• Journal of Acupuncture Research
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• v.37 no.1
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• pp.19-27
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• 2020

The effectiveness of fire needling or warm needling treatment in clinical studies for the treatment of ankle sprains was reviewed using 4 international (PubMed, Cochrane library, EMBASE, CNKI) and 5 Korean databases (NDSL, RISS, KISS, OASIS, KTKP). Randomized controlled trials, that performed fire needling or warm needling treatment for ankle sprains until October, 2018 were retrieved (n = 8). All studies were performed in China, and 7 out of 8 studies were published within the last 5 years. There were 4 studies that used fire needling treatment, 3 studies used warm needling treatment, and 1 study used fire and warm needling treatment. The ashi-points and gallbladder meridian were the most frequently selected acupoint and meridian each. All intervention groups in the 8 studies showed statistically significant beneficial effects compared with control groups. The results of this study could provide preliminary data as the basis for well-designed randomized controlled trials on fire needling or warm needling treatment for ankle sprains.

• Journal of Pharmacopuncture
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• v.25 no.4
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• pp.301-316
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• 2022

Objectives: This study aimed to evaluate the efficacy and safety of heat stimuli (e.g., fire needling, warm needling) in acupuncture for acute gout. Methods: Four international online databases (PubMed, Cochrane, Embase, and Chinese National Knowledge Infrastructure) were searched to identify randomized, controlled trials (RCTs) that used fire needling and warm needling for acute gout. The methodological quality of the RCTs was evaluated using the Cochrane risk-of-bias (RoB) tool. Thirteen RCTs (840 patients) were included and analyzed. Three evaluation tools (total effective rate, uric acid level, and pain score) were mainly used. Comparisons were made between Western medicine (WM) and i) fire needling or warm needling treatment alone, ii) fire needling and bloodletting combination treatment, iii) combination of fire needling, bloodletting, and herbal medicine, iv) warm needling (concurrently). Heat stimuli in acupuncture alone or in combination treatment were more effective in terms of the total efficacy rates, uric acid levels, and pain scores than WM alone. Results: In all the evaluation tools, the treatment effects in the fire needling alone or warm needling alone treatment group and the fire needling and bloodletting combination intervention group were significantly better than those in the WM control group. The warm needling and WM combination intervention groups also experienced significantly better treatment effects in terms of total efficacy rates and uric acid levels. Only the pain scores in the fire needling, bloodletting, and herbal medicine combination groups demonstrated significant improvement. Only four studies mentioned adverse reactions: one reported loss of appetite; three studies reported none. According to the Cochrane RoB tool, most studies showed either high or uncertain RoB. Conclusion: Heat stimuli during acupuncture could be effective for acute gout. However, as the included studies were regionally biased, more high-quality studies are needed to confirm the level of evidence.

• Korean Journal of Acupuncture
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• v.26 no.2
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• pp.75-89
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• 2009

Objectives: Warm needling combines simultaneously the effects of acupuncture and moxibustion. This study was to investigate whether warm needling could relieve acute knee arthritis induced by carrageenan in rats. Methods: To illuminate the underlying mechanisms of the warm needling-induced antinociception, weight bearing force (WBF) was observed on the acute knee arthritic rat model. Under general anesthesia, ST36, SP9, Hakjung extra point, LI4 were punctured and stimulated with 30 mg moxa ball combustion on top of the needle (${\emptyset}0.18{\times}8mm$). Results: In behavioral test, rats subsequently showed a reduced stepping force of the affected limb 3 hours after the induction of arthritis. Warm needling on the contralateral or ipsilateral ST36 failed to show antinociceptive effect on the acute knee arthritis. Warm needling on the contralateral SP9 or LI4 increased WBF values to normal level in the acute stage of the arthritis. Warm needling on the Hakjung extra-point resulted in the significant antinociceptive effects through acute stage. These effects of warm needling were suppressed by opioids receptor antagonist naltrexone (10 mg/kg, i.p.) and alpha adrenoceptor antagonist phentolamine (5 mg/kg, i.p.). Conclusion: The data suggest that warm needling-induced antinociception is differently mediated by acupoints and accomplished by activating the descending inhibitory systems including endogenous opioids and $\alpha$-adrenoceptors.

