The Cross-Sectional Study Of The Correlation Between Acupoint Pain Sensitization And Autonomic Nerve Function For Patients With Chronic Neck Pain

Objective:This study on patients with chronic neck pain and healthy subjects as the research object,using cross-sectional survey research methods,analysis of characteristics of acupoints of patients with chronic neck pain pain sensitization and patients' clinical symptoms of pain and the correlation of autonomic nervous function,in order to further clarify points of patients with chronic neck pain pain sensitization characteristics,provide choice for clinical acupuncture treatment of chronic neck pain point reference.Methods:A clinical epidemiological cross-sectional study was conducted on 222 patients with chronic neck pain and 115 healthy subjects.The point PPT of patients with chronic neck pain and healthy subjects was detected by Wagner tenderness instrument,the clinical pain symptom information of patients and healthy subjects was collected by VAS and other indicators,and the HRV information of patients was collected by 24-hour dynamic electrocardiogram.Using SPSS25.0 statistical software will collect good data for the following analysis: The meridians pain sensitization is calculated by applying the ROC curve of diagnostic value,the definition of pain sensitization acupoints,by calculating of patients with chronic neck pain,pain sensitization rate of the healthy subjects point,and through the t test and chi-square test comparison of healthy subjects and patients with lateral PPT,pain sensitization rate difference,was revealed by acupuncture pain sensitization characteristics of patients with chronic neck pain.By spearman correlation analysis calculate the patients with chronic neck pain acupoint PPT and the correlation coefficient between the various indicators of clinical symptoms of pain,HRV of each index and the clinical symptoms of pain index and the correlation coefficient between the meridians PPT with the index,the correlation coefficient between HRV analysis of characteristics of acupoints of patients with chronic neck pain pain sensitization and patients' clinical symptoms of pain and the correlation of autonomic nervous function,acupuncture treatment in patients with chronic neck pain pain pain sensitization characteristics,clinical symptoms,the interaction of the relations between and among autonomic nervous function,in order to further clarify points of patients with chronic neck pain pain sensitization.Results:1.Preliminary analysis results of acupoint PPT in patients with chronic neck pain(1)According to ROC curve analysis,the AUC of each acupoint was between0.642-0.728,and the diagnostic threshold was between 1392.50gf-3176.67 gf.Both the AUC and diagnostic threshold had statistical significance(P < 0.05).The best points of differentiation are Jugu,Tianzong,Shousanli,Tiaoliao and Jianwaishu.(2)PPT of all points on the affected side of patients with chronic neck pain was lower than PPT of all points on the healthy subjects,and the difference was statistically significant(P < 0.05).The difference in PPT of all acupoints is between351.62-694.12 gf,among which,the difference is larger for Tiaoliao,Jugu,Jianwaishu and so on.(3)The acupoint pain sensitization rate of patients with chronic neck pain was higher than that of healthy subjects at all acupoints,and the difference was statistically significant(P < 0.05).The acupoint pain sensitization rate of the affected side of the patient was 43.85-79.89%,and that of the healthy subjects was16.52%-54.78%.The points with the highest pain sensitization on the affected side of the patient were Dazhui,Jugu,Jianjing,Zhongzhu,Tianliao,Jianzhongshu and Shousanli,while the points with the highest pain sensitization on the healthy subjects were Dazhui,Jianjing,Jugu,Jianzhongshu,Tianliao,Zhongzhu and Shousanli.2.Analysis results of the correlation between acupoint PPT and clinical pain symptoms in patients with chronic neck pain(1)Correlation analysis results between acupoint PPT and clinical pain sensation indicators There was no correlation between VAS and PPT at all acupoints(P >0.05).There was a negative correlation between NPQ and Tianzhu,Dazhu and Tianzong PPT(P < 0.05).There was a negative correlation between NDI and Dazhu,Jianwaishu and Tianzong PPT(P < 0.05).(2)Correlation analysis results between acupoint PPT and clinical pain emotional indicators There was a negative correlation between SAS and PPT of all acupoints except Wangu,Fengchi,Lieque and Houxi(P < 0.05).There was a negative correlation between SDS and PPT at all acupoints(P < 0.05).3.Analysis results of correlation between autonomic nerve function and clinical pain symptoms in patients with chronic neck pain(1)Correlation analysis results between autonomic nerve function and clinical pain perception indicators There was a negative correlation between VAS and time domain index PNN50 and frequency domain index LF and HF(P < 0.05).NPQ was negatively correlated with RMSSD,PNN50 and LF and HF in frequency domain(P < 0.05).There was a negative correlation between NDI and time domain indexes RMSSD,PNN50 and frequency domain indexes LF and HF(P < 0.05).(2)Correlation analysis results between autonomic nerve function and clinical pain emotional indicators There was no correlation between SAS,SDS and time domain indexes SDNN,SDANN,RMSSD,PNN50 and frequency domain indexes LF,HF and LF/LF(P >0.05).4.Results of correlation analysis between acupoint PPT and autonomic nerve function in patients with chronic neck pain(1)Correlation analysis results between acupoint PPT and time domain indexes of autonomic nerve function There was a negative correlation between PPT and SDNN at all acupoints except Tianzhu,Houxi and Lieque(P < 0.05).There was a negative correlation between PPT and SDANN at all acupoints except Houxi and Lieque(P <0.05).There was a negative correlation between PPT and RMSSD except Lieque(P< 0.05).There was a negative correlation between PPT and PNN50 at all acupoints(P < 0.05).(2)Correlation analysis results between acupoint PPT and autonomic nerve functional frequency domain indicators There was a negative correlation between PPT and LF at all acupoints except Jianwaishu and Tianzong(P < 0.05).There was a negative correlation between PPT and HF at all points(P < 0.05).There was a positive correlation between PPT and LF/HF in all acupoints except Houxi,Tianliao,Jianzhongshu,Lieque,Dazhui,Tianzhu,Fengchi,Dazhu,Jianwaishu and Wangu(P < 0.05).Conclusion:1.PPT on the affected side of chronic neck pain was significantly lower than that of healthy subjects,and the pain sensitization rate was significantly higher than that of healthy subjects.The 7 acupoints with the highest pain sensitization rate of the patients were Dazhui,Jugu,Jianjing,Zhongzhu,Tianliao,Jianzhongshu and Shousanli in turn.2.Acupoint PPT in patients with chronic neck pain is related to clinical pain symptoms: it shows that acupoint PPT of patients is negatively correlated with clinical pain symptoms.The more severe the pain symptom,the more likely to have pain sensitization.3.Clinical pain symptoms of patients with chronic neck pain may be related to autonomic nerve function: the clinical pain sensation of patients is negatively related to vagus nerve function.The more severe the clinical pain sensation,the lower the vagus function.4.Acupoint PPT in patients with chronic neck pain may be related to autonomic nerve function: it is shown that acupoint PPT is positively correlated with sympathetic nerve function,negatively correlated with vagus nerve function,and positively correlated with sympathetic-vagus nerve balance.The lower the sympathetic nerve function,the higher the vagus nerve function,and the lower the sympathetic-vagus nerve balance,the easier the acupoint pain sensitization.