The Importance of De Qi In Acupuncture Treatment

A new Chinese study comparing standard acupuncture to a more intensive form of the treatment saw that the latter led to greater improvements in function for facial paralysis-stricken patients.

Scientists discovered that when the acupuncture needles are wiggled after being inserted into the skin, it generated a sensation known as “de qi” which gave the patient a better chance of getting back his/her full facial function within half a year than if the needles were left alone after being inserted into the skin.

Wuhan, Hubei, Key Laboratory of Neurological Diseases of Chinese Ministry of Education Dr, Wei Wang states that de qi “needs to be taken into consideration in acupuncture treatment clinical guidelines.”

The study failed to observe how well patients would have recovered without being given acupuncture, so there’s no way of telling whether the treatment worked any better than no therapy at all or Western conventional modalities.

Wang said that de qi can be a blend of feelings – including tingling, warmth, coolness, and achiness – which TCM or traditional Chinese medicine sees as a good sign that guarantees good therapeutic results.

Wang added that “although the belief about de qi has been held by TCM practitioners for thousands of years, it has not yet been confirmed by Western medicine.” He and his colleagues requested 317 adult Bell’s palsy patients to receive 30-minute acupuncture treatments for five days for a whole month to see whether de qi makes a difference to acupuncture therapy’s effectiveness.

Bell’s palsy usually lasts a few months and is a temporary facial paralysis that oftentimes affects side one of a person’s face. The condition is usually caused by a viral infection causing facial nerve inflammation. The most common treatment for it is the steroid prednisone. Also used for treatment are physical therapy, vitamins, and over-the-counter analgesics.

Based on statistics from the National Institute of Neurological Disorders and Stroke, about 40,000 people in the United States develop Bell’s palsy each year.

Since the recuperation of the facial nerves affected by Bell’s may seem not to be as susceptible to the placebo effect as pain and other nerve conditions, Wang and his group decided to focus on this condition.

Treatments that were meant to generate de qi were randomly assigned to half of the subjects. All the subjects were given prednisone. The treatment involved the twisting of the needles by the acupuncturist as well as moving the needles up and down many times during the procedure. The rest of the subjects were also treated with acupuncture without any manipulation of the needles while they were inserted into the subjects’ skin.

Neurologists measure the facial function score of the subjects on a scale of 200 with higher numbers corresponding to better movement. The neurologists were not told what type of treatment each subject was given.

Subjects In both groups started out with facial function scores around 130 – 135. Those in the de qi group showed improved facial function such as baring teeth, blinking, and raising the eyebrows after half a year of treatment. The acupuncture without de qi group scored 186, while the de qi group scored 195, on average.

Wang noted that it’s hard to know just what these numbers signify in terms of the performance of the facial muscles – say, whether the patient a person can fully smile or not – although a nine point difference can be readily noticeable to the subjects. Also, the researchers saw that 77% in the acupuncture group without de qi treatment showed complete facial function after six months, while 94% of the subjects given de qi treatment did. Despite acupuncture’s success, no one can explain how it is able to treat Bell’s palsy.

Massachusetts General Hospital and Harvard Medical School assistant professor Dr. Jian Kong explains that the acupuncture needles tend to boost the flow of blood in the face “therefore, doctors can provide more nutrition to the affected part and quickly lessen the inflammation in order for the person to recover. “

Like the researchers, Kong agreed that de qi is a key factor in acupuncture study, and unfortunately, it is usually ignored. Why is this so? Kong explained that clinical studies usually overlook de qi because acupuncturists practice different types of acupuncture with some giving greater importance on de qi than others.

De qi is also difficult to quantify, subjective and complex. Kong said that there are people who even think that, at times, the acupuncturist’s sensations may even be a stronger factor in generating de qi than the patient’s. He added that “a lot of clinical trials don’t measure de qi sensation so no one really knows how clinical results are connected to this sensation. The lack of testing standards when it comes to acupuncture treatment is perhaps the reason research has produced a mixed bag of results – sometimes not showing a benefit and other times producing one.” He said that “acupuncture’s effect can be significantly compromised when de qi is not elicited.”

Dr. Kong continued by saying that he and other researchers have been developing standard de qi scales in order to give uniformity across studies. He said that “we can hopefully, know hen, how de qi is related with the study’s results.”

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