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La recherche du deqi est-elle un indicateur d'efficacité thérapeutique de l'acupuncture ?

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On peut se poser la question de savoir si la recherche du deqi est un indicateur de l'efficacité du traitement acupunctural. L'objectif des auteurs de cette revue systématique a été de rechercher puis d'étudier toute la littérature présente dans les banques de données internationales qu'elles soient asiatiques (CNKI, VIP, Wanfang) ou occidentales (PubMed, Embase et Cochrane Central Register of Controlled Trials). Trois types d'étude ont été incluses : (1) la recherche empirique prouvant le rôle du deqi en acupuncture, (2) les études sur le mécanisme d'action permettant d'examiner l'effet du deqi sur les paramètres physiologiques dans les modèles d'animaux et des sujets humains, (3) les études cliniques qui comparent les résultats de l'acupuncture avec recherche du deqi versus acupuncture sans deqi. Les résultats objectivent qu'effectivement, les acupuncteurs traditionnels chinois considèrent que la recherche du deqi est essentiel à la fois comme outil de diagnostic, indicateur de pronostic et partie nécessaire à la procédure thérapeutique. De même, les résultats concernant la recherche expérimentale moderne apportent des preuves préliminaires dans le mécanisme physiologique produit par le deqi. Mais peu d'études cliniques génèrent des preuves contradictoires sur l'efficacité comparative de l'acupuncture avec deqi versus acupuncture sans deqi dans une variété de maladies. De ce fait, la base de données actuelle n'est pas assez solide pour tirer la conclusion qu'il est nécessaire de rechercher le deqi pour obtenir une plus grande efficacité clinique. L'intérêt thérapeutique de la manipulation de l'aiguille à la recherche du deqi n'est pas non plus démontré.


Méridiens Medline du 21 juillet 2013 au 25 août 2013 (articles en libre accès)

1 : Wang X, Chan ST, Fang J, Nixon EE, Liu J, Kwong KK, Rosen BR, Hui KK. Neural encoding of acupuncture needling sensations : evidence from a FMRI study. Evid Based Complement Alternat Med. 2013 ;2013:483105. doi : 10.1155/2013/483105. Epub 2013 Aug 25. PubMed PMID : 24062782 ; PubMed Central PMCID : PMC3766991.

3 : Lim BS, Moon HJ, Li DX, Gil M, Min JK, Lee G, Bae H, Kim SK, Min BI. Effect of bee venom acupuncture on oxaliplatin-induced cold allodynia in rats. Evid Based Complement Alternat Med. 2013 ;2013:369324. doi : 10.1155/2013/369324. Epub 2013 Aug 22. PubMed PMID : 24058370 ; PubMed Central PMCID : PMC3766591.

4 : Pichora-Fuller MK, Santaguida P, Hammill A, Oremus M, Westerberg B, Ali U, Patterson C, Raina P. Evaluation and Treatment of Tinnitus : Comparative Effectiveness [Internet]. Rockville (MD) : Agency for Healthcare Research and Quality (US) ; 2013 Aug. Available from http://www.ncbi.nlm.nih.gov/books/NBK158963/ PubMed PMID : 24049842.

5 : Chen R, Chen M, Xiong J, Su T, Zhou M, Sun J, Chi Z, Zhang B, Xie D. Comparative effectiveness of the deqi sensation and non-deqi by moxibustion stimulation : a multicenter prospective cohort study in the treatment of knee osteoarthritis. Evid Based Complement Alternat Med. 2013 ;2013:906947. doi : 10.1155/2013/906947. Epub 2013 Aug 21. PubMed PMID : 24027596 ; PubMed Central PMCID : PMC3763268.

6 : Cui J, Ha L, Zhu X, Wang F, Jing X, Bai W. Specificity of Sensory and Motor Neurons Associated with BL40 and GB30 in the Rat : A Dual Fluorescent Labeling Study. Evid Based Complement Alternat Med. 2013 ;2013:643403. doi : 10.1155/2013/643403. Epub 2013 Aug 21. PubMed PMID : 24027595 ; PubMed Central PMCID : PMC3763267.

