Hu Ni-Juan, Liu Yu-Qi, Zhao Min-Yi, Wang Pei, Wu Gui-Wen, Hu Shang-Qing, Sun Jun-Jun, Wang Ya-Feng, Zhang Zhuang, Ma Liang-Xiao, Zhu Jiang
School of Acupuncture, Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China.
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China.
Evid Based Complement Alternat Med. 2019 May 16;2019:6462576. doi: 10.1155/2019/6462576. eCollection 2019.
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 . 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 , that a moderate deqi response predicted a prolonged analgesic effect better than a strong deqi response.
尽管得气(针刺时经络中经气激发的现象)对于针灸实践及其疗效至关重要,但人们对其了解甚少。因此,我们在一项针对原发性痛经(一种疼痛且常见的病症)患者的随机对照试验中,研究了得气感觉对针灸镇痛效果的影响。评估了两组:得气组(使用粗针深刺并进行手法操作,n = 17)和非得气组(使用细针浅刺且不进行手法操作,n = 51)。两组均针刺三阴交(SP6)30分钟。通过视觉模拟疼痛量表评估基线、拔针时以及拔针后10、20和30分钟时的疼痛评分。通过针刺得气临床评估量表评估得气感觉。选择有真实得气感觉的患者(n = 39)进行进一步分析。与非得气组中有得气感觉的患者(n = 25)相比,得气组中自我报告有得气感觉的患者(n = 14)得气感觉更强,更频繁地出现酸、胀感,酸、胀、麻、窜、放射感的强度更大,且窜感距离更大。在得气组中有得气感觉的患者中,感觉强度以及酸、胀程度与疼痛减轻呈负相关。在非得气组中有得气感觉的患者中,得气强度与疼痛减轻呈正相关,而酸痛与疼痛减轻呈负相关。两组中窜感距离与疼痛减轻均无相关性。我们发现,在针刺原发性痛经患者的三阴交时,适度的得气反应比强烈的得气反应更能预测更长时间的镇痛效果。