1.湖北中医药大学针灸骨伤学院/针灸治未病湖北省协同创新中心,湖北省武汉市武昌区昙华林188号,430061
2.武汉市中心医院康复科
3.武汉体育学院
4.Research Center of Traditional Chinese Medicine, Medical University of Graz, Austria
gerhard.litscher@medunigraz.at
fxliang5@hotmail.com
收稿:2021-08-29,
修回:2022-04-14,
纸质出版:2022-06-17
移动端阅览
李桐,王华,吴松等.针刺足三里、关元对气虚证患者心率变异性的影响——盲法随机对照研究[J].中医杂志,2022,63(12):1149-1154.
LI Tong,WANG Hua,WU Song,et al.Effects of Acupuncture at Zusanli (ST36) and Guanyuan (CV4) on Heart Rate Variability in People with Qi Deficiency Syndrome: A Blinded, Randomized Controlled Trial[J].Journal of Traditional Chinese Medicine,2022,63(12):1149-1154.
李桐,王华,吴松等.针刺足三里、关元对气虚证患者心率变异性的影响——盲法随机对照研究[J].中医杂志,2022,63(12):1149-1154. DOI: 10.13288/j.11-2166/r.2022.12.010.
LI Tong,WANG Hua,WU Song,et al.Effects of Acupuncture at Zusanli (ST36) and Guanyuan (CV4) on Heart Rate Variability in People with Qi Deficiency Syndrome: A Blinded, Randomized Controlled Trial[J].Journal of Traditional Chinese Medicine,2022,63(12):1149-1154. DOI: 10.13288/j.11-2166/r.2022.12.010.
目的
2
观察针刺足三里、关元穴对气虚证患者临床症状及心率变异性指标的影响,并探究穴位特异性。
方法
2
将90例气虚证患者随机分为足三里组、关元组、假针刺组,每组30例。足三里组针刺双侧足三里穴,同时假针刺关元穴;关元组针刺关元穴,同时假针刺双侧足三里穴;假针刺组同时假针刺双侧足三里穴和关元穴。各组均隔日治疗,共治疗10次。治疗前后进行气虚证症状量化评分并检测患者心率变异性指标,包括时域指标的平均心率(mean HR)、全部窦性心搏R-R间期的标准差(SDNN)、24h内相邻窦性R-R间期差值的均方根(r-MSSD)和频域指标的心率变异性总功率(HRV total)、低频(LF)、高频(HF)、极低频带(VLF)、低频高频比对数值[log(LF/HF)]。
结果
2
治疗后足三里组、关元组患者气虚证症状量化评分均较本组治疗前下降,且治疗后评分均低于假针刺组,而治疗后足三里组评分又低于关元组(
P
<0.05)。足三里组治疗后SDNN、r-MSSD、VLF、LF、HRV total均显著增高,关元组HRV total升高,差异有统计学意义(
P
<0.05)。足三里组治疗后SDNN、r-MSSD、VLF、LF、HRV total显著高于关元组(
P
<0.05)。
结论
2
针刺足三里、关元穴可改善气虚证患者临床症状,并调控心率变异性,两者作用有差异且针刺足三里对自主神经功能调节的作用优于针刺关元穴。
Objective
2
To observe the effect of acupuncture at Zusanli (ST36) and
Guanyuan
(CV4) on the symptoms and heart rate variability (HRV) in patients with
qi
deficiency syndrome, and to explore the acupoint specificity.
Methods
2
Totally, 90 patients with
qi
deficiency syndrome were randomly divided into Zusanli group, Guanyuan group, and sham acupuncture group, with 30 cases in each group. In Zusanli group, bilateral Zusanli (ST36) were needled while sham acupuncture was used at bilateral Guanyuan(CV4); in Guanyuan group, bilateral Guanyuan(CV4) were needled, while sham acupuncture was used at bilateral Zusanli(ST36); in sham acupuncture group, both bilateral Zusanli(ST36) and Guanyuan(CV4) were shamly needled. All groups were treated once every other day, for 10 times in total. Before and after treatment, the score of symptoms of
qi
deficiency syndrome was assessed, and the HRV was detected including the mean heart rate (mean HR), the standard deviation of NN intervals (SDNN), and the root mean square of difference between adjacent NN intervals (r-MSSD) of the time domain indicators, and the total heart rate variability (HRV total), low frequency (LF), high frequency (HF), very low frequency (VLF), and log (low frequency/high frequency, LF/HF of the frequency domain indicators.
