Differential Effects of Two Individual Acupuncture Points (BL62, KI6) on Heart Rate Variability in Healthy Volunteers : A Randomized, Single-Blind, Self-Controlled Trial

건강한 지원자에서 두 경혈(신맥, 조해)이 심박변이도에 미치는 영향의 차이 : 무작위, 단일 맹검, 자기 대조군 임상시험

  • Lee, Ji-Hye (Division of Meridian and Structural Medicine, School of Korean Medicine, Pusan National University) ;
  • Choi, Young-Joon (Division of Meridian and Structural Medicine, School of Korean Medicine, Pusan National University) ;
  • Shin, Byung-Chul (Division of Clinical Medicine, School of Korean Medicine, Pusan National University) ;
  • Koo, Sung-Tae (Division of Meridian and Structural Medicine, School of Korean Medicine, Pusan National University)
  • 이지혜 (부산대학교 한의학전문대학원 경락구조의학부) ;
  • 최영준 (부산대학교 한의학전문대학원 경락구조의학부) ;
  • 신병철 (부산대학교 한의학전문대학원 임상의학부) ;
  • 구성태 (부산대학교 한의학전문대학원 경락구조의학부)
  • Received : 2010.11.11
  • Accepted : 2010.12.14
  • Published : 2010.12.27

Abstract

목적 : 이 연구는 서로 다른 두 경혈이 심박변이도에 미치는 영향을 비교하고, 자율신경계에 미치는 영향을 평가하기 위해 수행하였다. 재료 및 방법 : 13명의 지원자가 3개의 세션에 균등하게 무작위 배정되었다. 각 세션에서 지원자들은 신맥(BL62), 조해(KI6), 또는 비경혈에 각각 침처치를 받았다. 10분간 휴식을 한 후에 자침 전, 유침기간, 발침 후 기간에 5분 동안 심박변이도 측정을 하였다. 유침기간에는 2분 간격을 두고 2회 심박변이도를 측정하였다. 결과 : 신맥에 자침한 군에서는 자침후 기간에 total power(TP)와 standard deviation N-N interval(SDNN)이 유의하게 증가하였다. 유침기간 중 첫 5분 동안의 TP와 SDNN은 자침전 값과 유의한 차이가 없었으며 유침기간 중 마지막 5분 동안에는 다소 증가하는 경향은 있었지만 통계적인 유의성은 없었다. 반면에 조해와 비경혈에 자침한 군에서는 TP와 SDNN에 유의한 변화가 관찰되지 않았다. 발침 후에 신맥자침군에서는 조해와 비경혈 자극군과 비교해서 TP가 유의하게 변화하였다. 그러나 SDNN은 발침 후에 세 군 사이에 유의한 차이가 없었다. 결론 : 이 실험 결과는 조해와 비교했을 때 신맥에 자침한 경우 심장 기능 및 자율신경계와 관련이 있는 대체적인 활성이 증가한다는 것을 보여주었다. 이 결과는 신맥 자침이 자율신경계와 관계되어 있는 심장의 기능에 미치는 영향을 통해서 경혈의 특이성을 관찰할 수 있음을 의미한다.

