Journal of Korean Medicine Rehabilitation (한방재활의학과학회지)

The society of Korean Medicine Rehabilitation (한방재활의학과학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of Ultrasound Therapy at the ST11 on Sympathetic Nervous System Change: A Prospective Randomized Controlled Study

기사혈(氣舍穴, ST11)에 적용한 혈위 초음파요법이 교감신경계에 미치는 영향: 전향적 무작위 대조군 연구

  • Shinwoo Kang (Department of Korean Medicine Rehabilitation, Dongguk University Bundang Oriental Hospital) ;
  • Dongho Keum (Department of Korean Medicine Rehabilitation, Dongguk University Bundang Oriental Hospital)
  • 강신우 (동국대학교 분당한방병원 한방재활의학과) ;
  • 금동호 (동국대학교 분당한방병원 한방재활의학과)
  • Received : 2023.09.21
  • Accepted : 2023.10.10
  • Published : 2023.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives This study was designed to assess the effectiveness of ultrasound therapy at the ST11 for regulation of sympathetic hyperactivity. Methods Forty healthy adult subjects were assigned to experimental group and control group. After taking mental stress, ultrasound therapy was applied at the ST11 in experimental group and sham-ultrasound therapy was applied in control group. The evaluation of sympathetic activity was measured by blood pressure, pulse rate, and heart rate variability at 3 times (Time 1: before the stress stimulation, Time 2: after the stress stimulation, Time 3: after the intervention). The primary end point was consisted of normalized (norm) low frequency (LF)/high frequency (HF) ratio, LF (norm), HF (norm). The secondary end point was consisted of systolic blood pressure, diastolic blood pressure, pulse rate, mean heart rate, standard deviation of NN intervals, root mean square of the successive differences, total power (log). Results After the stress stimulation, all subjects showed sympathetic hyperactivity. After the intervention, the experimental group showed lower sympathetic activity than the control group. Comparing the Time 3 and Time 1, the experimental group showed no significantly differences in sympathetic activity while the control group showed higher sympathetic activity in Time 3 than Time 1. Comparing the Time 3 and Time 2, the experimental group showed lower sympathetic activity in Time 3 than Time 2 while the control group showed higher sympathetic activity in Time 3 than Time 2. Conclusions We suggest that the ultrasound therapy at ST11 can decrease sympathetic activity in sympathetic hyperactivity condition.

