Qihuang Needle Acupuncture Improves Motor and Nonmotor Parkinson Disease Symptoms

A randomized, sham-controlled trial recently published in Movement Disorders reported that Qihuang needle (QHN) therapy, a specialized acupuncture technique, produced clinically meaningful improvements in motor function, nonmotor symptoms, and quality of life in patients with idiopathic Parkinson disease (PD) when added to stable medication regimens. The benefits were sustained, and some measures increased, at 10-week follow-up, 4 weeks after the final treatment session.¹

Study Overview

Conducted by senior author Zhenhu Chen, MD, chief physician at the First Affiliated Hospital of Guangzhou University of Chinese Medicine, and colleagues, the study enrolled 140 patients (mean age, 67.9 years; men, 55.7%) with idiopathic PD and Hoehn and Yahr stages 1 to 4, randomizing them 1:1 to receive either QHN therapy or sham acupuncture over 9 sessions across 6 weeks, alongside their usual anti-PD medications.

QHN uses a hollow, oval-tipped needle and targets 3 to 5 acupoints per session with strong manual stimulation to elicit Deqi sensation, in contrast to conventional multi-point, retained acupuncture approaches. Sham controls received shallow needling at non-acupoint sites with no manual stimulation.

The primary outcome was change in Unified Parkinson's Disease Rating Scale Part III (UPDRS-III) score from baseline to week 6, with follow-up assessment at week 10. Secondary outcomes included the Non-Motor Symptoms Scale (NMSS) and the 39-item Parkinson's Disease Questionnaire (PDQ-39).

Of the 140 randomized patients, 129 (92.1%) completed the trial. The single-center study may have addressed a persistent gap in PD management, which is the need for adjunctive therapies that can address symptoms not fully controlled by levodopa-based treatment, without adding to the motor and nonmotor complications associated with long-term dopaminergic therapy.²

Key Findings

At week 6, the QHN group showed a mean UPDRS-III improvement of 13.78 points versus 5.32 points in the sham group, yielding a between-group difference of 8.45 points (95% CI, 5.49-11.42; P <.001), which is a margin exceeding the established minimal clinically important difference for the scale.³ This advantage widened to 10.88 points by week 10 (95% CI, 7.89-13.87; P <.001). Significant between-group differences favoring QHN were also observed for NMSS and PDQ-39 scores at both time points (all, P <.001).

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Subgroup analysis by motor phenotype revealed a significant treatment-by-subtype interaction, with the greatest motor benefit seen in patients with postural instability and gait disorder–dominant disease, followed by mixed and tremor-dominant subtypes. Exploratory shear-wave elastography demonstrated a significant reduction in biceps brachii muscle stiffness in the treatment group, though objective gait parameters did not differ significantly between groups. Adverse events were reported as mild and transient, primarily needle-site bleeding or hematoma, with no serious events or withdrawals attributable to treatment.

Clinical Context and Interpretation

PD affects a growing global population, and neither current medical nor surgical therapies alter disease progression, underscoring interest in adjunctive, non-pharmacologic strategies.^2,4 Prior acupuncture research in PD has been heterogeneous in quality, and rigorous, sham-controlled data specific to specialized techniques such as QHN have been limited.⁵

The authors noted that penetrating sham needles are now understood to carry their own “insert-specific” physiological effects, meaning the observed between-group differences may represent a conservative estimate of QHN's true benefit. Blinding was well maintained, with comparable proportions of participants in both arms believing they received real acupuncture.

Limitations and Future Research

The single-center design, 10-week follow-up window, and lack of blinding among treating acupuncturists limit generalizability and introduce potential performance bias. Biomechanical assessments were restricted to a small prespecified subset, limiting power to detect modest gait and balance effects, and a higher dropout rate in the control group may have modestly inflated the estimated treatment effect. The authors called for multicenter trials with larger cohorts, longer follow-up, alternative sham-control designs, and neuroimaging or biomarker analyses to clarify the central mechanisms underlying QHN's effects.

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REFERENCES
1. Peng W, Zhao R, Huang Z, et al. Qihuang Needle Therapy for Motor Symptoms in Parkinson's Disease: A Randomized Controlled Trial. Mov Disord. 2026;41(8):2051-2061. doi:10.1002/mds.70343
2. Armstrong MJ, Okun MS. Diagnosis and Treatment of Parkinson Disease: A Review. JAMA. 2020;323(6):548-560. doi:10.1001/jama.2019.22360
3. Jankovic J, McDermott M, Carter J, et al. Variable expression of Parkinson's disease: a base-line analysis of the DATATOP cohort. The Parkinson Study Group. Neurology. 1990;40(10):1529-1534. doi:10.1212/wnl.40.10.1529
4. Bloem BR, Okun MS, Klein C. Parkinson's disease. Lancet. 2021;397(10291):2284-2303. doi:10.1016/S0140-6736(21)00218-X
5. Cho KH, Kim TH, Kwon S, et al. Complementary and Alternative Medicine for Idiopathic Parkinson's Disease: An Evidence-Based Clinical Practice Guideline. Front Aging Neurosci. 2018;10:323. Published 2018 Oct 15. doi:10.3389/fnagi.2018.00323