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

이지혜; 최영준; 신병철; 구성태

건강한 지원자에서 두 경혈(신맥, 조해)이 심박변이도에 미치는 영향의 차이 : 무작위, 단일 맹검, 자기 대조군 임상시험
Differential Effects of Two Individual Acupuncture Points (BL62, KI6) on Heart Rate Variability in Healthy Volunteers : A Randomized, Single-Blind, Self-Controlled Trial 원문보기

경락경혈학회지= Korean journal of acupuncture, v.27 no.4, 2010년, pp.85 - 97

이지혜 (부산대학교 한의학전문대학원 경락구조의학부) , 최영준 (부산대학교 한의학전문대학원 경락구조의학부) , 신병철 (부산대학교 한의학전문대학원 임상의학부) , 구성태 (부산대학교 한의학전문대학원 경락구조의학부)

초록
AI-Helper

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.

주제어

AI 본문요약
AI-Helper

* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.

문제 정의

The aim of this study was to compare the effects of acupuncture applied on different acupoints, BL62 and KI6, by using power spectral analysis of the HRV changes in normal subjects. This comparison allowed us to investigate the ANS responses following acupuncture stimulations on different acupoints.

가설 설정

The experiment was carried out to test the hypothesis that acupuncture has an effect on the cardiac vagal regulation and/or it has a suppressive effect on sympathetic regulation. The HRV measuring technique was especially used to monitor the effects of needling the acupoints, BL62 and KI6 on ANS.
In particular, we looked at the specificities of the two acupoints in modulating the ANS responses by measuring the HRV changes in the subjects. We hypothesized that the manual stimulations of the two acupoints would induce different ANS responses based on the specificities of the two acupoints. Two individual acupoints, BL62 and KI6 on extraordinary meridians (Yin and Yang Stepping Vessels) have different effects on balancing Yin and Yang in the divergent organs.

제안 방법

Session for the control group. Acupuncture needles (0.25-mm diameter, 40mm, Dong Bang Acupuncture Inc.) were inserted bilaterally and superficially (1mm) into the non-acupoint (on the medial side of the foot, in the depression between the tip of the medial malleolus and Achilles tendon; 1cm above the KI 3 point) and no manipulations were given to these points.
Session for the BL62 and the KI6 groups. Acupuncture needles (0.30-mm diameter, 50mm, Dong Bang Acupuncture Inc.) were inserted bilaterally into the BL62 point (on the lateral side of the foot, in the depression, 0.5 cun directly below the external malleolus) or into the KI6 point (on the medial side of the foot, in the depression slightly below the tip of the medial malleolus) with 1 cm depth and manual stimulations were given at these two points for 10s to achieve the De-Qi sensation, which consisted of feelings of heaviness, fullness, or soreness.
All data are expressed as mean ± SEM for the values of the HRV components including heart rate (HR), standard deviation of N-N intervals (SDNN), total power (TP), low frequency power (LF), high frequency power (HF) and the LF/HF ratio during the baseline, the acupuncture and thepost acupuncture periods in the control group, the BL62 and the KI6 groups.
Korea). All human subjects rested in the supine position and the HRV electrodes were positioned on both of their wrists and their right ankle for the measurements. The heart rate (HR), standard deviation of N-N intervals (SDNN), total power (TP), low-frequency (LF, 0.
In considering our methodology, we chose the cross-over design to minimize the variations of the baseline HRV values among the subjects, which would strengthen the reliability of the results obtained for all the groups. This established methodology allows the present study to serve as a pilot study for future prospective studies on investigating specificities of acupoints in relation to HRV.
We chose two acupoints, sinmaek (BL62) and johae (KI6), which have different and even contrary effects associated with sleep control, to evaluate their specificities. In particular, we looked at the specificities of the two acupoints in modulating the ANS responses by measuring the HRV changes in the subjects. We hypothesized that the manual stimulations of the two acupoints would induce different ANS responses based on the specificities of the two acupoints.
The analysis of the recorded measurement of heart rate variability was processed with SA-3000P (Medicore Co. Ltd. Korea). All human subjects rested in the supine position and the HRV electrodes were positioned on both of their wrists and their right ankle for the measurements.