7 : Kuang H, Li Y, Wu X, Hou L, Wu T, Liu J, Ng EH, Stener-Victorin E, Legro RS, Zhang H. Acupuncture and clomiphene citrate for live birth in polycystic ovary syndrome : study design of a randomized controlled trial. Evid Based Complement Alternat Med. 2013 ;2013:527303. doi : 10.1155/2013/527303. Epub 2013 Aug 20. PubMed PMID : 24023577 ; PubMed Central PMCID : PMC3762180.

8 : Choi EJ, Yun Y, Yoo S, Kim KS, Park JS, Choi I. Autonomic conditions in tinnitus and implications for korean medicine. Evid Based Complement Alternat Med. 2013 ;2013:402585. doi : 10.1155/2013/402585. Epub 2013 Aug 19. PubMed PMID : 24023574 ; PubMed Central PMCID : PMC3760126.

9 : Chen S, Bai L, Xu M, Wang F, Yin L, Peng X, Chen X, Shi X. Multivariate granger causality analysis of acupuncture effects in mild cognitive impairment patients : an FMRI study. Evid Based Complement Alternat Med. 2013 ;2013:127271. doi : 10.1155/2013/127271. Epub 2013 Aug 19. PubMed PMID : 24023568 ; PubMed Central PMCID : PMC3760118.

10 : Park JY, Park HJ, Choi YY, Kim MH, Kim SN, Yang WM. Effects of Acupuncture on 1-Chloro-2,4-dinitrochlorobenzene-Induced Atopic Dermatitis. Evid Based Complement Alternat Med. 2013 ;2013:982095. doi : 10.1155/2013/982095. Epub 2013 Aug 7. PubMed PMID : 23997805 ; PubMed Central PMCID : PMC3755411.

11 : Zhang WB, Xu YH, Tian YY, Li H, Wang GJ, Huang T, Jia SY. Induction of Hyperalgesia in Pigs through Blocking Low Hydraulic Resistance Channels and Reduction of the Resistance through Acupuncture : A Mechanism of Action of Acupuncture. Evid Based Complement Alternat Med. 2013 ;2013:654645. doi : 10.1155/2013/654645. Epub 2013 Aug 13. PubMed PMID : 23997798 ; PubMed Central PMCID : PMC3755403.

12 : Zhang WB, Wang LL, Xie HH, Li H, Tian YY. Comparison of Acupuncture Effect on Blood Perfusion between Needling Nonacupoint on Meridian and Needling Nonacupoint off Meridian. Evid Based Complement Alternat Med. 2013 ;2013:426052. doi : 10.1155/2013/426052. Epub 2013 Aug 12. PubMed PMID : 23997794 ; PubMed Central PMCID : PMC3753753.

13 : Stenger M, Bauer NE, Licht PB. Is pneumothorax after acupuncture so uncommon ? J Thorac Dis. 2013 Aug ;5(4) :E144-6. doi : 10.3978/j.issn.2072-1439.2013.08.18. PubMed PMID : 23991325 ; PubMed Central PMCID : PMC3755677.

14 : Wang R, Luo D, Xiao C, Lin P, Liu S, Xu Q, Wang Y. The time course effects of electroacupuncture on promoting skeletal muscle regeneration and inhibiting excessive fibrosis after contusion in rabbits. Evid Based Complement Alternat Med. 2013 ;2013:869398. doi : 10.1155/2013/869398. Epub 2013 Aug 6. PubMed PMID : 23990848 ; PubMed Central PMCID : PMC3748402.

15 : Kim KS, Nam HJ. Detoxification combining fasting with fluid therapy for refractory cases of severe atopic dermatitis. Evid Based Complement Alternat Med. 2013 ;2013:561290. doi : 10.1155/2013/561290. Epub 2013 Aug 6. PubMed PMID : 23986784 ; PubMed Central PMCID : PMC3748731.

