BACKGROUND: A certain therapeutic effects of acupuncture have been achieved on the treatment of primary Parkinson disease (PD), but the mechanism of it has been unknown yet. OBJECTIVE: To study the therapeutic effects of needling and point-injection on the treatment of primary PD and the possible therapeutic methods. DESIGN: Randomized and controlled single-blind trial. SETTING AND PARTICIPANTS: All the participants from the Department of Neurosurgery, Nanjing Brain Hospital from June 1998 to October 2000, were accorded with Diagnosis and Identifying Diagnosis on Parkinson disease and Parkinson Syndromes determined on National Symposium on Extrapyramidal Disease held in October 1984, and stopped medicinal treatment for more than 3 weeks. According to visiting sequence, at the ratio of 2:2:1, the participants were randomized into 21 cases in needling group, 23 cases in point-injection group and 10 cases in the control. INTERVENTIONS: In the needling group, treatment was given with filiform needles, once daily for 15 days. In point-injection group, injection was given on acupoints with mailuoning injection (produced by Nanjing Jinling Pharmaceutical (group) Co Ltd, No (1985) 177601), 2 mL on each acupoint, two points each time, once daily for 15 days. In the control, neither needling nor point injection was given. The modified Webster evaluation table for symptoms was adopted to evaluate the therapeutic effects. Before and after treatment, the concentrations of beta-endorphin and leucine enkephalin (LEK) and nitric oxide in cerebrospinal fluid were measured. MAIN OUTCOME MEASURES: The therapeutic effects of PD patients, concentrations of beta-endorphin, leucine enkephalin and nitric oxide in cerebrospinal fluid in every group. RESULTS: The total effective rate in needling and point-injection groups was 71% and 65% respectively. In point-injection group, the concentration of LEK was decreased (1.81 +/- 0.29 mug/L), of beta-endorphin increased (184.13 +/- 9.94 mug/L) and of nitric oxide increased (10.45 +/- 0.53 mumol/L). In needling group, the concentration of beta-endorphin was increased (144.73 +/- 12.72 mug/L), of LEK decreased (4.18 +/- 0.56 mug/L) and of nitric oxide increased (8.46 +/- 0.55 mumol/L). Compared with the results before treatment, there were significant differences for all (t = 5.74 to 9.47, p < 0.001). Nitric oxide increasing in needling group was significantly related with the therapeutic effects (t = 3.019, p < 0.01). In the control, there were no significant differences in the concentrations of three substances during this period. CONCLUSION: Both acupuncture and point injection have achieved a certain therapeutic effects on the treatment of primary PD, the mechanism of which is probably related with the changes in concentrations of central leucine enkephalin, beta-endorphin and nitric oxide.

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