PT  - JOURNAL ARTICLE
AU  - Sha-bei Xu
AU  - Bo Huang
AU  - Chen-yan Zhang
AU  - Peng Du
AU  - Qi Yuan
AU  - Gui-juan Bi
AU  - Gui-bin Zhang
AU  - Min-jie Xie
AU  - Xiang Luo
AU  - Guang-ying Huang
AU  - Wei Wang
TI  - Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy: a randomized controlled trial
AID  - 10.1503/cmaj.121108
DP  - 2013 Apr 02
TA  - Canadian Medical Association Journal
PG  - 473--478
VI  - 185
IP  - 6
4099  - http://www.cmaj.ca/content/185/6/473.short
4100  - http://www.cmaj.ca/content/185/6/473.full
SO  - CMAJ2013 Apr 02; 185
AB  - Background: The traditional Chinese theory of acupuncture emphasizes that the intensity of acupuncture must reach a threshold to generate de qi, which is necessary to achieve the best therapeutic effect. De qi is an internal compound sensation of soreness, tingling, fullness, aching, cool, warmth and heaviness, and a radiating sensation at and around the acupoints. However, the notion that de qi must be achieved for maximum benefit has not been confirmed by modern scientific evidence.Methods: We performed a prospective multicentre randomized controlled trial involving patients with Bell palsy. Patients were randomly assigned to the de qi (n = 167) or control (n = 171) group. Both groups received acupuncture: in the de qi group, the needles were manipulated manually until de qi was reached, whereas in the control group, the needles were inserted without any manipulation. All patients received prednisone as a basic treatment. The primary outcome was facial nerve function at month 6. We also assessed disability and quality of life 6 months after randomization.Results: After 6 months, patients in the de qi group had better facial function (adjusted odds ratio [OR] 4.16, 95% confidence interval [CI] 2.23–7.78), better disability assessment (differences of least squares means 9.80, 95% CI 6.29–13.30) and better quality of life (differences of least squares means 29.86, 95% CI 22.33–37.38). Logistic regression analysis showed a positive effect of the de qi score on facial-nerve function (adjusted OR 1.07, 95% CI 1.04–1.09).Interpretation: Among patients with Bell palsy, acupuncture with strong stimulation that elicited de qi had a greater therapeutic effect, and stronger intensity of de qi was associated with the better therapeutic effects. Trial registration: Clinicaltrials.gov no. NCT00685789.See related editorial by Fletcher on page 459 and at www.cmaj.ca/lookup/doi/10.1503/cmaj.130319