16 : Yeom M, Kim SH, Lee B, Zhang X, Lee H, Hahm DH, Sohn Y, Lee H. Effects of laser acupuncture on longitudinal bone growth in adolescent rats. Evid Based Complement Alternat Med. 2013 ;2013:424587. doi : 10.1155/2013/424587. Epub 2013 Aug 6. PubMed PMID : 23986782 ; PubMed Central PMCID : PMC3748745.

17 : Lin RT, Pai HC, Lee YC, Tzeng CY, Chang CH, Hung PH, Chen YI, Hsu TH, Tsai CC, Lin JG, Chang SL. Electroacupuncture and rosiglitazone combined therapy as a means of treating insulin resistance and type 2 diabetes mellitus : a randomized controlled trial. Evid Based Complement Alternat Med. 2013 ;2013:969824. doi : 10.1155/2013/969824. Epub 2013 Jul 29. PubMed PMID : 23983807 ; PubMed Central PMCID : PMC3745852.

18 : Li QQ, Shi GX, Fu XX, Han LL, Liu LY, Liu CZ, Wang LP, Hou N. Effects of deqi on autonomic balance in adult tinnitus patients : study design of a randomized controlled trial. Evid Based Complement Alternat Med. 2013 ;2013:756012. doi : 10.1155/2013/756012. Epub 2013 Jul 29. PubMed PMID : 23983802 ; PubMed Central PMCID : PMC3745851.

19 : Zhang S, Mu W, Xiao L, Zheng WK, Liu CX, Zhang L, Shang HC. Is deqi an indicator of clinical efficacy of acupuncture ? A systematic review. Evid Based Complement Alternat Med. 2013 ;2013:750140. doi : 10.1155/2013/750140. Epub 2013 Jul 31. PubMed PMID : 23983801 ; PubMed Central PMCID : PMC3747467.

20 : Liang ZH, Xie CC, Li ZP, Zhu XP, Lu AP, Fu WB. Deqi sensation in placebo acupuncture : a crossover study on chinese medicine students. Evid Based Complement Alternat Med. 2013 ;2013:620671. doi : 10.1155/2013/620671. Epub 2013 Jul 29. PubMed PMID : 23983794 ; PubMed Central PMCID : PMC3745883.

21 : Soh KS, Kang KA, Ryu YH. 50 years of bong-han theory and 10 years of primo vascular system. Evid Based Complement Alternat Med. 2013 ;2013:587827. doi : 10.1155/2013/587827. Epub 2013 Jul 31. PubMed PMID : 23983793 ; PubMed Central PMCID : PMC3747427.

22 : Franconi G, Manni L, Schröder S, Marchetti P, Robinson N. A systematic review of experimental and clinical acupuncture in chemotherapy-induced peripheral neuropathy. Evid Based Complement Alternat Med. 2013 ;2013:516916. doi : 10.1155/2013/516916. Epub 2013 Jul 24. PubMed PMID : 23983788 ; PubMed Central PMCID : PMC3741953.

23 : Park ES, Lee JH, Kim WJ, Heo J, Shin DM, Leem CH. Expression of stem cell markers in primo vessel of rat. Evid Based Complement Alternat Med. 2013 ;2013:438079. doi : 10.1155/2013/438079. Epub 2013 Jul 31. PubMed PMID : 23983780 ; PubMed Central PMCID : PMC3747494.

24 : Kim W, Kim SK, Min BI. Mechanisms of electroacupuncture-induced analgesia on neuropathic pain in animal model. Evid Based Complement Alternat Med. 2013 ;2013:436913. doi : 10.1155/2013/436913. Epub 2013 Jul 31. PubMed PMID : 23983779 ; PubMed Central PMCID : PMC3747484.

25 : Yun Y, Kim S, Kim M, Kim K, Park JS, Choi I. Effect of facial cosmetic acupuncture on facial elasticity : an open-label, single-arm pilot study. Evid Based Complement Alternat Med. 2013 ;2013:424313. doi : 10.1155/2013/424313. Epub 2013 Jul 28. PubMed PMID : 23983778 ; PubMed Central PMCID : PMC3745857.