Keywords

References

  1. Nishijo K, Mori H, Yosikawa K, Yazawa K. Decreased heart rate by acupuncture stimulation in humans via facilitation of cardiac vagal activity and suppression of cardiac sympathetic nerve. Neurosci Lett. 1997 ; 227(3) : 165-8. https://doi.org/10.1016/S0304-3940(97)00337-6
  2. Imai K, Kitakoji H. Comparison of transient heart rate reduction associated with acupuncture stimulation in supine and sitting subjects. Acupunct Med. 2003 ; 21(4) : 133-7. https://doi.org/10.1136/aim.21.4.133
  3. Pagani M, Lucini D, Mela GS, Langewitz W, Malliani A. Sympathetic overactivity in subjects complaining of unexplained fatigue. Clin Sci (Lond). 1994 ; 87(6) : 655-61. https://doi.org/10.1042/cs0870655
  4. Wang Ju-Yi JDR, editor. Applied channel theory in Chinese medicine : Wang Ju-Yi's lectures on channel therapeutics. Seattle: Eastland Press; 2008.
  5. Cardiology TFotESo. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996 ; 93(5) : 1043-65 https://doi.org/10.1161/01.CIR.93.5.1043
  6. Montano N, Ruscone TG, Porta A, Lombardi F, Pagani M, Malliani A. Power spectrum analysis of heart rate variability to assess the changes in sympathovagal balance during graded orthostatic tilt. Circulation. 1994 ; 90(4) : 1826-31. https://doi.org/10.1161/01.CIR.90.4.1826
  7. Pagani M, Montano N, Porta A, Malliani A, Abboud FM, Birkett C, et al. Relationship between spectral components of cardiovascular variabilities and direct measures of muscle sympathetic nerve activity in humans. Circulation. 1997 ; 95(6) : 1441-8. https://doi.org/10.1161/01.CIR.95.6.1441
  8. Zhang H, Bian Z, Lin Z. Are acupoints specific for diseases? A systematic review of the randomized controlled trials with sham acupuncture controls. Chin Med. 2010 ; 5 : 1. https://doi.org/10.1186/1749-8546-5-1
  9. Moffet HH. Sham Acupuncture May Be as Efficacious as True Acupuncture: A Systematic Review of Clinical Trials. J Altern Complem Med. 2009 ; 15(3) : 213-6. https://doi.org/10.1089/acm.2008.0356
  10. Thomas D, Collins S, Strauss S. Somatic Sympathetic Vasomotor Changes Documented by Medical Thermographic Imaging during Acupuncture Analgesia. Clin Rheumatol. 1992 ; 11(1) : 55-9. https://doi.org/10.1007/BF02207085
  11. Ohsawa H, Okada K, Nishijo K, Sato Y. Neural mechanism of depressor responses of arterial pressure elicited by acupuncture-like stimulation to a hindlimb in anesthetized rats. J Auton Nerv Syst. 1995 ; 51(1) : 27-35. https://doi.org/10.1016/0165-1838(95)80004-T
  12. Zhen HL, Wang Y, Liu XJ. Observation on therapeutic effect of warming needle moxibustion on chronic pelvic inflammation of cold-damp stagnation type. Zhongguo Zhen Jiu. 2008 ; 28(10) : 736-8.
  13. Biella G, Sotgiu ML, Pellegata G, Paulesu E, Castiglioni I, Fazio F. Acupuncture produces central activations in pain regions. Neuroimage. 2001 ; 14(1 Pt 1) : 60-6. https://doi.org/10.1006/nimg.2001.0798
  14. Zhang WT, Jin Z, Luo F, Zhang L, Zeng YW, Han JS. Evidence from brain imaging with fMRI supporting functional specificity of acupoints in humans. Neurosci Lett. 2004 ; 354(1) : 50-3. https://doi.org/10.1016/j.neulet.2003.09.080
  15. Campbell A. Point specificity of acupuncture in the light of recent clinical and imaging studies. Acupunct Med. 2006 ; 24(3) : 118-22. https://doi.org/10.1136/aim.24.3.118
  16. Subbalakshmi NK, Basha A, Ramesh B. Impact of acute respiratory stress on cardiac autonomic control in young healthy subjects explored by time and frequency domain methods. Chin J Physiol. 2009 ; 52(5) : 299-305. https://doi.org/10.4077/CJP.2009.AMH047
  17. Kleiger RE, Miller JP, Bigger JT, Jr., Moss AJ. Decreased heart rate variability and its association with increased mortality after acute myocardial infarction. Am J Cardiol. 1987 ; 59(4) : 256-62. https://doi.org/10.1016/0002-9149(87)90795-8
  18. La Rovere MT, Bigger JT, Jr., Marcus FI, Mortara A, Schwartz PJ. Baroreflex sensitivity and heart-rate variability in prediction of total cardiac mortality after myocardial infarction. ATRAMI(Autonomic Tone and Reflexes After Myocardial Infarction) Investigators. Lancet. 1998 ; 351(9101) : 478-84. https://doi.org/10.1016/S0140-6736(97)11144-8
