| Objective: To evaluate the influence of traditional Chinese medicine(TCM) constitution on “deqi†response and acupuncture analgesic effect by observing the “deqi†response when manual acupuncture is performed at ST36 and comparing the analgesic effect at different times among nine kinds of TCM constitution.Methods: 600 healthy volunteers were recruited and the TCM constitution was identified by the TCM Constitution Questionnaire and classified into nine groups according to the constitution of individual, which consisted of gentleness type, qi-deficiency type, yang-deficiency type, yin-deficiency type, phlegm-wetness type, wetness-heat type, blood-stasis type, qi-depression type and special diathesis type. The conventional manual acupuncture was performed at the left Zusanli(ST36) for 30 minutes. The pressure-pain thresholds(PPTs) were measured by 2390-type electronic von Frey anesthesiometer before acupuncture, at the time receiving needling sensation and 10 min needle retention, 30 min needle retention, 15 min after needle removal separately. Subjects were asked to record the components and overall intensity of needling sensation which they experienced in the acupuncture process. All data were processed by SPSS19.0 software package. The appearance rate of needling sensation in subjects with different TCM constitution was checked by Chi-square test and the intensity of each sensation was analyzed by one-way ANOVA. PPTs at different time were compared with two factor repeated measures analysis of variance.Results:1. From the analysis about the prevalence of subjective “deqi†sensations, which was expressed as the percentage of individuals in group, we found that fullness(90.3% of subjects) was the most common needling sensations experienced in the acupuncture process, followed by soreness(46.3% of subjects). There were no significant differences in occurrence rate of soreness, numbness, heaviness, fullness and dull pain among different TCM constitutional types(P > 0.05). Nevertheless, the appearance rate of needling sensation propagating along the channel in the gentleness-type group was significantly higher than that in qi-deficiency type, yang-deficiency type, blood-stasis type, qi-depression type(P < 0.05). When estimating the difference in the intensity for each sensation among the nine groups, the one-way ANOVA results showed that there were no significant differences in the intensity of numbness, heaviness and dull pain(P < 0.05). However, the difference of soreness sensation was detected to be significant(P < 0.05). The intensity of fullness was found to be significant only between gentleness type and yang-deficiency type(P < 0.05).2. According to the analysis of PPTs, an interaction was found between TCM constitution and the needle retaining time(P < 0.05). PPT in the needle retention showed a significantly increase than that before acupuncture at ST36(P < 0.01), especially at 30 min needle retention. At the time of 15 min after needle removal, there were no statistically significant differences between pre-acupuncture and 15 min after needle removal except gentleness type and wetness-heat type constitution(P > 0.01). The PPTs of gentleness constitution type at 10 min and 30 min during the needle retention increased higher than that of other constitution type(P < 0.05).Conclusion:There is no selectivity in the prevalence of needling sensation elicited by the acupuncture stimulation among different TCM constitutions except the needling sensation propagating along the channel. The difference in the intensity of soreness sensation may explain the different analgesic effect among nine TCM constitution types. Assessment for deqi phenomenon associated with acupuncture, including the quantitative as well as qualitative characterization of the sensations, could predict for clinical effectiveness of acupuncture to a certain extent. Manual acupuncture at Zusanli could achieve a significant analgesic effect, which is closely related to the constitution type. In conclusion, TCM constitution is a powerful factor for therapeutic effect of acupuncture. |
