A new study in China that pitted traditional acupuncture to a more intensive form of the treatment revealed that patients suffering from facial paralysis experienced much better improvements in terms of facial muscle function.
The conductors of the study discovered that by wiggling the acupuncture needles to generate a sensation named “de qi”, the patient had a better chance of getting back full facial function within half a year than if the needles were just stuck in the skin and left alone without being manipulated.
The study was performed in Wuhan, Hubei at the Key Laboratory of Neurological Diseases of Chinese Ministry of Education. The head of the research Dr. Wei Wang stated that de qi should always be included or at least taken into account in acupuncture therapy guidelines.
However, since the study did not consider how well the patients would have improvements in their condition without the help of acupuncture, there was no way to tell whether no therapy at all or Western conventional therapies would work less than, be equal to, or be superior to acupuncture treatment.
De qi is seen by traditional Chinese medicine (TCM) practitioners to posses great therapeutic value said Dr. Wang. In TCM, de qi is a collection of feelings that includes tingling, warmth, coolness, and achiness and is a sign that the acupuncture treatment works.
Unfortunately, no scientific study has ever confirmed this ancient belief, added Dr. Wang.
To determine if de qi possesses real value in acupuncture therapy, Wang and his team experimented on 317 volunteers who were all suffering from Bell’s palsy. These patients had to undergo acupuncture treatments for four weeks five 30-minute treatments each week.
Bell’s palsy is a condition in which one side of the face becomes paralyzed, usually temporarily, for a few months. This is usually caused by a viral infection resulting in facial nerve inflammation. Western medicine commonly prescribes the steroid prednisone as treatment for Bell’s palsy. Other Western modes of treatment include physical therapy, vitamins, and over-the-counter painkillers.
Based on statistics provided by the National Institute of Neurological Disorders and Stroke, the United States has around 40,000 cases of Bell’s palsy each year. The study concentrated on this condition as facial nerve recovery due to Bell’s palsy is not likely to respond to the placebo effect as would the pain and other nerve symptoms related to Bell’s.
Random treatments were given to half of the patients and they (the treatments) were meant to generate de qi. To experience de qi , the needles were moved up and down and twisted several times during the treatment. The other patients were not treated this way and once the needles were inserted into their skin, they were left alone. Prednisone was given to all the patients.
The neurologists in the study were responsible for measuring the facial function score of the patients. The neurologists weren’t aware what type of treatment each patient received. The facial function score had a maximum score of 200, the higher the score the better the facial movement.
Initially, both groups registered facial function scores of around 130 – 135. But six months after, the patients who were given de qi experienced superior facial function than the other group. These functions included baring teeth, blinking, and raising eyebrows.
The group not given de qi treatment registered an average facial function score of 186 while the de qi group averaged an impressive 195. The study said it was hard to interpret just what those statistics meant in relation to muscle performance (i.e., whether a person can or cannot fully smile) but when the difference in score is nine points, the difference would be very obvious to the patients.
Moreover, 94% of the patients who were given de qi treatment fully got back their facial function after six months compared to only 77% in the non-de qi group. There is no clear consensus as to how de qi acupuncture treatment in particular, and standard acupuncture treatment, in general improves the symptoms of Bell’s palsy.
One explanation was given by Dr. Jian Kong, a Harvard Medical School and Massachusetts General Hospital assistant professor. He said that when the needles are inserted in the face, they helped boost the flow of blood into the area. As a result, the facial nerves were adequately nourished which helped relieve the inflammation and made recovery much faster.
Although not a member of the study team, Dr. Kong agreed with the team that de qi is often overlooked and should be an integral factor in all future acupuncture studies.
Kong added that the many schools of thought about acupuncture, with some placing emphasis on de qi than others is one reason why de qi is not always considered in the plan of treatment of a patient.
De qi is also difficult to quantify, subjective, and complex. A lot of the outcomes of clinical studies are not interested in measuring de qi sensation so this sensation is ignored most of the time, said Kong.
This may explain why many studies have yielded contrasting outcomes- some showing a benefit and other times not, said Dr. Wang. This is one fundamental flaw in the clinical studies involving acupuncture treatment. By not factoring in de qi stimulation, the effect of acupuncture can be severely undermined, he added.
Kong believes that including standard de qi measurement, in acupuncture studies will lead to a level of uniformity across studies. This will help determine the effect of this sensation in the results of the clinical studies, he added.