The Relationship Between Deqi and the Effect of Acupuncture on Pressure Pain Threshold: A Randomized Crossover-Controlled Study—Short Report

Background: The needling sensation known as deqi is theorized to be integral to acupuncture's effects, yet its correlation with clinical improvement requires further objective validation through controlled studies. Objectives: This human experimental study aimed to examine how pressure pain threshold (PPT) changes correlate with subjective deqi sensations following three standardized protocols, two needling interventions, and a sham laser (SL), in healthy volunteers. We hypothesized that the manual needle manipulation would enhance deqi more than non-manipulation needling or the SL. Materials and Methods: This randomized, three-intervention crossover trial evaluated 32 healthy participants who received three distinct SI3 acupoint interventions on the right hand in varying sequences: (1) non-manipulated needling (SI3m⁻), (2) manually stimulated needling (SI3m⁺), and (3) SL control. Outcomes included post-intervention changes in PPT and deqi visual analog scale (VAS) and the Massachusetts General Hospital Acupuncture Sensation Scale (MASS). The present research utilized a linear mixed-effects model (LMM) for data analysis. Results: Of 32 participants, 31 completed all interventions. Both SI3m⁺ and SI3m⁻ significantly increased PPT compared to SL, with SI3m⁺ being most effective. Meanwhile, deqi, as measured by both MASS and VAS, differed between the two needling interventions and SL acupuncture, but its intensity did not correlate with the observed analgesic effect. Conclusion: SI3 needling was associated with statistically higher deqi scores than SL and did not show an association between deqi intensity and the observed PPT changes. VAS alone may serve as a practical tool for measuring deqi in experimental settings.