대상 데이터

As this trial was crossover-designed, 13 normal subjects participated in each of the three randomly distributed sessions. There were three different sessions that included the acupoints, BL62 and KI6, and one non-acupoint used as the control.
As this trial was crossover-designed, 13 normal subjects participated in each of the three randomly distributed sessions. There were three different sessions that included the acupoints, BL62 and KI6, and one non-acupoint used as the control.
The experiment procedures were approved by Korean Medicine Clinical Research Center IRB (Institutional Review Board) of Pusan National University (KCRC IRB 2009-01) and were performed in accordance with the ethical standards laid down in the 1964 Helsinki Declaration. Thirteen healthy male and female volunteers aged 24~35, recruited from students within university were scheduled to participate in the study (Table 1). The subjects were healthy as confirmed by their medical histories and they did not suffer from cardiovascular or autonomic disease.

데이터처리

The significance of differences within each group was compared using one-way repeated measures ANOVA (SPSS version 17). The significance of differences among groups was compared using one-way ANOVA. Post-hoc test was processed in Dunnett's method.
Results were given as mean ± SE. The significance of differences within each group was compared using one-way repeated measures ANOVA (SPSS version 17). The significance of differences among groups was compared using one-way ANOVA.

이론/모형

Post-hoc test was processed in Dunnett's method.

성능/효과

The outcome showed that acupuncture applied to BL62 significantly enhanced the overall activity related to heart function and ANS in comparison with KI6. From these results, we reached the conclusion that some acupoints may have stronger influences on HRV than others, and that specificity of acupoints could be observed in the human body through the effects of BL62 on the heart function associated with ANS.
In summary, in the present study we analyzed the different influences on HRV induced by acupuncture applied to different acupoints. The outcome showed that acupuncture applied to BL62 significantly enhanced the overall activity related to heart function and ANS in comparison with KI6. From these results, we reached the conclusion that some acupoints may have stronger influences on HRV than others, and that specificity of acupoints could be observed in the human body through the effects of BL62 on the heart function associated with ANS.

후속연구

In considering our methodology, we chose the cross-over design to minimize the variations of the baseline HRV values among the subjects, which would strengthen the reliability of the results obtained for all the groups. This established methodology allows the present study to serve as a pilot study for future prospective studies on investigating specificities of acupoints in relation to HRV.

참고문헌 (36)

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.

상세보기
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.

상세보기
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.

상세보기
Wang Ju-Yi JDR, editor. Applied channel theory in Chinese medicine : Wang Ju-Yi's lectures on channel therapeutics. Seattle: Eastland Press; 2008.
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

상세보기
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.

상세보기
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.

상세보기
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.

상세보기
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.

상세보기
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.

상세보기
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.

상세보기
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.

상세보기
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.

상세보기
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.

상세보기
Campbell A. Point specificity of acupuncture in the light of recent clinical and imaging studies. Acupunct Med. 2006 ; 24(3) : 118-22.

상세보기
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.

상세보기
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.

상세보기
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.

상세보기
Kleiger RE, Stein PK, Bigger JT, Jr. Heart rate variability: measurement and clinical utility. Ann Noninvasive Electrocardiol. 2005 ; 10(1) : 88-101.

상세보기
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.

상세보기
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.

상세보기
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.

상세보기
Wang SG. Clinical observation on acupuncture at Zhaohai(KI6) and Shenmai(BL62) for treatment of insomnia. Zhongguo Zhen Jiu. 2005 ; 25(11) : 771-2.

상세보기
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.

원문보기 상세보기
Maciocia G, editor. The channels of acupuncture : clinical use of the secondary channels and eight extraordinary vessels. Edinburgh: Churchill Livingstone; 2006.
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.

상세보기
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.

상세보기
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.

상세보기
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.

상세보기
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.

상세보기
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.

상세보기
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.

상세보기
Helms JM, editor. Acupuncture energetics : a clinical approach for physicians. Berkeley, Calif., U.S.A.: Medical Acpuncture Publishers; 1995.
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.

상세보기
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.

상세보기
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.

상세보기

저자의 다른 논문 :

표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format