以脈膊變異度取代心率變異度應用於肌筋膜疼痛症之可行性研究

The Feasibility to Apply the Pulse Rate Variability as a Substitute for Heart Rate Variability in Patients with Myofascial Pain Syndrome

黃如男(Ru-Nan Huang) ； 謝鴻海(Hong-Hai Sie) ； 葉青釗(Jing-Jhao Ye) ； 周盈妤(Ying-Yu Chou) ； 莊炯承(Chiung-Cheng Chuang)

《物理治療》 42卷2期 (2017/06) Pp. 88-94

https://doi.org/10.6215/FJPT.PTS20170642025

摘要

背景：在臨床上，常使用心率變異度（heart rate variability, HRV）來當作自主神經活性的指標，並且也應用在疼痛的相關研究上。近幾年來，也已有學者開始探討脈率變異度（pulse rate variability, PRV）是否可取代HRV應用在相關研究上。然而，目前仍鮮少研究應用在病患身上來進行探討，主要還是應用在健康正常人身上。目的：本研究主要探討PRV是否可取代HRV應用於慢性肌筋膜病症（myofascial pain syndromes, MPS）上，以協助相關研究建立臨床上應用PRV取代HRV的相關依據。方法：本研究收取26位MPS病患，藉由多訊號擷取系統，擷取MPS病患於熱敷以及電療前、後之心電圖（electrocardiography, ECG）、光體積描記器（photoplethysmography, PPG）訊號，進而取得PRV與HRV參數。結果：研究結果經由相關性與一致性統計檢定得知，PRV幾乎所有時頻域參數與HRV時頻域參數呈現統計意義上的高度相關和高度一致；而個別在治療前後的參數差異性結果中也發現PRV參數與HRV參數具有相同的變化趨勢。結論：因此本研究結果推測以脈膊間期（pulse-pulse interval, PPI）為基礎取代心律間期（R-R interval, RRI）進行HRV分析，並應用於臨床上MPS病患評估疼痛具有可行性。

關鍵字

肌筋膜疼痛症 ； 心率變異度 ； 脈膊變異度

並列摘要

Background: The heart rate variability (HRV) is commonly used to assess the autonomic nervous functions in pain-related studies. The pulse rate variability (PRV), which is determined by photoplethysmography, has been suggested as a substitute for HRV to assess the autonomic nervous functions. However, up to date, the interchangeability between the two indexes was only considered in a limited group of subjects. Objective: This study was to investigate the feasibility of substituting PRV for HRV in patients with myofascial pain syndrome (MPS) to expand the clinical applications of the PRV. Methods: Twenty-six MPS patients were recruited in this study. Their HRV and PRV parameters were recorded by using the electrocardiography and plethysmography in a pre- and post-treatment study design. RESULTS: Almost all of the time-and frequency-domain parameters of the PRV showed highly significant correlations with those for HRV. Conclusion: The results suggest that the substituting PRV for HRV in the MPS patients is clinically feasible.

並列關鍵字

Myofascial pain syndrome ； Heart rate variability ； Pulse rate variability