Zhang John, Dean Douglas, Nosco Dennis, Strathopulos Dennis, Floros Minas
Logan College of Chiropractic, Chesterfield, MO 63017, USA.
J Manipulative Physiol Ther. 2006 May;29(4):267-74. doi: 10.1016/j.jmpt.2006.03.010.
The purpose of this study is to investigate the effect of chiropractic care in a multiclinic setting on sympathetic and parasympathetic nervous system activities using heart rate variability (HRV) analysis.
Physicians of chiropractic in private practice were provided with an HRV device to perform analysis before and after chiropractic adjustments on 10 subjects. At each site, 8 subjects were monitored before and after a single chiropractic adjustment, and 2 additional patients were followed for a 4-week period with 2 HRV recordings per week. Patient information forms and a visual analog scale (VAS) questionnaire were completed both before and after each chiropractic adjustment.
Data from 96 physicians were divided into single-visit and 4-week groups. After 1 chiropractic adjustment, pain as analyzed by VAS was reduced significantly from 3.7 +/- 2.2 to 2.1 +/- 2.0 (P < .001). The mean heart rate reduced from 76.7 +/- 12.7 to 74.3 +/- 12.4 (P < .01), the SD of normal-to-normal QRS increased from a range of 55.8 to 44.6 to a range of 60.6 to 47.2 (P < .001), the high-frequency component increased from 359 +/- 968 to 444 +/- 1069 (P < .01), the low-frequency component increased from 403 +/- 753 to 465 +/- 755 (P < .05), and the total power increased from 1063 +/- 1886 to 1265 +/- 2048 (P < .01). After 4 weeks of chiropractic adjustments, pain measured by the VAS was reduced significantly before and after each visit as analyzed by t tests, but the significant changes were not found using analysis of variance analysis. The reduction of pain from each treatment was not maintained over the 4 weeks of study period. The analysis of variance on the HRV 4-week data found that changes in the SD of normal-to-normal QRS, total power, and low-frequency components reached statistically significant levels (P < .05). The heart rate and the high-frequency component did not change significantly (P > .05).
In this study, HRV and VAS changed in patients as a result of chiropractic care.
本研究旨在通过心率变异性(HRV)分析,调查多诊所环境下整脊疗法对交感神经系统和副交感神经系统活动的影响。
为私人执业的整脊医师提供一台HRV设备,对10名受试者进行整脊调整前后的分析。在每个诊所,8名受试者在单次整脊调整前后接受监测,另外2名患者在4周内每周进行2次HRV记录。每次整脊调整前后均填写患者信息表和视觉模拟量表(VAS)问卷。
来自96名医师的数据分为单次就诊组和4周组。经过1次整脊调整后,VAS分析的疼痛从3.7±2.2显著降低至2.1±2.0(P<.001)。平均心率从76.7±12.7降至74.3±12.4(P<.01),正常到正常QRS的标准差从55.8至44.6的范围增加到60.6至47.2的范围(P<.001),高频成分从359±968增加到444±1069(P<.01),低频成分从403±753增加到465±755(P<.05),总功率从1063±1886增加到1265±2048(P<.01)。经过4周的整脊调整后,通过t检验分析,每次就诊前后VAS测量的疼痛均显著降低,但方差分析未发现显著变化。在4周的研究期间,每次治疗的疼痛减轻情况未得到维持。对HRV 4周数据的方差分析发现,正常到正常QRS的标准差、总功率和低频成分的变化达到统计学显著水平(P<.05)。心率和高频成分无显著变化(P>.05)。
在本研究中,整脊疗法导致患者的HRV和VAS发生变化。