| ObjectivesTo explore the characteristics of heart rate and heart rate variability in patients with Qi-deficiency syndrome, observe the instant and therapeutic effects of acupuncture and moxibustion therapies on mean heart rate 、 heart rate variability,compare the clinical efficacy of acupuncture and moxibustion therapies based on clinical syndrome scores.Methods30 patients suffering from Qi-deficiency syndrome were randomly assigned to acupuncture group and moxibustion group,each consisting of 15 patients and another 15 healthy volunteers were recruited as healthy control group.Within the first experiment, Qi-deficiency scores were assesed and the duration of R-R intervals of all Qi-deficiency syndrome patients and healthy volunteers was measured in a resting state during a special time period(5min) for 45 minutes in total.Within the second experiment, patients received respectively acupuncture and moxibustion therapies on acupoints of Guanyuan(CV4) and Zusanli(ST36).For each group,before,during and after the first treatment, researchers used a medilog AR12 HRV monitor provided by the Graz Medical University for electrocardiographic(ECG) data collection by using three adhesive electrodes applied to the chest. For acupuncture group,researchers chose sterile single-use needles to operate at the acupoints and sustained them for 30 minutes every other day,as for moxibustion group,researchers used a burning moxa stick placed in a box to warm the acupoints for 30 minutes every other day. After the tenth treatment,the Qideficiency scores were assessed again as well as before the first time and HRV was measured once again for 45 minutes in a resting state.The raw data were then transferred to Graz Medical University via internet for analysis.Results1. We collected complete data of 13 cases of healthy volunteers and 21 cases of patients with Qi-deficiency syndrome including 10 cases in acupuncture group and 11 cases in moxibustion group.2. Patients with Qi-deficiency syndrome got lower symptom scores(P < 0.01) and possessed no significance in mean HR,total HRV and lg LF/HF(P>0.05) in a resting state compared to the healthy volunteers, while key parameter total HRV in patients with Qi-deficiency syndrome was lower with a P value of 0.12.3. During the overall process of the first treatment,mean HR and total HRV of acupuncture group varied significantly over time(P<0.05).Mean HR decreased mainly during the needle inserted and retained phases and increased after removing theneedles significantly(P < 0.05).Total HRV declined significantly before the last 5 minutes of acupuncture process(P < 0.05).While lg LF/HF showed a declining trend with no significance yet(P>0.05).Within the moxibustion group,mean HR rised gradually and showed significant difference 5 to 10 minutes after the moxibustion process(P<0.05).There exhibited a rising trend as to total HRV and lg LF/HF with no significance supported(P > 0.05).The interactions of time and group( time*group), which represented if the effects of interventions differed from each other over time, suggested different effects on mean HR by acupuncture and moxibustion over time(P=0.004),while the effects on total HRV of these two therapies showed no difference(P > 0.05) over time and the effects on lg LF/HF,of which P value is 0.072,had not been observed statistically different yet.4. After the tenth treatment,there was higher total HRV and lower mean HR than before in both groups, and lower lg LF/HF in acupuncture group,higher lg LF/HF in moxibustion group, respectively.While statistical significances had not been observed yet(P>0.05).5. Qi-deficiency scores after the treatment course decreased significantly(P<0.05) than before in both groups and there was no significance between these two therapies.(P>0.05).Conclusions1. There’s no significant difference between the healthy and patients with Qi-deficiency syndrome. However,lower total HRV in patients with Qi-deficiency syndrome has thepotential to take on a statistical significance after expansion of sample size.2. Instant effects of acupuncture and moxibustion therapies on patients with Qi-deficiency syndrome varied in mean heart rate and heart rate variability.Needle stimulation leads a significant decline in mean HR、total HRV and a downward trend of lg LF/HF in contrast to the significant rise of mean HR and a upward trend of total HRV and lg LF/HF in moxibustion group.This may due to the possibility that acupuncture and moxibustion exert instant effects through different modulation of autonomic nervous system,including the vagus nerve and the sympathetic nerve.3. Neither acupuncture nor moxibustion therapy improves heart rate variability of patients with Qi-deficiency syndrome significantly after the treatment session,while the upregulated trend of total HRV in both groups suggests the two therapies may have the potential to increase total HRV as therapeutic effects.4. Acupuncture and moxibustion therapies are both effective for the improvement of clinical symptoms in patients with Qideficiency syndrome and these two therapies display no difference based on current sample size. |
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