• Korean Journal of Acupuncture
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• v.26 no.2
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• pp.61-74
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• 2009

Objectives: The warm needling technique is a method which combines the effects of acupuncture with those of moxibustion. The purpose of this study was to find the stimulus effects of a high frequency warm needling device when stimulating acupoint $LI_4$ on the carrageenan-induced arthritis. Methods: This study was to observe the effects to edema reaction, WBF(weight bearing force), NO concentration, nNOS expression after the electro high frequency stimulus of high frequency warm needling device on LI4 with insulated acupuncture needle. Results: The effect of the high frequency warm needling device is to rise up the temperature in proportion to the current intensity. After stimulating on the acupoint $LI_4$ of the carrageenan-induced arthritis in rats with the high frequency warm needling device, it significantly reduced edema in the rat's foot. In addition, WBF, NO concentration of spinal cord (nmol/mg), and nNOS relative expression were reduced. Conclusions: The above results support the idea that stimulus by the high frequency warm needling device on $LI_4$ produces a potent analgesic effect in the arthritis pain model of the rat. Moreover, stimulus by the high frequency warm needling device modulates endogenous NO through the suppression of nNOS protein expression.

• Korean Journal of Acupuncture
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• v.30 no.3
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• pp.178-184
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• 2013

Objectives : The warm needling technique is the method combining the effects of acupuncture needle with those of moxibustion. We need to standardize the characteristics of the warm needling technique, in order to get more systematic and objective results in operation and effects and then get more clinical abilities in these fields. Methods : In this study, using labview system on the warm needling technique, we measured and compared partial temperature changes according to the kind of needle. We studied relations of moxa cones of various sizes with the peak combustion temperature. Results and Conclusions: When we measured the warm needling's partial temperature, temperature measured at 1 and 2 cm below the head, according to the kind of needle, gold needle got the higher result on the peak than SS304 stainless steel needle. In the case of combustion of the moxa cones, cones weighing 0.4 g and 0.8 g, respectively, and the apex ignition method with gold needle showed the higher result than the apex ignition method with stainless steel needle, when we measured the effective stimulus time at 2 cm below the head and the mean temperature during the effective stimulus time. Although more research to standardize the characteristics of the warm needling technique will be needed, we suggest, according to these results, that warm needling of gold needle combined with moxa cone of 0.4 or 0.8 g is effective.

• Korean Journal of Acupuncture
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• v.36 no.4
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• pp.210-220
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• 2019

Objectives : Warm needling is a combined treatment technique of acupuncture and moxibustion. In this study, we aimed to find out the components related with the thermal stimulation of the warm needling and to provide basic data for the guideline of the warm needling technique in the clinic. Methods : In this study, we measured thermal change of 3% agarose phantom embedding K-type thermocouples in depths of 0, 1, 2, 4, 8 and 16 mm. The warm needling was performed with acupuncture needles of various specifications (0.50×30, 0.50×40, 0.30×30, 0.30×40, 0.20×30 and 0.20×40 mm). A linear regression analysis was performed to find out the major component and quantify the effectiveness of the thermal stimulation during warm needling. Results : As a result of the measurement of temperature change, we could observe the thermal change pattern from the surface of the phantom to the 16mm deep part of the phantom. The thermal pattern was similar among the needles of different specifications. The regression analysis pointed the distance between the moxa cautery and the skin surface as the main component for the thermal stimulation of the warm needling. Conclusions : The authors suggest considering the distance between moxa cautery and the skin rather than the diameter of the acupuncture needle in accordance to the result of the study.

