Short-Term Reactions to Acupuncture Treatment and Adverse Events Following Acupuncture: A Cross-Sectional Survey of Patient Reports in Korea

Objectives: The objective of this study was to explore the type and frequency of short-term reactions, de qi associated with acupuncture treatment, and to determine the incidence of adverse events following acupuncture treatment in Korea. Subjects and methods: This study is a retrospective and cross-sectional survey of patient reports using 1095 subjects; 585 subjects are outpatients of the East-West NEO Medical Center and the remaining 510 subjects are outpatients of the Kyung Hee Medical Center. In the period of June to November 2006, the participating subjects, who had all received acupuncture, consented and completed a single survey form. On this form, patients were asked to report their short-term reactions to the acupuncture, de qi, a patient satisfaction score (using the Visual Analogue Scale [ VAS]) and any adverse events related to the acupuncture treatment. The 8 acupuncturists involved in this study were Korean medicine doctors who had more than 10 years' experience working as practitioners. Results: The average age of the 1095 subjects was 58 years old. Positive short-term acupuncture reactions were reported by 878 (80.2%) of the 1095 subjects. Seventy-five (75) (6.8%) subjects described negative short-term acupuncture reactions. The most common positive short-term acupuncture reaction was that of a relaxed'' feeling in 472 (43.1%), followed by 90 (8.2%) who acknowledged a feeling of less pain''; 16 (1.5%) felt energized''; 16 (1.5%) experienced tingling'' and a sensation of Heat'' or Coldness'' was reported by 10 (0.9%). Negative short-term acupuncture reactions included feelings of pain'' 37 (3.4%), tiredness 24 (2.2%), and dizziness 9 (0.8%). Traditionally, the needling sensations of de qi refer to a patient's response to treatment, such as distension, pulling, soreness, heaviness, and numbness. Some (39.7%) subjects reported de qi during needling. A number experienced distension'' 333 (30.4%), soreness'' 52(4.7%), pulling'' 22(2.0%), heaviness'' 18(1.6%), and numbness'' 10 (0.9%). Positive short-term acupuncture reactions and de qi ratings were highest in those less than 40 years of age (83/96 86.5%, 50/96 52.1%). No reaction responses to acupuncture were the highest frequency in subjects over 70 years of age (31/187, 16.6%). Patient satisfaction level using VAS was comparatively high: 72.9 +/- 19.9. The only adverse events reported were bleeding in 92 (8.4%) of the participants. The majority of patients treated with acupuncture had suffered from stroke (430; 16.9%), headache (185; 16.9%), hypertension (97; 8.9%), or dizziness (85; 7.8%). Conclusions: Short-term acupuncture reactions and de qi were related to the age group. With the exception of bleeding, there were no adverse events related to the acupuncture treatment in this study. We consider acupuncture treatment to be very safe if the practitioners are well educated, trained and experienced. The number of post-treatment positive short-term acupuncture reactions was 12 times higher than that of the negative short-term reactions. Overall, subjects were comparatively satisfied with the acupuncture treatment.