The Effect of Electroacupuncture on the Heart Rate Variability of Stroke Patients under Mental Arithmetic Stress

  • Oh, Jae-Gun (Department of Internal Medicine, College of Oriental Medicine, Wonkwang University) ;
  • Kwon, So-Yeon (Department of Internal Medicine, College of Oriental Medicine, Wonkwang University) ;
  • Yun, Henja (Department of Oriental Medicine Prescription, College of Oriental Medicine, Wonkwang University) ;
  • Sung, Kang-Keyng (Department of Internal Medicine, College of Oriental Medicine, Wonkwang University)
  • 투고 : 2012.10.22
  • 심사 : 2012.12.10
  • 발행 : 2012.12.31

초록

Objectives: This study aimed to compare the effects of high frequency electroacupuncture, low frequency electroacupuncture and manual acupuncture on the autonomic nervous system in stroke patients by using a heart rate variability measuring device. Methods: Thirty-nine participants were recruited and each participated in the high frequency electroacupuncture group, low frequency electroacupuncture group, manual acupuncture group and non-acupuncture group. Some participants received needle insertion with 100 Hz stimulation, with 2Hz stimulation and manual stimulation under mental arithmetic stress during 2 sections. Other participants maintained in the supine position without acupuncture under mental arithmetic stress during the 2 sections. Acupuncture needles were directly inserted perpendicularly to the right Liv 3 acupoint followed by delivery of electric pulses to these points for 8 minutes. Heart rate variability was measured 8 minutes before and 16 minutes after acupuncture stimulation by a heart rate variability measuring system. Results: We found a significant elevated HF total power between 1 section and 2 section and between 1 section and 4 section in the non-acupuncture group, between 3 section and 4 section in the 100Hz electroacupuncture group, and between 1 section and 2 section in the manual acupuncture group and with no change in the 2Hz electroacupuncture group. We also found a significant VLF total power between 2 section and 3 section in the 2Hz electroacupuncture group and between 1 section and 4 section and between 2 section and 4 section in the 100Hz electroacupuncture group. All four groups showed no significant differences in other parameters including heart rate mean, low-frequency power, and the ratio of low-frequency power to high-frequency power. Conclusions: This study may be a basis for research about effects of acupuncture and electroacupuncture because the parameters measured, heart rate variability, showed differences according to acupuncture.