• Journal of Acupuncture Research
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• v.37 no.2
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• pp.69-78
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• 2020

Although there have been studies investigating the clinical effects of warm needling (WN) for specific diseases, a comprehensive review of WN is needed. Four Korean internet databases were used in the review of WN treatment performed in Korea. The search terms used to retrieve articles were "warm needling (in Korean; 온침)," "warm acupuncture," and "warm needle." A total of 29 articles were reviewed. The following aspects of WN were investigated: language and terminology, study design, use of Standards for Reporting Interventions in Clinical Trials of Acupuncture, research ethics, moxibustion types, number of moxa used, moxa combustion time, needle retention time, treatment time and frequency, acupoints, meridians, acupuncture size and depth, disease classification, pattern identification, outcome measures, and adverse effect. More sophisticated and precise studies on WN are required.

• Journal of Korean Medicine Rehabilitation
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• v.24 no.3
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• pp.111-119
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• 2014

Objectives This study aims to analyze a thermal distribution in biological living tissue during warm needling therapy by using a finite element method. The analysis provides an understanding of warm needling's efficacy and safety. Methods A model which consisted of four-layered tissue and stainless steel needle was adopted to analyze the thermal distribution in living tissue with a bioheat transfer analysis. The governing equation for the analysis was a Pennes' bioheat equation. A heat source characteristic of warm needling therapy was obtained by previous experimental measurements. The first analysis of the time-dependent temperature distribution was conducted through points on a boundary between the needle and the tissue. The second analysis was conducted to visualize the horizontal temperature distribution. Results When heat source's peak temperatures was above $500^{\circ}C$ and temperature rising rates were relatively slow, the peak temperature at skin surface exceeded a threshold of pain and tissue damage ($45^{\circ}C$), whereas when the peak temperature was around $400^{\circ}C$, the peak temperature at the skin surface was within a safe limit. In addition, the conduction of combustion energy from the moxa was limited to the skin layer around the needle. Conclusions The results suggest that the skin layer around the needle can be heated effectively by warm needling therapy, but it appears to have little effect at the deeper tissue. These findings enhance our understanding of the efficacy and the safety of the warm needling therapy.

• Korean Journal of Acupuncture
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• v.38 no.4
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• pp.222-234
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• 2021

Objectives : The purpose of this study is to examine the efficacy of fire needling and warm needling for De Quervain Syndrome by reviewing clinical studies for recent 10 years. Methods : Randomized controlled trials, non-randomized controlled trials, and case series containing more than 20 cases about fire needling and warm needling for De Quervain Syndrome published since 2011 were searched through four foreign online databases (CNKI, Pubmed, EMBASE, Cochrane Library) and five Korean online databases (OASIS, Science ON, DBPIA, KISS, RISS). The number and characteristics of participants, treatment points and main treatment methods involving other combination treatments, treatment cycle or total periods of treatments, evaluation indices, efficacy, and adverse events were analyzed. Risk of bias of included randomized clinical trials was assessed using a revised tool for assessing risk of bias in randomized trials (RoB 2). Results : A total of 6 randomized clinical trials and 2 case series involving 471 participants were included. Tender point or 'Ashi point' was the most commonly used treatment point, followed by LU4. Treatment frequency ranged from once a day to once a week. One to three outcome measures were used to evaluate the results of the studies, with the efficacy rate the most frequently used, followed by visual analogue scale. Overall risk of bias of all included randomized clinical trials was judged to have some concerns. Conclusions : All selected studies showed that fire needling and warm needling treatments for De Quervain syndrome were more effective than other clinical methods or acupuncture treatments. However, as the number of clinical studies is still too small and the risk of bias of the studies is not low, it is believed that more systematic and objective studies should be conducted.

• Korean Journal of Acupuncture
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• v.25 no.1
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• pp.247-257
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• 2008

Objectives : The warm needling technique is the method in combining the effects of acupuncture needle with the effects of moxibustion. We need to standardize the characteristics of the warm needling technique in order to get more systematic and objective result in operation mechanism and effects and then get more clinical abilities in these fields. Methods : In this study, using of labview system on the warm needling technique we studied about measurement and comparison with partial temperature changes according to the position of ignition. Results & conclusion : When we measured the warm needling's partial temperature according to the position of ignition, the bottom ignition method got the higher result on the peak temperature measured at 2cm below the head than the apex ignition method.