Manipulation Needed to achieve De Qi
Previous studies on acupuncture have focused on the ancient arts therapeutic effects, but recent UVM research has established scientific evidence of the body's response to acupuncture needling.
No previous research has looked at the effect of the manipulation of the acupuncture needle on the tissue. The two-year College of Medicine study takes a major step towards establishing credibility among Western medical practitioners for the therapy long considered "alternative." A report on the study, titled "Biomechanical Response to Acupuncture Needling in Humans," will be featured in the December issue of the Journal of Applied Physiology.
Much of the skepticism about acupuncture stems from the fact that use of hypodermic needles, although routine in Western medicine, is not in itself considered therapeutic. Lead investigator Dr. Helene Langevin says the key to acupunctures biomechanical effect is not the insertion of each ultra-fine acupuncture needle, but its manipulation.
During an acupuncture session, each needle is manipulated in order to elicit the de qi (pronounced "day-chee") response. De qi is traditionally believed to be essential in achieving acupunctures therapeutic effect. A phenomenon called "needle grasp" is a component of de qi that is often described by acupuncturists as feeling like a fish tugging on a line. When de qi occurs, patients typically experience an aching sensation.
To establish a scientific basis for acupunctures effect, the Vermont researchers sought to measure the force required to overcome the tissue-needle connection that occurs during needle grasp. Using a unique, computer-controlled, acupuncture-needling device, Langevin and her colleagues found that a much greater pullout force 167 percent was required when the needle was rotated in one direction after insertion than when it was not rotated. When the needle was rotated back and forth, the pullout force was 53 percent greater. This clinical study which had a total of 60 participants was the first to measure this effect using an objective methodology.
"We now know that needle manipulation has a measurable, biomechanical effect on the tissue," says Langevin, research assistant professor of neurology and licensed acupuncturist.
"This effect was present at the control and acupuncture points that we measured, but somewhat more at the acupuncture points."
Although previously believed to be a muscle contraction, Langevins research indicates that layers superficial to the muscle skin and/or subcutaneous connective tissues may be involved in the bodys response to acupuncture needling. When the needle is pulled back during needle grasp, the biomechanical phenomenon is visibly recognizable as the tissue below the skin maintains its grasp on the needle, causing the skin to "tent."
"Our working hypothesis right now is that the needle grasp is due to connective tissue winding around the needle," says Langevin. "We also think that the needle may come into contact with more connective tissue at the acupuncture points identified in ancient texts. This may explain why the pullout force was slightly greater at those points."
Langevin also is the lead author of a hypothesis paper on research that supplements these findings. "Mechanical Signaling through Connective Tissue: A Mechanism for the Therapeutic Effect of Acupuncture" appeared in the October issue of The Federation of American Societies for Experimental Biology Journal. She and her colleagues plan to focus future research on trying to prove that connective tissue is indeed involved in needle grasp.
In addition to Langevin, the research team included David Churchill, Gale Weld and Jason Yandow, neurology; Dr. Martin Krag, and James Fox, orthopaedics and rehabilitation; Gary Badger, medical biostatistics; and Dr. Brian Garra, radiology.
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