Influence of the Deqi Sensation by Suspended Moxibustion Stimulation in Lumbar Disc Herniation: Study for a Multicenter Prospective Two Arms Cohort Study

Abstract

Moxibustion stimulates the Deqi (Qi arrival) phenomenon. Many clinical observations have documented that the character of the Deqi was a composite heat-sensitive moxibustion sensation. In this prospective multicentre comparative observational nonrandomized study, 92 patients with moderate to severe LDH were included. This study consisted of two parallel arms (A: heat-sensitive moxibustion sensation group; B: nonheat-sensitive moxibustion sensation group). Moxibustion was applied in the following three acupuncture points simultaneously: Da Changshu (BL25), Wei Zhong (BL40), and A-Shi acupuncture point (tenderness). The adjusted mean total Modified-JOA score showed significant differences between the groups in the first week (10.32 ± 4.27 95% CI [9.23 ~ 11.40] versus control group 12.42 ± 5.02 [11.62 ~ 13.69], P = 0.03). The outcome in the second week also presented significant differences in both groups (7.62 ± 4.80 [6.46 ~ 8.77] versus 10.56 ± 4.75 [9.35 ~ 11.76], P = 0.005). Significant differences were also manifested in the follow-up period (P = 0.007). It can be inferred that the existence of the Deqi (heat-sensitive moxibustion sensation) phenomenon in the process of suspended moxibustion is closely related to the curative effect, and arrival of heat-sensitive moxibustion sensation could improve the clinical curative effect of moxibustion.

Characterizing Heat-Sensitization Responses in Suspended Moxibustion with High-Density EEG

“…It is still unclear why this phenomenon occurs in some patients but not others. Clinical data from the present study did not support gender, age, and pain duration as crucial factors, consistent with results from our previous studies [2][3][4][5][6].…”

“…A crucial clinically relevant question is the behavioral correlates of heat‐sensitization and/or the corresponding EEG changes. Previous clinical trials indicated that the presence of heat‐sensitization during moxibustion treatment is correlated with better therapeutic effects, not only in low back pain [2–4] but also in other diseases such as knee osteoarthritis [5,6] and persistent asthma [7]. Although increasing evidence confirms the therapeutic effects of moxibustion, very few studies have addressed the underlying mechanisms.…”

“…For example, patients with chronic low back pain (CLBP) frequently showed heat‐sensitization around Yaoyangguan (DU3) areas [2–4]. Recent randomized controlled trials revealed that patients with heat‐sensitization responses during moxibustion had significantly better clinical outcomes than those without [1–3,5], and that performing moxibustion on these functionally sensitized locations yields better therapeutic effects than the anatomically defined but nonsensitized acupoints [3]. These studies suggest a potential link between the sensitization responses induced by moxibustion and its modulatory effects on pain and inflammation.…”

“…It can be applied either with a small amount of burning moxa directly on the skin (direct moxibustion) or with heat generated from burning moxa 3-5 cm away from the skin surface (suspended or indirect moxibustion, supplementary Figure S1). Moxibustion exerts antinociceptive, antiinflammatory, and immunomodulatory effects in humans, and gains increasing popularity from both clinicians and researchers worldwide [1][2][3][4][5][6][7].…”

“…Each disease has a specific set of such sensitized acupoints, and such phenomenon is not bs_bs_banner Pain Medicine 2014; 15: 1272-1281 commonly seen in healthy volunteers. For example, patients with chronic low back pain (CLBP) frequently showed heat-sensitization around Yaoyangguan (DU3) areas [2][3][4]. Recent randomized controlled trials revealed that patients with heat-sensitization responses during moxibustion had significantly better clinical outcomes than those without [1][2][3]5], and that performing moxibustion on these functionally sensitized locations yields better therapeutic effects than the anatomically defined but nonsensitized acupoints [3].…”