針刺內關穴前後心率變異度及血液流體力學之變化

Heart Rate Variability and Hemodynamics after Acupuncture at Neiguan Point

呂萬安(Wan-An Lu)

《北市醫學雜誌》 7卷2期 (2010/06) Pp. 134-143

https://doi.org/10.6200/TCMJ.2010.7.2.04

摘要

目的：藉由心率變異度的分析方法，評估針刺內關穴（P6）是否能提升副交感神經的活性。方法：三十二名針刺組以及三十一名對照組參與本研究，比較針刺組與對照組之間血液流體力學及心率變異度各項指標間的差異，進一步比較針刺P6前、後血液流體力學與心率變異度的變化。心電圖訊號的取樣頻率為200赫茲，高頻功率比（高頻功率／總功率）為副交感神經活性的指標，低頻功率比（低頻功率／總功率）為交感與副交感神經共同調控的指標。結果：針刺P6之後，收縮壓明顯低於對照組，心跳速率下降，心跳間期、心跳間期標準偏差、心跳間期變異係數反而上升。高頻功率比從針刺前的27.1±13.2nu上升到針刺後的37.6±14.1 nu，收縮壓從針刺前的124.9±14.0 mmHg下降到針刺後的116.0±11.2 mmHg。結論：針刺內關穴可以提升健康人副交感神經的活性，降低收縮壓，對於心血管系統可能有助益。

關鍵字

針刺 ； 內關穴 ； 心率變異度 ； 血液流體力學 ； 頻譜分析

並列摘要

Objectives: The use of heart rate variability analysis to evaluated whether acupuncture at the Neiguan point (P6) can improve vagal modulation. Methods: One group consisting of 32 P6 acupuncture patients and a second control group made up of 31 no-treatment patients were included in this study. We compared the P6 acupuncture group and notreatment group in terms of hemodynamics and heart rate variability (HRV) measurements. We further compared HRV and hemodynamics before and after acupuncture for the P6 group. The sampling frequency for the ECG recording was 200 Hz. Normalized highfrequency power (nHFP = HFP/TP) was used as the index of vagal modulation while normalized lowfrequency power (nLFP = LFP/TP) was used as the index of sympathetic and vagal modulation. Results: We found that the systolic blood pressure (SBP) of the P6 acupuncture group after acupuncture at P6 was significantly lower than that of the no-treatment group. The heart rate (HR) of the P6 acupuncture group after acupuncture at P6 was also significantly decreased. In contrast, the mean RR intervals (mean RRI), the standard deviation and coefficient of variation of RR intervals (SDRR, CVRR) were all significantly increased in the P6 group compared to the notreatment group. After acupuncture at P6, the nHFP increased significantly from 27.1±13.2 normalized units (nu) before acupuncture at P6 to 37.6±14.1 nu after acupuncture at P6. Fur thermore, after acupuncture at P6, the SBP decreased significantly from 124.9±14.0 mmHg before acupuncture at P6 to 116.0±11.2 mmHg after acupuncture at P6. Conclusion: We concluded that acupuncture at Neiguan point is able to increase vagal modulation and decrease the SBP of healthy subjects. This might have beneficial to the cardiovascular system.

並列關鍵字

Acupuncture ； neiguan point ； heart rate variability ； hemodynamics ； spectrum analysis