Keywords

References

  1. The Society of Korean Medicine Rehabilitation. Korean rehabilitation medicine. 5th ed. Koonja Publishing. 2020:393-8, 408-10.
  2. Meridians & Acupoints Compilation Committee of Korean medical Colleges. Acupuncture points. 1st ed. Jeongdam Publishing. 2020:165-7.
  3. Micael H, Norbert K, Karl C. Handbook of acupuncture. 1st ed. Hansol medical book. 2011:44.
  4. Mehrotra M, Reddy V, Singh P. Neuroanatomy, stellate ganglion. StatPearls Publishing. 2022.
  5. Narouze S. Ultrasound-guided stellate ganglion block: safety and efficacy. Current Pain and Headache Reports. 2014;18(6):424.
  6. Larsen B, Macher F, Bolte M, Larsen R. Stellate ganglion block with transcutaneous electric nerve stimulation (TENS): a double-blind study with healthy probands. Anasthesiol Intensivmed Notfallmed Schmerzther. 1995;30(3):155-62. https://doi.org/10.1055/s-2007-996465
  7. Otsuka H, Kemmotsu O, Imai M, Kaseno S. The combination of low reactive-level laser therapy (LLLT) and stellate ganglion block for the treatment of allergic rhinitis. Laser Therapy. 1992;4(3):117-20. https://doi.org/10.5978/islsm.92-OR-13
  8. Momota Y, Kani K, Takano H, Matsumoto F, Aota K, Takegawa D. High-wattage pulsed irradiation of linearly polarized near-rared light to stellate ganglion area for burning mouth syndrome. Case Reports in Dentistry. 2014;2014:171657.
  9. Hazneci B, Tan AK, Ozdem T, Dincer K, Kalyon TA. The effects of transcutaneous electroneurostimulation and ultrasound in the treatment of reflex sympathetic dystrophy syndrome. Turkish Journal of Physical Medicine and Rehabilitation. 2005;51(3):83-9.
  10. Nacitarhan V, Elden H, Kisa M, Kaptanogglu E, Nacitarhan S. The effects of therapeutic ultrasound on heart rate variability: a placebo controlled trial. Ultrasound in Medicine and Biology. 2005;31(5):643-8. https://doi.org/10.1016/j.ultrasmedbio.2005.01.010
  11. Askin A, Savas S, Koyuncuoglu HR, Baloglu HH, Inci MF. Low dose high frequency ultrasound therapy for stellate ganglion blockade in complex regional pain syndrome type I: a randomised placebo controlled trial. International Journal of Clinical and Experimental Medicine. 2014;7(12):5603-11.
  12. Kang MS, Kim LH. The effect of mental stress stimulation and acupuncture at Shinmun (HT7) on heart rate variability. Journal of Oriental Neuropsychiatry. 2009;20(1):165-76.
  13. An SJ, Keum DH. Effect of acupuncture at the field of the auricular branch of the vagus nerve on autonomic nervous system change. J Korean Med Rehabil. 2021:31(2):81-97. https://doi.org/10.18325/jkmr.2021.31.2.81
  14. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behavior Research Methods. 2009;41(4):1149-60. https://doi.org/10.3758/BRM.41.4.1149
  15. Pham T, Lau ZJ, Chen SHA, Makowski D. Heart rate variability in psychology: a review of HRV indices and an analysis tutorial. Sensors (Basel). 2021;21(12):3998.
  16. Reims HM, Sevre K, Fossum E, Hoieggen A, Eide I, Kjeldsen SE. Plasma catecholamines, bloodpressure responses and perceived stress during mental arithmetic stress in young men. Blood Pressure. 2004;13(5):287-94. https://doi.org/10.1080/08037050410016474
  17. Middlekauff HR, Nguyen AH, Negrao CE, Nitzsche EU, Hoh CK, Natterson BA, Hamilton MA, Fonarow GC, Hage A, Moriguchi JD. Impact of acute mental stress on sympathetic nerve activity and regional blood flow in advanced heart failure: implications for 'triggering' adverse cardiac events. Circulation. 1997;96(6):1835-42. https://doi.org/10.1161/01.CIR.96.6.1835
  18. Park KJ, Jeong HJ. Assessing methods of heart rate variability. The Korean Society of Clinical Neurophysiology. 2014;16(2):49-54. https://doi.org/10.14253/kjcn.2014.16.2.49
  19. Kim SY, Han CW, Park SH, Kwon JN, Lee I, Hong JW, Choi JY. Correlation study between electrogastrography and heart rate variability in dyspeptic patients. Journal of Physiology & Pathology in Korean Medicine. 2012;26(4):532-8.
  20. Prabhakar NR, Kumar GK. Mechanisms of sympathetic activation and blood pressure elevation by intermittent hypoxia. Respiratory Physiology and Neurobiology. 2010; 174(1-2):156-61. https://doi.org/10.1016/j.resp.2010.08.021
  21. Kim JY, Kim SJ, Jeong SH. The effects of ultrasonic lipolysis treatment on obesity compared to electroacupuncture. J Korean Med Rehabil. 2012;22(3):141-9.
  22. Choi SH, Kang SW, Park HS, Park SH, Keum DH. Three cases of cervical vertigo improved by traditional Korean medicine treatment. J Korean Med Rehabil. 2022;32(1):145-55. https://doi.org/10.18325/jkmr.2022.32.1.145