26 : Xie CC, Wen XY, Jiang L, Xie MJ, Fu WB. Validity of the "streitberger" needle in a chinese population with acupuncture : a randomized, single-blinded, and crossover pilot study. Evid Based Complement Alternat Med. 2013 ;2013:251603. doi : 10.1155/2013/251603. Epub 2013 Aug 1. PubMed PMID : 23983775 ; PubMed Central PMCID : PMC3747414.

27 : Dong J. The Relationship between Traditional Chinese Medicine and Modern Medicine. Evid Based Complement Alternat Med. 2013 ;2013:153148. doi : 10.1155/2013/153148. Epub 2013 Jul 30. PubMed PMID : 23983772 ; PubMed Central PMCID : PMC3745867.

28 : Luo D, Wang X, He J. A comparison between acute pressure block of the sciatic nerve and acupressure : methodology, analgesia, and mechanism involved. J Pain Res. 2013 Jul 26 ;6:589-93. doi : 10.2147/JPR.S47693. PubMed PMID : 23983488 ; PubMed Central PMCID : PMC3749058.

29 : Yin LM, Zhang GQ, Yan XK, Wang Y, Xu YD, Yang YQ. An In Vivo and In Vitro Evaluation of the Mutual Interactions between the Lung and the Large Intestine. Evid Based Complement Alternat Med. 2013 ;2013:695641. doi : 10.1155/2013/695641. Epub 2013 Jul 21. PubMed PMID : 23970934 ; PubMed Central PMCID : PMC3736455.

30 : Wang YS, Zhang JB, Jiang JF, Wang LL. Research on effects of the thermal stimulation by moxibustion at different temperatures on cardiac function in rats and on mast cells in the local site of moxibustion. Evid Based Complement Alternat Med. 2013 ;2013:545707. doi : 10.1155/2013/545707. Epub 2013 Jul 21. PubMed PMID : 23970933 ; PubMed Central PMCID : PMC3732631.

31 : Bae CH, Kim DS, Jun YL, Kwon S, Park HJ, Hahm DH, Lee H, Kim ST. Proteomic analysis of the effect of acupuncture on the suppression of kainic Acid-induced neuronal destruction in mouse hippocampus. Evid Based Complement Alternat Med. 2013 ;2013:436315. doi : 10.1155/2013/436315. Epub 2013 Jul 23. PubMed PMID : 23970931 ; PubMed Central PMCID : PMC3736462.

32 : Wang X, Lu Y, Wu L, Zhao C, Song C, Yu S, Zhao B, Zhao T, Liu H, Dou C, Zhang Y, Wu H. Moxibustion Inhibits the ERK Signaling Pathway and Intestinal Fibrosis in Rats with Crohn's Disease. Evid Based Complement Alternat Med. 2013 ;2013:198282. doi : 10.1155/2013/198282. Epub 2013 Jul 22. PubMed PMID : 23970928 ; PubMed Central PMCID : PMC3736408.

33 : Kim JH, Kim EJ, Seo BK, Lee S, Lee S, Jung SY, Lee MH, Kim AR, Park HJ, Shin MS, Choi SM. Electroacupuncture for chemotherapy-induced peripheral neuropathy : study protocol for a pilot multicentre randomized, patient-assessor-blinded, controlled trial. Trials. 2013 Aug 14 ;14:254. doi : 10.1186/1745-6215-14-254. PubMed PMID : 23945074 ; PubMed Central PMCID : PMC3751258.

34 : DuBois TA, Lang JF. Johan Turi's animal, mineral, vegetable cures and healing practices : an in-depth analysis of Sami (Saami) folk healing one hundred years ago. J Ethnobiol Ethnomed. 2013 Aug 13 ;9:57. doi : 10.1186/1746-4269-9-57. PubMed PMID : 23941666 ; PubMed Central PMCID : PMC3751750.

35 : Kwok T, Leung PC, Wing YK, Ip I, Wong B, Ho DW, Wong WM, Ho F. The effectiveness of acupuncture on the sleep quality of elderly with dementia : a within-subjects trial. Clin Interv Aging. 2013 ;8:923-9. doi : 10.2147/CIA.S45611. Epub 2013 Jul 31. PubMed PMID : 23940415 ; PubMed Central PMCID : PMC3736969.

