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得气感无皮肤感觉输入:随机对照试验的结果。

Deqi sensations without cutaneous sensory input: results of an RCT.

机构信息

Multidisciplinary Pain Center, Department of Anesthesiology, University of Munich, Munich, Germany.

出版信息

BMC Complement Altern Med. 2010 Dec 28;10:81. doi: 10.1186/1472-6882-10-81.

Abstract

BACKGROUND

Deqi 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.

METHODS

A 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").

RESULTS

Both, 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.

CONCLUSIONS

Since 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.

摘要

背景

在针刺中,“得气”被定义为一种不同性质的感觉感知。在最近发表的一项假激光验证研究中,我们发现真激光组和假激光组的受试者都体验到了“得气”感觉。因此,我们旨在进一步分析两个研究组报告的感知是否可区分,以及期望效应是否对我们的结果产生了显著影响。

方法

从先前发表的一项假激光评估的安慰剂对照、双盲、临床交叉试验中收集的数据中,我们进行了一项关于“得气”感觉的详细重新分析。34 名健康志愿者(28±10.7 岁;16 名女性,18 名男性)以随机顺序分别接受了三次 LI4(合谷)、LU7(列缺)和 LR3(太冲)三个穴位的真激光和假设备(包含非活性激光)的两次激光针刺治疗。主要结局指标为治疗过程中感觉的频率、强度(用视觉模拟量表评估;VAS)和质量(用“针刺感觉量表”评估)。

结果

真激光和假激光针刺的感觉频率(p 值=0.67)、强度(p 值=0.71)和质量(p 值在 0.15-0.98 之间)均相似。在两组中,最常用来描述这些感觉的形容词是“扩散”、“辐射”、“刺痛”、“牵拉”、“脉动”、“温暖”、“迟钝”和“电击”。报告的感觉与文献中先前定义的“得气”感知一致。受试者对激光针刺有效性的信任程度或以前接受过针刺治疗的历史与报告的感觉频率或强度无关。

结论

由于“得气”感觉被描述为感觉感知,且没有任何皮肤感觉输入,我们假设它们是整体治疗过程中产生的非特异性效应的产物。由于先前的针刺经验和对激光针刺的信任而产生的期望效应似乎在诱发“得气”感觉方面并没有起到主要作用。我们的结果表明,“得气”可能是意识和知觉的一种核心现象,即使在临床试验中也应该考虑到它的相关性。然而,需要进一步的研究来了解“得气”背后的机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c0b/3022896/ec86c44fa2e9/1472-6882-10-81-1.jpg

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