| 摘要: | 針刺已被廣泛的應用於神經及心血管疾病的治療，許多的研究認為足三里及陽陵泉可以用來治療血壓相關疾病，但據我們所知，足三里和陽陵泉這兩個相鄰近穴道卻分別屬於不同經脈，其對於調節心血管活動及皮膚血流之間關係的探討非常少。另外，雖然接經療法已被應用於臨床，有關科學驗證的報告也甚少被提起。因此，本研究目的是探討電針兩側足三里、陽陵泉對自律神經調控心血管活動及皮膚血流、皮膚溫度的影響，我們利用脈率變異度的變化，觀察電針兩側足三里、陽陵泉對心血管活動的影響，並記錄遠處局部皮膚血流和皮膚溫度的變化來觀察手足手同名經脈之關係。本研究設計為隨機完成區集設計（randomized complete block design ）。總共24名健康自願受試者，分別接受偽電針、電針雙側足三里和電針陽陵泉等三種試驗。每次試驗分為電針前期、電針期（中期）及電針後期，每期20分鐘，前15分鐘分別紀錄合谷穴與中渚穴之皮膚血流和皮膚溫度，而後5分鐘記錄脈率變異度，將所得資料輸入並貯存於個人電腦，以便進一步作資料分析。結果顯示2Hz電針足三里試驗的手腕部脈搏波的Angle、h1和h1/t1於電針後期─中期間的差比偽電針試驗小，h5於後期─前期間的差小於偽電針試驗；2Hz電針陽陵泉試驗h1和h1/t1於電針後期─中期間的差比偽電針試驗小。電針足三里和陽陵泉對於脈率變異及對合谷及中渚穴皮膚血流、皮膚溫度的變化與偽電針相似。
如此，2Hz電針足三里和陽陵泉兩者都能減小動脈壓力和射血容積，而2Hz電針足三里也能減少周邊血流阻力及主動脈彈性回流。至於電針足三里和陽陵泉對於脈率變異及對合谷及中渚穴皮膚血流、皮膚溫度影響，仍需要進一步的探討。
Acupuncture has became a widely accepted treatment strategy in nervous and cardiovascular system diseases, and a number of studies reported that acupuncture at the Zusanli (ST36) and Yanglingquan (GB34) acupoints were effective to treat blood pressure related disorders. To our knowledge, there is rare study about the difference of modulating cardiovascular activity, and skin blood flow and skin temperature between two adjacent acupoints which belong to different meridians. Besides, although the same-name meridians therapy has been used clinically for the treatments of disease, evidence-based studies still remain inadequate. Therefore, the purpose of this present study was to investigate the effect of electroacupuncture (EA) a both ST36-37 and at both GB34-36 acupoints on cardiovascular modulation , and skin blood flow and skin temperature. We recorded pulse rate variability and pulse waveforms to investigate the change of cardiovascular activities, and recorded distant skin blood flow and skin temperature recordings to investigate the relationship between the same-name meridian of hand and foot. A total of 24 adult healthy volunteers were recruited, they received the three sessions of sham EA, EA at ST36-37 and EA at GB34-36, respectively. Each session was divided into three periods (pre-EA, EA, and post-EA). Each period was 20 min in duration. The ahead 15 min of the period was the skin blood flow and skin temperature recordings at Hoku’s (LI4) and Zhongzhu’s(TE3) region of right hand; the final 5 min of the period was pulse rate variability and pulse waveform recordings of left hand. The data was stored and analyzed finally in a personal computer. The present findings was that angle , height of percussive wave(h1), height of dicrotic wave (h5) in 2 Hz EA at ST36-37 session became less than those in sham EA session and that h1and h1/t1 in EA at GB34-36 session became less than those in sham EA session. EA at ST36-37, EA at GB34-36, and sham EA had no effect on the pulse rate variability, skin blood flow and skin temperature of distant acupoints.
To conclude, the findings were suggested that 2Hz EA at ST36-37 and at GB34-36 could decrease arterial pressure and ejection volume. 2 Hz EA at ST36-37 could also decreased peripheral arterial resistance and aortic reflection. With regard to the effect of 2 Hz EA at ST36-37, 2 Hz EA at GB34-36, and sham EA on pulse rate variability and the skin blood flow and skin temperature recordings at Hoku’s and Zhongzhu’s region, further research is necessary to amass more evidence of clinical curative effects and adequate theoretical basis for this issue. |
