Oriental Medicine of Stroke & Neurological Disorders Center, East-West NEO Medical Center, Kyung Hee University, #149 Sangil-dong Gangdong-Gu, Seoul, Korea.
J Altern Complement Med. 2009 Dec;15(12):1275-83. doi: 10.1089/acm.2009.0181.
The objective of this study was to explore the type and frequency of short-term reactions, de qi associated with acupuncture treatment, and to determine the incidence of adverse events following acupuncture treatment in Korea.
This study is a retrospective and cross-sectional survey of patient reports using 1095 subjects; 585 subjects are outpatients of the East-West NEO Medical Center and the remaining 510 subjects are outpatients of the Kyung Hee Medical Center. In the period of June to November 2006, the participating subjects, who had all received acupuncture, consented and completed a single survey form. On this form, patients were asked to report their short-term reactions to the acupuncture, de qi, a patient satisfaction score (using the Visual Analogue Scale [VAS]) and any adverse events related to the acupuncture treatment. The 8 acupuncturists involved in this study were Korean medicine doctors who had more than 10 years' experience working as practitioners.
The average age of the 1095 subjects was 58 years old. Positive short-term acupuncture reactions were reported by 878 (80.2%) of the 1095 subjects. Seventy-five (75) (6.8%) subjects described negative short-term acupuncture reactions. The most common positive short-term acupuncture reaction was that of a "relaxed" feeling in 472 (43.1%), followed by 90 (8.2%) who acknowledged a feeling of "less pain"; 16 (1.5%) felt "energized"; 16 (1.5%) experienced "tingling" and a sensation of "Heat" or "Coldness" was reported by 10 (0.9%). Negative short-term acupuncture reactions included feelings of "pain" 37 (3.4%), tiredness 24 (2.2%), and dizziness 9 (0.8%). Traditionally, the needling sensations of de qi refer to a patient's response to treatment, such as distension, pulling, soreness, heaviness, and numbness. Some (39.7%) subjects reported de qi during needling. A number experienced "distension" 333 (30.4%), "soreness" 52(4.7%), "pulling" 22(2.0%), "heaviness" 18(1.6%), and "numbness" 10 (0.9%). Positive short-term acupuncture reactions and de qi ratings were highest in those less than 40 years of age (83/96 86.5%, 50/96 52.1%). No reaction responses to acupuncture were the highest frequency in subjects over 70 years of age (31/187, 16.6%). Patient satisfaction level using VAS was comparatively high: 72.9 +/- 19.9. The only adverse events reported were bleeding in 92 (8.4%) of the participants. The majority of patients treated with acupuncture had suffered from stroke (430; 16.9%), headache (185; 16.9%), hypertension (97; 8.9%), or dizziness (85; 7.8%).
Short-term acupuncture reactions and de qi were related to the age group. With the exception of bleeding, there were no adverse events related to the acupuncture treatment in this study. We consider acupuncture treatment to be very safe if the practitioners are well educated, trained and experienced. The number of post-treatment positive short-term acupuncture reactions was 12 times higher than that of the negative short-term reactions. Overall, subjects were comparatively satisfied with the acupuncture treatment.
本研究旨在探讨针刺治疗中的短期反应类型和频率、针下得气与针刺治疗的关系，并确定针刺治疗后的不良事件发生率。
本研究是一项回顾性和横断面调查，共纳入 1095 例患者，其中 585 例为东熙内医疗中心的门诊患者，其余 510 例为庆熙医疗中心的门诊患者。在 2006 年 6 月至 11 月期间，所有接受过针刺治疗的患者均同意并填写了一份单一的调查问卷。在这份问卷中，患者被要求报告他们对针刺的短期反应、针下得气、患者满意度评分（使用视觉模拟评分法[VAS]）以及与针刺治疗相关的任何不良事件。参与本研究的 8 名针灸师均为具有 10 年以上临床实践经验的韩医学博士。
1095 例患者的平均年龄为 58 岁。878 例（80.2%）患者报告了阳性短期针刺反应。75 例（6.8%）患者描述了阴性短期针刺反应。最常见的阳性短期针刺反应是“放松”感，有 472 例（43.1%）患者报告；其次是 90 例（8.2%）患者报告“疼痛减轻”；16 例（1.5%）患者感到“精力充沛”；16 例（1.5%）患者感到“刺痛”，10 例（0.9%）患者感到“热”或“冷”。负面的短期针刺反应包括疼痛 37 例（3.4%）、疲劳 24 例（2.2%）和头晕 9 例（0.8%）。传统上，针下得气是指患者对治疗的反应，如胀感、牵拉感、酸痛、沉重感和麻木感。一些（39.7%）患者在针刺过程中报告了针下得气。有 333 例（30.4%）患者报告有“胀感”，52 例（4.7%）患者报告有“酸痛”，22 例（2.0%）患者报告有“牵拉感”，18 例（1.6%）患者报告有“沉重感”，10 例（0.9%）患者报告有“麻木感”。年龄小于 40 岁的患者中，阳性短期针刺反应和针下得气评分最高（83/96，86.5%；50/96，52.1%）。70 岁以上患者对针刺无反应的频率最高（31/187，16.6%）。使用 VAS 的患者满意度水平相对较高，为 72.9 +/- 19.9。报告的唯一不良事件是 92 例（8.4%）患者出现出血。接受针刺治疗的患者中，大多数患有中风（430 例，16.9%）、头痛（185 例，16.9%）、高血压（97 例，8.9%）或头晕（85 例，7.8%）。
短期针刺反应和针下得气与年龄组有关。除出血外，本研究中针刺治疗无相关不良事件。如果针灸师接受过良好的教育、培训和经验，我们认为针灸治疗非常安全。治疗后阳性短期针刺反应的数量是阴性短期针刺反应的 12 倍。总体而言，患者对针刺治疗较为满意。