Results
2
The symptom scores of
qi
deficiency syndrome in the Zusanli group and Guanyuan group decreased after treatment, and were lower than that of the sham acupuncture group with the lowest score in the Zusanli group (
P
<0.05). The SDNN, r-MSSD, VLF, LF and HRV total of the Zusanli group, as well as the HRV total of the Guanyuan group significantly increased after treatment (
P
<0.05). The SDNN, r-MSSD, VLF, LF, and HRV total in Zusanli group were significantly higher than those in Guanyuan group (
P
<0.05).
Conclusion
2
Acupuncture at Zusanli(ST36) and Guanyuan (CV4) can both improve the clinical symptoms and regulate HRV in people with
qi
deficiency syndrome, but the effect is different that acupuncture at Zusanli(ST36) has better effects on the regulation of autonomic nerve function than acupuncture at Guanyuan(CV4).
宋燕娟 , 陈丽 , 梁凤霞 , 等 . 针刺治疗气虚证作用机制研究进展 [J]. 中华中医药学刊 , 2019 , 37 ( 1 ): 133 - 136 .
张惠敏 . 气虚体质评定标准规范化及其流行病学调查的初步研究 [D]. 北京 : 北京中医药大学 , 2004 .
于冰琰 , 毕建璐 , 陈晶 , 等 . 大学生亚健康状态与气虚质关系的调查分析 [J]. 时珍国医国药 , 2013 , 24 ( 8 ): 1966 - 1968 .
毕建璐 . 补中益气丸干预气虚质的临床观察及其血浆代谢组学机制研究 [D]. 广州 : 南方医科大学 , 2014 .
STEIN PK , KLEIGER RE . Insights from the study of heart rate variability [J]. Annu Rev Med , 1999 , 50 : 249 - 261 . doi: 10.1146/annurev.med.50.1.249 http://dx.doi.org/10.1146/annurev.med.50.1.249 .
戴跃龙 , 李方洁 , 杨阳 . 气阴两虚证(冠心病、糖尿病)心率变异性时域指标研究 [J]. 黑龙江中医药 , 2009 , 38 ( 6 ): 4 - 5 .
舒晴 , 孙丹红 , 王华 , 等 . 针刺与艾灸对气虚证心率变异性的不同影响:随机对照研究 [J]. 中国针灸 , 2017 , 37 ( 1 ): 25 - 30 .
宋燕娟 , 梁凤霞 , 王华 , 等 . 针灸关元、足三里对气虚证心率变异性即时效应的影响 [J]. 中国针灸 , 2020 , 40 ( 10 ): 1047 - 1051 .
阎英杰 , 王淑珍 , 刘福来 , 等 . 糖尿病心脏自主神经病变中医证型与心率变异性关系的分析 [J]. 时珍国医国药 , 2009 , 20 ( 11 ): 2784 - 2785 .
WANG JD , KUO TB , YANG CC . An alternative method to enhance vagal activities and suppress sympathetic activities in humans [J]. Auton Neurosci , 2002 , 100 ( 1/2 ): 90 - 95 .
NISHIJO K , MORI H , YOSIKAWA K , et al . Decreased heart rate by acupuncture stimulation in humans via faci-litation of cardiac vagal activity and suppression of cardiac sympathetic nerve [J]. Neurosci Lett , 1997 , 227 ( 3 ): 165 - 168 .
KIMURA Y , HARA S . The effect of electro-acupuncture stimulation on rhythm of autonomic nervous system in dogs [J]. J Vet Med Sci , 2008 , 70 ( 4 ): 349 - 352 .