36 : Shin HK, Jeong SJ, Lee MS, Ernst E. Adverse events attributed to traditional Korean medical practices : 1999-2010. Bull World Health Organ. 2013 Aug 1 ;91(8):569-75. doi : 10.2471/BLT.12.111609. Epub 2013 May 31. PubMed PMID : 23940404 ; PubMed Central PMCID : PMC3738306.

37 : Kong J, Spaeth R, Cook A, Kirsch I, Claggett B, Vangel M, Gollub RL, Smoller JW, Kaptchuk TJ. Are all placebo effects equal ? Placebo pills, sham acupuncture, cue conditioning and their association. PLoS One. 2013 Jul 31 ;8(7) :e67485. doi : 10.1371/journal.pone.0067485. Print 2013. PubMed PMID : 23935833 ; PubMed Central PMCID : PMC3729687.

38 : Wu WT, Huang YH, Chen DC, Huang YH, Chou LW. Effective management of intractable neuropathic pain using an intrathecal morphine pump in a patient with acute transverse myelitis. Neuropsychiatr Dis Treat. 2013 ;9:1023-8. doi : 10.2147/NDT.S47014. Epub 2013 Jul 29. PubMed PMID : 23935366 ; PubMed Central PMCID : PMC3735335.

39 : He W, Jing XH, Zhu B, Zhu XL, Li L, Bai WZ, Ben H. The auriculo-vagal afferent pathway and its role in seizure suppression in rats. BMC Neurosci. 2013 Aug 9 ;14:85. doi : 10.1186/1471-2202-14-85. PubMed PMID : 23927528 ; PubMed Central PMCID : PMC3751281.

40 : Quah-Smith I, Williams MA, Lundeberg T, Suo C, Sachdev P. Differential brain effects of laser and needle acupuncture at LR8 using functional MRI. Acupunct Med. 2013 Sep ;31(3):282-9. doi : 10.1136/acupmed-2012-010297. Epub 2013 Aug 6. PubMed PMID : 23920052 ; PubMed Central PMCID : PMC3786613.

41 : Zheng H, Xu J, Li J, Li X, Zhao L, Chang X, Liu M, Gong B, Li X, Liang F. Acupuncture for patients with functional dyspepsia : study protocol of a randomised controlled trial. BMJ Open. 2013 Jul 30 ;3(7). doi :pii : e003377. 10.1136/bmjopen-2013-003377. PubMed PMID : 23901030 ; PubMed Central PMCID : PMC3731711.

42 : Santos EL, Dias BH, de Andrade AC, Pascoal AM, de Vasconcelos Filho FE, Medeiros Fd, Guimarães SB. Effects of acupuncture and electroacupuncture on estradiol-induced inflammation and oxidative stress in health rodents. Acta Cir Bras. 2013 Aug ;28(8):582-8. PubMed PMID : 23896837.

43 : Vinjamury SP, Li JT, Hsiao E, Huang C, Hawk C, Miller J, Huang Y. Effects of acupuncture for cancer pain and quality of life - a case series. Chin Med. 2013 Jul 30 ;8(1):15. doi : 10.1186/1749-8546-8-15. PubMed PMID : 23895044 ; PubMed Central PMCID : PMC3734160.

44 : Li S, Berliner JC, Melton DH, Li S. Modification of electrical pain threshold by voluntary breathing-controlled electrical stimulation (BreEStim) in healthy subjects. PLoS One. 2013 Jul 24 ;8(7) :e70282. doi : 10.1371/journal.pone.0070282. Print 2013. PubMed PMID : 23894632 ; PubMed Central PMCID : PMC3722161.

45 : Jonkman FA, Jonkman-Buidin ML. Integrated approach to treatment-resistant atrial fibrillation : additional value of acupuncture. Acupunct Med. 2013 Sep ;31(3):327-30. doi : 10.1136/acupmed-2013-010380. Epub 2013 Jul 24. PubMed PMID : 23884291 ; PubMed Central PMCID : PMC3786618.

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