle removal, and at 10, 20, and 30 min after needle removal were evaluated by the Visual Analogue Scale for pain. The deqi sensation was evaluated by the Acupuncture Deqi Clinical Assessment Scale. Patients who experienced a genuine deqi sensation (n=39) were selected for further analysis. Compared with patients in the non-deqi group who experienced deqi (n=25), patients who self-reported deqi in the deqi group (n=14) felt a stronger deqi sensation, experienced soreness and fullness more frequently, felt a greater intensity of soreness, fullness, electric sensation, spreading, and radiating, and experienced larger spreading distances. In those who experienced the deqi sensation in the deqi group, the intensity of the sensation, as well as their degree of soreness and fullness, was negatively correlated with pain reduction. In patients who experienced the deqi sensation in the non-deqi group, deqi intensity was positively correlated with pain reduction, while soreness was negatively correlated with pain reduction. The distance of spreading was not correlated with pain reduction in either group. We found, in SP6 needling of patients with primary dysmenorrhea with cold and dampness stagnation, that a moderate deqi response predicted a prolonged analgesic effect better than a strong deqi response.

Highlights

Dysmenorrhea is a common pelvic pain disorder [1]
Primary dysmenorrhea (PD) is a gynaecological disease with no identifiable pathology which has an adverse impact on the lives of many young women, such as school or work absenteeism [2, 3]
Previous research has found that acupuncture can achieve significant pain reduction and relief of primary dysmenorrhea when compared with no treatment, pharmacological treatment, or treatment with herbal medicine alone [5, 6]

Summary

Introduction

Dysmenorrhea is a common pelvic pain disorder [1]. Primary dysmenorrhea (PD) is a gynaecological disease with no identifiable pathology which has an adverse impact on the lives of many young women, such as school or work absenteeism [2, 3]. Evidence-Based Complementary and Alternative Medicine by inhibiting the production and release of prostaglandins. Side effects, such as headaches, dizziness, and drowsiness, can occur with long-term NSAID use [4]. Even when needling occurs only at SP6 in patients with PD, the resultant analgesic effect is considerable [9, 14, 15] This is especially evident among patients who have the traditional Chinese medicine (TCM) condition referred to as cold and dampness stagnation [16], a pattern/syndrome marked by cold and pain in the lower abdomen, dysmenorrhea or delayed periods with dark menstrual discharge, white tongue coating, and sunken tight pulse [17]. Needling of SP6 in PD patients activates the cortical and subcortical limbic systems and pain-related areas in the cerebellum [19]

Methods

Results

Conclusion