Chinese Journal of Integrative Medicine

, Volume 18, Issue 1, pp 7–15 | Cite as

De-qi, not psychological factors, determines the therapeutic efficacy of acupuncture treatment for primary dysmenorrhea

  • Jin Xiong (熊 瑾)
  • Fang Liu (刘 芳)
  • Ming-min Zhang (张明敏)
  • Wei Wang (王 伟)
  • Guang-ying Huang (黄光英)
Original Article



To study the impact of De-qi (得气, obtaining qi) and psychological factors on the efficacy of acupuncture treatment for primary dysmenorrhea, with an attempt to explore the relationship among De-qi, psychological factors, and clinical efficacy.


The patients with primary dysmenorrhea were randomly assigned to a group of acupuncture with manual manipulation (manipulation group, n=67) and an acupuncture group without manipulation (non-manipulation group, n=64). Pain intensity and pain duration were used as measures for evaluating the therapeutic efficacy of the acupuncture treatment. De-qi, the sensations a patient experienced during the acupuncture treatment, was scored on a 4-point scale by the subjects. In addition, the psychological factors, including belief in acupuncture, the level of nervousness, anxiety, and depression, were quantitatively assessed. The personality of the subject was assessed using the Eysenck personality questionnaire (EPQ) and 16 personality factor questionnaire (16PF).


Complete data were obtained from 120 patients, 60 patients in each group. There were statistically significant differences in pain intensity (W=2410.0, P<0.01) and pain duration (W=3181.0, P<0.01) between the two groups. The number of De-qi acupoints (W=1150.5, P<0.01) and the average intensity of De-qi (W=1141.0, P<0.01) were significantly higher in the manipulation group as compared with their non-manipulation counterparts. The correlation coefficients between De-qi and therapeutic efficacy of acupuncture were greater than those between psychological factors and therapeutic efficacy.


Compared with the psychological factors, De-qi contributed more to the pain-relieving effect of acupuncture in subjects with primary dysmenorrhea. Moreover, manual manipulation is a prerequisite for eliciting and enhancing the De-qi sensations, and De-qi is critical for achieving therapeutic effects.


