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Summaries of recent papers
  1. Adrian White1,
  2. Michael Meinen2,
  3. Amer Sheikh3
  1. 1Institute of Translational and Stratified Medicine, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
  2. 2Denton Park Health Centre, Newcastle upon Tyne, UK
  3. 3Ashford Health Centre, Ashford Hospital, Ashford, Middlesex, UK
  1. Correspondence to Dr Adrian White, Department of Primary Care, Peninsula Medical School, N21 ITTC Building, Tamar Science Park, Plymouth PL6 8BX, UK; Adrian.white{at}

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Clinical effectiveness trials

Effect of de qi in Bell’s palsy

▸ Xu SB, Huang B, Zhang CY, et al. Effectiveness of strengthened stimulation during acupuncture for the treatment of Bell palsy: a randomized controlled trial. CMAJ 2013;185:473–9.

Randomised controlled trial (n=338) testing the effect of eliciting de qi.


Three hundred and thirty-eight patients with Bell's palsy diagnosed within 1 week of onset of symptoms were randomised to two groups. The acupuncture group had vigorous needle stimulation to achieve de qi while the control group had needle insertion without manipulation in the same predetermined acupuncture points. Both groups received a course of prednisolone in a tapering dose for 2 weeks as standard medical treatment.

Acupuncture points used were GB14, ST4, ST6, ST7, TE17 and LI4 on the affected side. Both groups received 20 sessions lasting 30 min, five sessions per week for 4 weeks.

The primary outcome measure was the House–Brackmann scale, which is a 6-grade objective score for Bell’s palsy (6 is complete paralysis). The scorers were blinded to group allocation. Secondary outcomes were the Facial Disability Index and the World Health Organization’s Quality of Life questionnaire.


At 6-month follow-up, patients in the de qi group had better facial function (OR 4.16), better disability assessment and better quality of life than controls. Complete recovery occurred in 94.3% of patients in the de qi group compared with 77.1% of controls (figure 1), which is a significant difference. The size of the effect was correlated with the strength of the de qi sensation. The control group had the same recovery rate as would be expected with patients who took prednisolone alone.

Figure 1

Numbers making full recovery from Bell's palsy. Based on CMAJ 2013;185:473–9.


At last this is a study that addresses the question whether de qi is necessary for acupuncture to have an effect. The answer from this randomised controlled trial, which has a sound research …

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