  19. Kleiger RE, Stein PK, Bigger JT, Jr. Heart rate variability: measurement and clinical utility. Ann Noninvasive Electrocardiol. 2005 ; 10(1) : 88-101. https://doi.org/10.1111/j.1542-474X.2005.10101.x
  20. Sato A, Sato Y, Suzuki A, Uchida S. Reflex modulation of catecholamine secretion and adrenal sympathetic nerve activity by acupuncture -like stimulation in anesthetized rat. Jpn J Physiol. 1996 ; 46(5) : 411-21. https://doi.org/10.2170/jjphysiol.46.411
  21. Tjen ALSC, Li P, Longhurst JC. Medullary substrate and differential cardiovascular responses during stimulation of specific acupoints. Am J Physiol Regul Integr Comp Physiol. 2004 ; 287(4) : R852-62. https://doi.org/10.1152/ajpregu.00262.2004
  22. Li Z, Jiao K, Chen M, Wang C. Effect of magnitopuncture on sympathetic and parasympathetic nerve activities in healthy drivers-assessment by power spectrum analysis of heart rate variability. Eur J Appl Physiol. 2003 ; 88(4-5) : 404-10. https://doi.org/10.1007/s00421-002-0747-5
  23. Wang SG. Clinical observation on acupuncture at Zhaohai(KI6) and Shenmai(BL62) for treatment of insomnia. Zhongguo Zhen Jiu. 2005 ; 25(11) : 771-2.
  24. Kim Su-Hyun LC-H, Yuk Sang-Won, Lee Kwang-Gyu, Lee Tae-Young, Lee Sang-Ryoung. Central Neural Pathways Projecting to the Acupoints B62 and K6 Using the Neural Tracer. The Journal of Korean Acupuncture & Moxibustion Society. 2001 ; 18(2) : 51-66.
  25. Maciocia G, editor. The channels of acupuncture : clinical use of the secondary channels and eight extraordinary vessels. Edinburgh: Churchill Livingstone; 2006.
  26. Vickland V, Rogers C, Craig A, Tran Y. Anxiety as a factor influencing physiological effects of acupuncture. Complement Ther Clin Pract. 2009 ; 15(3) : 124-8. https://doi.org/10.1016/j.ctcp.2009.02.013
  27. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996 ; 93(5) : 1043-65. https://doi.org/10.1161/01.CIR.93.5.1043
  28. Li Z, Wang C, Mak AF, Chow DH. Effects of acupuncture on heart rate variability in normal subjects under fatigue and non-fatigue state. Eur J Appl Physiol. 2005 ; 94(5-6) : 633-40. https://doi.org/10.1007/s00421-005-1362-z
  29. Middlekauff HR, Hui K, Yu JL, Hamilton MA, Fonarow GC, Moriguchi J, et al. Acupuncture inhibits sympathetic activation during mental stress in advanced heart failure patients. J Card Fail. 2002 ; 8(6) : 399-406. https://doi.org/10.1054/jcaf.2002.129656
  30. Haker E, Egekvist H, Bjerring P. Effect of sensory stimulation(acupuncture) on sympathetic and parasympathetic activities in healthy subjects. J Auton Nerv Syst. 2000 ; 79(1) : 52-9. https://doi.org/10.1016/S0165-1838(99)00090-9
  31. Kimura K, Masuda K, Wakayama I. Changes in skin blood flow and skin sympathetic nerve activity in response to manual acupuncture stimulation in humans. Am J Chin Med. 2006 ; 34(2) : 189-96. https://doi.org/10.1142/S0192415X06003758
  32. Agelink MW, Sanner D, Eich H, Pach J, Bertling R, Lemmer W, et al. Does acupuncture influence the cardiac autonomic nervous system in patients with minor depression or anxiety disorders?. Fortschr Neurol Psychiatr. 2003 ; 71(3) : 141-9. https://doi.org/10.1055/s-2003-37756
  33. Helms JM, editor. Acupuncture energetics : a clinical approach for physicians. Berkeley, Calif., U.S.A.: Medical Acpuncture Publishers; 1995.
  34. Langevin HM, Churchill DL, Fox JR, Badger GJ, Garra BS, Krag MH. Biomechanical response to acupuncture needling in humans. J Appl Physiol. 2001 ; 91(6) : 2471-8. https://doi.org/10.1152/jappl.2001.91.6.2471
  35. Sakai S, Hori E, Umeno K, Kitabayashi N, Ono T, Nishijo H. Specific acupuncture sensation correlates with EEGs and autonomic changes in human subjects. Auton Neurosci. 2007 ; 133(2) : 158-69. https://doi.org/10.1016/j.autneu.2007.01.001
  36. Moffet HH. Sham acupuncture may be as efficacious as true acupuncture: a systematic review of clinical trials. J Altern Complement Med. 2009 ; 15(3) : 213-6. https://doi.org/10.1089/acm.2008.0356