CHUNG JW , YAN VC , ZHANG H . Effect of acupuncture on heart rate variability: a systematic review [J]. Evid Based Complement Alternat Med , 2014 : 819 - 871 . doi: 10.1155/2014/819871 http://dx.doi.org/10.1155/2014/819871 .
郑筱萸 . 中药新药临床研究指导原则(试行) [M]. 北京 : 中国医药科技出版社 , 2002 : 379 - 380 .
SHU Q , WANG H , LITSCHER D , et al . Acupuncture and moxibustion have different effects on fatigue by regulating the autonomic nervous system: a pilot controlled clinical trial [J]. Sci Rep , 2016 , 6 : 37846 . doi: 10. 1038/srep37846 http://dx.doi.org/10.1038/srep37846 .
STREITBERGER K , KLEINHENZ J . Introducing a placebo needle into acupuncture research [J]. Lancet , 1998 , 352 ( 9125 ): 364 - 365 .
王利敏 , 曲彬彬 , 赵歆 , 等 . 基于结构方程模型的亚健康状态中医证候量化分析研究 [J]. 中华中医药杂志 , 2011 , 26 ( 5 ): 1033 - 1036 .
周仙仕 , 李俊 , 刘云涛 , 等 . 4833例内科脓毒症入院患者中医证素分布规律回顾性研究 [J] 中医杂志 , 2021 , 62 ( 8 ): 683 - 686 .
吴孝政 , 王振兴 , 王依澜 , 等 . 慢性阻塞性肺疾病稳定期患者肺肾气虚证与血管紧张素转换酶基因单核苷酸多态性的相关性 [J] 中医杂志 , 2019 , 60 ( 15 ): 1299 - 1303 .
BONEVA RS , DECKER MJ , MALONEY EM , et al . Higher heart rate and reduced heart rate variability persist during sleep in chronic fatigue syndrome: a population-based study [J]. Auton Neurosci , 2007 , 137 ( 1/2 ): 94 - 101 .
TEISALA T , MUTIKAINEN S , TOLVANEN A , et al . Associations of physical activity, fitness, and body composition with heart rate variability-based indicators of stress and recovery on workdays: a cross-sectional study [J]. J Occup Med Toxicol , 2014 , 9 : 16 . doi: 10.1186/1745-6673-9-16 http://dx.doi.org/10.1186/1745-6673-9-16 .
AMIRIAN I , TOFTEGåRD ANDERSEN L , ROSENBERG J , et al . Decreased heart rate variability in surgeons during night shifts [J]. Can J Surg , 2014 , 57 ( 5 ): 300 - 304 .
LI K , RüDIGER H , ZIEMSSEN T . Spectral Analysis of Heart Rate Variability: Time Window Matters [J]. Front Neurol , 2019 , 10 : 545 . doi: 10.3389/fneur. 2019. 00545 http://dx.doi.org/10.3389/fneur.2019.00545 .
YU Z . Neuromechanism of acupuncture regulating gastrointestinal motility [J]. World J Gastroenterol , 2020 , 26 ( 23 ): 3182 - 3200 .
ARMSTRONG K , GOKAL R , TODORSKY W . Neuromodulating influence of two electroacupuncture treatments on heart rate variability, stress, and vagal activity [J]. J Altern Complement Med , 2020 , 26 ( 10 ): 928 - 936 .
WANG S , CHENG ZD , JIN D , et al . Moxibustion at Front-Mu point of abdomen for intestinal dysbacteriosis in rats [J]. J Acupunct Tuina Sci , 2011 , 9 ( 1 ): 21 - 25 .
柳钶 , 姜劲峰 , 卢圣锋 . 针灸调节自主神经研究的效应特点及其途径分析 [J]. 针刺研究 , 2021 , 46 ( 4 ): 335 - 341 .
LIU S , WANG ZF , SU YS , et al . Somatotopic organization and intensity dependence in driving distinct npy-expressing sympathetic pathways by electroacupuncture [J]. Neuron , 2020 , 108 ( 3 ): 436 - 450 .
0
浏览量
4
下载量
5
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号