acupuncture De-qi psychological factors manual acupuncture needle manipulation therapeutic efficacy primary dysmenorrhea 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Witt CM, Jena S, Selim D, Brinkhaus B, Reinhold T, Wruck K, et al. Pragmatic randomized trial evaluating the clinical and economic effectiveness of acupuncture for chronic low back pain. Am J Epidemiol 2006;164:487–96.PubMedCrossRefGoogle Scholar
  2. 2.
    Witt C, Brinkhaus B, Jena S, Linde K, Streng A, Wagenpfeil S, et al. Acupuncture in patients with osteoarthritis of the knee: a randomized trial. Lancet 2005;366:136–143.PubMedCrossRefGoogle Scholar
  3. 3.
    Li Y, Liang FR, Yang XG, Tian XP, Yan J, Sun GJ, et al. Acupuncture for treating acute attacks of migraine: a randomized controlled trial. Headache 2009;49:805–816.PubMedCrossRefGoogle Scholar
  4. 4.
    Willich SN, Reinhold T, Selim D, Jena S, Brinkhaus B, Witt CM. Cost-effectiveness of acupuncture treatment in patients with chronic neck pain. Pain 2006;125:107–113.PubMedCrossRefGoogle Scholar
  5. 5.
    Nassim P, Assefi, Karen J, Sherman, Clemma J, Jack G, et al. A randomized clinical trial of acupuncture compared with sham acupuncture in fibromyalgia. Ann Intern Med 2005;143:10–19.Google Scholar
  6. 6.
    Klaus L, Andrea S, Susanne J, Andrea H, Benno B, Claudia W, et al. Acupuncture for patients with migraine: a randomized controlled trial. JAMA 2005;293:2118–2125.CrossRefGoogle Scholar
  7. 7.
    Klaus L, Claudia MW, Andrea S, Wolfgang W, Stefan W, Benno B, et al. The impact of patient expectations on outcomes in four randomized controlled trials of acupuncture in patients with chronic pain. Pain 2007;128:264–271.CrossRefGoogle Scholar
  8. 8.
    Vas J, Perea-Milla E, Mendez C, Sanchez Navarro C, Leon Rubio JM, Brioso M, et al. Efficacy and safety of acupuncture for chronic uncomplicated neck pain: a randomized controlled study. Pain 2006;126:245–255.PubMedCrossRefGoogle Scholar
  9. 9.
    Victor V, Carole R, Ashley C, Yvonne T. Anxiety as a factor influencing physiological effects of acupuncture. Complem Therap Clin Pract 2009;15:124–128.CrossRefGoogle Scholar
  10. 10.
    Karst M, Reinhard M, Thum P, Wiese B, Rollnik J, Fink M. Needle acupuncture in tension-type headache: a randomized placebo-controlled study. Cephalalgia 2001;21:637–642.PubMedCrossRefGoogle Scholar
  11. 11.
    Baischer W. Acupuncture in migraine: long-term outcome and predicting factors. Headache 1995;35:472–474.PubMedCrossRefGoogle Scholar
  12. 12.
    Sun GJ, ed. Acupuncture. 1st ed. Shanghai: Shanghai Science and Technology Press; 2000:169–170.Google Scholar
  13. 13.
    Vas J, Perea-Milla E, Me’ndez C, Sa’chez Navarro C, Leo’n Rubio JM, Brioso M, et al. Efficacy and safety of acupuncture for chronic uncomplicated: neck pain: a randomized controlled study. Pain 2006;126:245–255.PubMedCrossRefGoogle Scholar
  14. 14.
    Usichenko TI, Dinse M, Hermsen M, Witstruck T, Pavlovic D, Lehmann Ch. Auricular acupuncture for pain relief after total hip arthroplasty-a randomized controlled study. Pain 2005;114:320–327.PubMedCrossRefGoogle Scholar
  15. 15.
    Jubb RW, Tukmachi ES, Jones PW, Dempsey E, Waterhouse L, Brailsford S. A blinded randomised trial of acupuncture (manual and electroacupuncture) compared with a non-penetrating sham for the symptoms of osteoarthritis of the knee. Acupunct Med 2008;26:69–78.PubMedCrossRefGoogle Scholar
  16. 16.
    Kong J, Fufa DT, Gerber AJ, Rosman IS, Vangel MG, Gracely RH, et al. Psychophysical outcomes from a randomized pilot study of manual, electro, and sham acupuncture treatment on experimentally induced thermal pain. J Pain 2005;6:55–64.PubMedCrossRefGoogle Scholar
  17. 17.
    Zhang JH, Cao XD, Lie J, Tang WJ, Liu HQ, Fenga XY. Neuronal specificity of needling acupoints at same meridian: a control functional magnetic resonance imaging study with electroacupuncture. Acupunct Electrother Res 2007;32:179–193.PubMedGoogle Scholar
  18. 18.
    Claudia MW, Thomas R, Benno B, Stephanie R, Susanne J, Stefan NW. Acupuncture in patients with dysmenorrhea: a randomized study on clinical effectiveness and cost-effectiveness in usual care. Am J Obstet Gynecol 2008;198:166.e1–166.e8.CrossRefGoogle Scholar
  19. 19.
    Habek D, Cerkez Habek J, Bobi-Vukovi M, Vuji B. Efficacy of acupuncture for the treatment of primary dysmenorrheal. Gynakol Geburtshilfliche Rundsch 2003;43:250–253.PubMedCrossRefGoogle Scholar
  20. 20.
    Nahid K, Fariborz M, Ataolah G, Solokian S. The effect of an Iranian herbal drug on primary dysmenorrhea: a clinical controlled trial. J Midwifery Women’s Health 2009;54:401–404.CrossRefGoogle Scholar
  21. 21.
    Büssing A, Ostermann T, Raak C, Matthiessen PF. Adaptive coping strategies and attitudes toward health and healing in German homeopathy and acupuncture users. Explore 2010;6:237–245.PubMedCrossRefGoogle Scholar
  22. 22.
    Zung WWK. A rating instrument for anxiety disorders. Psychosomatics 1971;12: 371–379.PubMedGoogle Scholar
  23. 23.
    Zung WWK. A self-rating depression scale. Arch Gen Psychiatry 1965;12:63–70.PubMedCrossRefGoogle Scholar
  24. 24.
    Eysenck HJ, Eysenck SBG. Manual of the eysenck personality questionnaire. Hodder & Stoughton Ltd., Dunton Green, England; 1975.Google Scholar
  25. 25.
    Cattle RB, Eber HE, Tatsuoka MM. Handbook for the sixteen personality factor questionnaire (16PF). Champaign: Institute for Personality and Ability Testing; 1970.Google Scholar
  26. 26.
    Stevens J, ed. Applied multivariate statistics for the social sciences. New Jersey: Lawrence Erlbaum Associates Inc.; 1986:373–397.Google Scholar
  27. 27.
    Thompson B. Canonical correlation analysis: uses and interpretation. In: Quantitative applications in the social sciences. Thousand Oaks, CA Sage Publications; 1984:47.Google Scholar
  28. 28.
    Lambert ZV, Durand RM. Some precautions in using canonical analysis. J Mark Res 1975;7:468–475.CrossRefGoogle Scholar
  29. 29.
    Han JS. Acupuncture: neuropeptide release produced by electrical stimulation of different frequencies. Trends Neurosci 2003;26:17–22.PubMedCrossRefGoogle Scholar
  30. 30.
    Takeda W, Wessel J. Acupuncture for the treatment of pain of osteoarthritic knees. Arthritic Care Res 1994;7:118–122.CrossRefGoogle Scholar

Copyright information

© Chinese Association of the Integration of Traditional and Western Medicine and Springer-Verlag Berlin Heidelberg 2011

Authors and Affiliations

  • Jin Xiong (熊 瑾)
    • 1
  • Fang Liu (刘 芳)
    • 1
  • Ming-min Zhang (张明敏)
    • 1
  • Wei Wang (王 伟)
    • 2
  • Guang-ying Huang (黄光英)
    • 1
  1. 1.Institute of Integrated Traditional and Western Medicine, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  2. 2.Department of Neurology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina

Personalised recommendations