키워드

참고문헌

  1. Sok SH, Kim KB. The effect of auricular acupuncture pressure therapy on insomnia of elderly people [in Korean]. J Korean Acad Soc Adult Nurs 2000;12:222-33.
  2. Park YC, Jo JH, Hong KE, Kang WC, Choi SM. Effect of acupuncture on nasal obstruction in patients with persistent allergic rhinitis: a randomized controlled trial [in Korean]. J Korean Acupunct Mox Soc 2005;22:229-39.
  3. Kim SC, Kim SN, Lim JA, Choi CM, Shim EK, Koo ST, et al. Effects of acupuncture treatment on the premenstrual syndrome: controlled clinical trial [in Korean]. J Korean Acupunct Mox Soc 2005;22:41-60.
  4. Lee H, Hong KE, Kim YI, Yim YK, Ahn TW, Kang WC, et al. A clinical trial of acupuncture treatment for frozen shoulder [in Korean]. J Korean Acupunct Mox Soc 2006;23:165-77.
  5. Kwon YD, Lee SG, Lee CW, Jung SK, Kim DE, Choi SM. The short-term efficacy of acupuncture for chronic low back pain: randomized sham controlled trial. J Orient Rehab Med 2007;17:123 -32.
  6. Choi DY, Lim S, Cha NH, Kim KS, Lee SH, Kim SY, et al. Effects on pain behavior in non-medicinal treatment applied to chronic headache patients [in Korean]. Korean J Meridian Acupoint 2005;22:55-66.
  7. Yuk SS, Lim EM. A clinical study on the effect of crossing over treatment of acupuncture and herbal medication for primary dysmenorrhea [in Korean]. J Orient Obstet Gynacol 2005;18:144-52
  8. Kim ES, Cho JH, Jung WS, Lee SH. Effect of Acupuncture on Heart Rate Variability in Primary Dysmenorrheic Women. The American J Chin Med 2011;39(2):243-9. https://doi.org/10.1142/S0192415X11008786
  9. Sun H, Zhao H, Zhang J, Bao F, Wei J, Wang DH, et al. Effect of acupuncture at Baihui (GV 20) and Zusanli (ST 36) on the level of serum inflammatory cytokines in patients with depression. Zhongguo Zhen Jiu 2010;30(3): 195-9.
  10. Kang SY, Jeong EW, Lee SK, Sung KK. Effects of Electroacupuncture on Immune Function. The J Korean Acupunct Mox Soc 2007;24(6):29-36.
  11. Kimura K, Masuda K, Wakayama I. Changes in skin blood flow and skin sympathetic nerveactivity in response to manual acupuncture stimulation in humans. Am J Chin Med 2006;34:189-96. https://doi.org/10.1142/S0192415X06003758
  12. Hsieh CL. Modulation of cerebral cortex in acupuncture stimulation: a study using sympathetic skin response and somatosensory evoked potentials. Am J Chin Med 1998;26:1-11. https://doi.org/10.1142/S0192415X98000026
  13. Knardahl S, Elam M, Olausson B, Wallin BG. Sympathetic nerve activity after acupuncture in humans. Pain 1998;75:19-25. https://doi.org/10.1016/S0304-3959(97)00197-8
  14. 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;8:399-406. https://doi.org/10.1054/jcaf.2002.129656
  15. Dyrehag LE, Widerstrom-Noga EG, Carlsson SG, Andersson SA. Effects of repeated sensory stimulation sessions (electroacupuncture) on skin temperature in chronic pain patients. Scand J Rehabil Med 1997;29:243-50.
  16. Thomas D, Collins S, Strauss S. Somatic sympathetic vasomotor changes documented by medical thermographic imaging during acupuncture analgesia. Clin Rheumatol 1992;11: 55-9. https://doi.org/10.1007/BF02207085
  17. Choi YT. Jung-hae acupuncture. 1st edition. Seoul: Hanglim publisher. 1974:228-9.
  18. Brod J, Fencl V, Hejl Z, Jirka J. Circulatory changes underlying blood pressure evaluation during acute emotional stress (mental arithmetic) in normotensive and hypertensive subjects. Clin. Sc 1959;19, 269-79.
  19. Nestel PJ. Blood pressure and catecholamine excretion after mental stress in labile hypertension. Lancet 1969;692-4.
  20. Korpelainen JT, Sotaniemi KA, Mäkikallio A, Huikuri HV, Myllylä VV. Dynamic behavior of heart rate in ischemic stroke. Stroke 1999;30:1008-13. https://doi.org/10.1161/01.STR.30.5.1008
  21. Karemaker JM. Autonomic integration: the physiological basis of cardiovascular variability. J Physiol 2012:316.
  22. Lombardi F. Chaos theory, heart rate variability and arrhythmic mortality. Circulation 2000;101: 8-10. https://doi.org/10.1161/01.CIR.101.1.8
  23. Akselrod S, Gordon D, Ubel FA, Shannon DC, Berger AC, Cohen RJ. Power spectrum analysis of heart rate fluctuation: a quantitative probe of beat-to-beat cardiovascular control. Science 1981;213(4504): 220-2. https://doi.org/10.1126/science.6166045
  24. Pomeranz B, Macaulay RJ, Caudill MA, Kutz I, Adam D, Gordon D, et al. Assessment of autonomic function in humans by heart rate spectral analysis. Am. J. Physiol 1985;248(1): 151-3.
  25. Moon SK, Kim YS, Park SW, Jung WS, Ko CN, Cho KH, et al. The Effect of L14-LI11 Electrical Acupuncture at Unaffected Limb on Cerebral Blood Flow in Ischemic Stroke Patients using SPECT. J Korean Acupunct Mox Soc 2004; 21(1):111-8.
  26. Stener-Victorin E, Kobayashi R, Watanabe O, Lundeberg T, Kurosawa M. Effect of Electro-acupuncture Stimulation of Different Frequencies and Intensities on Ovarian Blood Flow in Anaesthetized Rats with Steroid-Induced Polycystic Ovaries. Reprod Biol Endocrinol 2004;2:16. https://doi.org/10.1186/1477-7827-2-16
  27. Cho MH, Choi BT, Jang KJ. The Effects of 120 Hz High Frequency Electroacupuncture on the Gastric Mucosa damage in Cold-Restraint Stressed Rats. J Korean Acupunct Mox Soc 2003;20(3):177-93.
  28. Yun SH. Response of electrical stimulation at shuigou point (GV26) on blood pressure, pulse, and regional cerebral blood flow in rats. J Kyung Hee University Medical Center 1992;8(4):412-8.
  29. Ogata A, Sugenoya J, Nishimura N, MatsumotoT. Low and high frequency acupuncture stimulation inhibits mental stress induced sweating in humans via different mechanisms. Auton Neurosci 2005;118:93-101. https://doi.org/10.1016/j.autneu.2004.11.008
  30. Task force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: Standards of measurement, physiological interpretation, and clinical use. J Eur. Heart 1996;17:354-81. https://doi.org/10.1093/oxfordjournals.eurheartj.a014868
  31. Lombardi F. Chaos theory, heart rate variability and arrhythmic mortality. Circulation 2000;101: 8-10. https://doi.org/10.1161/01.CIR.101.1.8
  32. Borne P, Montano N, Pagani M, Oren R, Somers V. K. Absence of low-frequency variability of sympathetic nerve activity in severe heart failure. Circulation 1997;95:1449-54.
  33. Milicevic G, Lakusic N, Majsec M. Disease progression shifts heart rate variability spectra leftward. Europace 2002;3(Suppl. A): A202.