  23. Shuai Q. Clinical effect of Neiguan acupoint and Danzhong acupoint combined Qishe acupoint in the treatment of recalcitrant hiccups in the lateral medullary syndrome. World Latest Medicine Information. 2019;19(48):179-87.
  24. Jiarui M, Duo W. Effects of electro-acupuncture treatment on TLR4 signaling pathway in prehypertension rats. China Journal of Traditional Chinese Medicine and Pharmacy. 2017;32(07):3256-8.
  25. Liu LD, Duricka DL. Stellate ganglion block reduces symptoms of Long COVID: a case series. Journal of Neuroimmunology. 2022;362:577784.
  26. Wittwer ED, Radosevich MA, Ritter M, Cha YM. Stellate ganglion blockade for refractory ventricular arrhythmias: implications of ultrasound-guided technique and review of the evidence. Journal of Cardiothoracic and Vascular Anesthesia. 2020;34(8):2245-52. https://doi.org/10.1053/j.jvca.2019.12.015
  27. Lee YS, Wie C, Pew S, Kling JM. Stellate ganglion block as a treatment for vasomotor symptoms: clinical application. Cleveland Clinic Journal of Medicine. 2022;89(3):147-53. https://doi.org/10.3949/ccjm.89a.21032
  28. Guttuso T. Stellate ganglion block for treating hot flashes: a viable treatment option or sham procedure? Maturitas. 2013;76(3):221-4. https://doi.org/10.1016/j.maturitas.2013.08.001
  29. Gibbons CH. Basics of autonomic nervous system function. Handbook of Clinical Neurology. 2019;160:407-18. https://doi.org/10.1016/B978-0-444-64032-1.00027-8
  30. Wehrwein EA, Orer HS, Barman SM. Overview of the anatomy, physiology, and pharmacology of the autonomic nervous system. Comprehensive Physiology. 2016;6(3):1239-78. https://doi.org/10.1002/cphy.c150037
  31. Mulkey SB, du Plessis AJ. Autonomic nervous system development and its impact on neuropsychiatric outcome. Pediatric Research. 2019;85(2):120-6. https://doi.org/10.1038/s41390-018-0155-0
  32. Goldberger JJ, Arora R, Buckley U, Shivkumar K. Autonomic nervous system dysfunction: JACC focus seminar. Journal of the American College of Cardiology. 2019;73(10):1189-206. https://doi.org/10.1016/j.jacc.2018.12.064
  33. Chen Z, Li G, Liu J. Autonomic dysfunction in Parkinson's disease: implications for pathophysiology, diagnosis, and treatment. Neurobiology of Disease. 2020;134:104700.
  34. Piraccini E, Munakomi S, Chang KV. Stellate ganglion blocks. StatPearls Publishing. 2022.
  35. Shanks J, Gao L, Zucker IH. Sympathomodulation in heart failure: a role for stellate ganglia Nrf2. FASEB Journal. 2019;33:564-565. https://doi.org/10.1096/fasebj.2019.33.1_supplement.564.5
  36. Li YL. Stellate ganglia and cardiac sympathetic over-activation in heart failure. International Journal of Molecular Sciences. 2022;23(21):13311.
  37. Hasan W. Autonomic cardiac innervation: development and adult plasticity. Organogenesis. 2013;9(3):176-93. https://doi.org/10.4161/org.24892
  38. Hoang JD, Salavatian S, Yamaguchi N, Swid MA, David H, Vaseghi M. Cardiac sympathetic activation circumvents high-dose beta blocker therapy in part through release of neuropeptide Y. JCI Insight. 2020;5:e135519.
  39. Wang QX, Wang XY, Fu NA, Liu JY, Yao SL. Stellate ganglion block inhibits formalin-induced nociceptive responses: mechanism of action. European Journal of Anaesthesiology. 2005;22(12):913-8. https://doi.org/10.1017/S0265021505001559
  40. Uchida K, Tateda T, Hino H. Novel mechanism of action hypothesized for stellate ganglion block related to melatonin. Medical Hypotheses. 2002;59(4):446-9. https://doi.org/10.1016/S0306-9877(02)00158-5
  41. Goel V, Patwardhan AM, Ibrahim M, Howe CL, Schultz DM, Shankar H. Complications associated with stellate ganglion nerve block: a systematic review. Regional Anesthesia and Pain Medicine. 2019;44(6):669-78. https://doi.org/10.1136/rapm-2018-100127
  42. Anderson TP, Wakim KG, Herrick JF, Bennett WA, Krusen FH. An experimental study of the effects of ultrasonic energy on the lower part of the spinal cord and peripheral nerves. Archives of Physical Medicine and Rehabilitation. 1951;32(2):71-83.
  43. Haar GT. Therapeutic ultrasound. European Journal of Ultrasound. 1999;9:3-9. https://doi.org/10.1016/S0929-8266(99)00013-0
  44. Herrick JF. Temperatures produced in tissues by ultrasound: experimental study using various technics. The Journal of the Acoustical Society of America. 1953;25:12-6. https://doi.org/10.1121/1.1906986