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DE QI SENSATION - HISTORICAL, PHYSIOLOGICAL UND PSYCHOLOGICAL OVERVIEW
Dominik Irnich
Munich, Germany
An important phenomena of acupuncture is deQi, known as needling sensation, feeling along the cannel,
propagated sensation along the channel, needling reaction, or arrival of qi. The Chinese word “deqi” is built of the two
characters: 得 for “de” which means “arrival” and 氣 for “qi” that can be translated as “life energy”. It does not appear
in all cases and shows varying character. 1 Acupuncture elicited in 34 of 60 cases deQi in naïve subjects. 2 According
to common textbooks the needling sensation refers to a feeling of soreness, numbness, distension or heaviness
around the point or their transmission upward and downward along the meridians after the needle is inserted to a
certain depth. At the same time the physician may feel tenseness around the needle.3 Several eastern and western
acupuncture schools see the elicitation of deQi as a sign for having reached the acupuncture point and necessary
for efficient treatment. The physician is advised to manipulate the needle until needling sensation appears. 3, 4
However according to Lingshu, one of the most important classical textbooks of acupuncture, it is not important
to elicite deQi in the patient, but it is a feeling of therapists. In summary, from a historical point of view there is a high
variability in the appraisal of deQi depending on different schools.
In addition, there is a lack of scientific basic to understand the phenomena deQi sensation from a physiological
point of view. The physiological structures transmitting deQi are not well understood. Regarding clinical research,
there is a lack of evidence about the impact of deQi on the study outcome, too.
Some clinical acupuncture studies used the achievement of Qeqi to assess the adequate degree of manual or
electrical stimulation, 5,6 others regard deQi not as required. 7 Only a few studies investigated the quality of sensations
following acupuncture 8, 9 Several studies emphasise the impact of deQi-elicitation. Sandberg et al. measured stronger
increase of blood flow in skin and muscle following needle stimulation eliciting deQi than stimulation without deQi. 10
Hui et al. showed that neuronal hemodynamic activity in fMRI following acupuncture of ST 36 is depending on the
kind of needle stimulation used. 11 Stimulation with elicitation of deQi provoked a decrease of activity in limbic and
paralimbic structures of cortical and subcortical regions of the diencephalon, the brainstem and cerebellum.
The fact that sensation of deqi may unblind volunteers in placebo-controlled trials adds certain interest to this
topic. 12
But it is still more complicated, than ever thought. Recently our group has shown that deQi sensation can be
elicited without needles, even without touch 13 . This brings up the questions, if deQi sensation can be seen as a central
phenomena.
To summarise, deQi sensation is a common, but not understood phenomena in acupuncture.
References
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3 Cheng X Chinese acupuncture and moxibustion. (Revised Edition) Beijing: Foreign Languages Press; 1999
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Psychosomatic Research 1989; 33 (4): 489-496
9 Park H, Park J, Lee H, Lee H Does deqi (needle sensation) exist The American Journal of Chinese Medicine 2002; 30
(1): 45-50
10 Sandberg M, Lundeberg T, Lindberg LG, Gerdle B Effects of acupuncture on skin and muscle blood flow in healthy
subjects. Eur J Appl Physol 2003; 90 (1-2): 114-119
11 Hui KK, Liu J, Marina O et al. The integrated response of the human cerebro-cerebellar and limbic systems to acupuncture
stimulation at ST36 as evidenced by fMRI. Neuroimage 2005; 27 (3): 479-496
12 Zaslawski C, Rogers C, Garvey M et al. Strategies to maintain the credibility of sham acupuncture used as a control
treatment in clinical trials. J Altern Complement Med 1997; 3: 257-266
13 Salih N, Offenbächer M, Irnich D. DeQi Sensation: It´s just in our heads A randomised double-blind placebo-controlled
trial. Proceedings of the German Acupuncture Congress, 2007, Eds.: Stör W, Irnich D, Banzer W. Elsevier GmbH, Munich,
2007, 37-38
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