Strudwick Mark W, Hinks Roderick C, Choy S T Boris
Centre for Magnetic Resonance, University of Queensland, St Lucia Brisbane, Australia.
Acupunct Med. 2007 Dec;25(4):166-74. doi: 10.1136/aim.25.4.166.
Point injection as a therapeutic technique is well documented, but its physiological effects have not been formally compared with traditional acupuncture. One aim of this study was to compare the effects of the two techniques at one acupuncture point, as a step towards understanding the mode of action of point injection and validating its clinical use. A second aim was to explore whether repeated point injection at the same site might provide a way of increasing the dose of stimulation, in the hope of identifying a dose response curve which could be an alternative strategy to placebo control in demonstrating the biological effects of acupuncture.
Sixty nine healthy subjects (age range 18-56 years, mean 29.9; 48 females) completed the study, which employed a counterbalanced experimental design with two stimulation sessions of LI4 approximately one week apart. One half of the participants received point injection first, and the other half received traditional acupuncture first. Baseline physiological data were recorded, then measurements were made before, during and after stimulation; each subject also reported needle sensation (de qi). The measures were heart rate, derived pressure rate product and mean arterial pressure.
Although stronger sensations of de qi were reported with point injection, no significant differences were found for mean heart rate (HR), pressure rate product (PRP) and mean arterial pressure (MAP) before and after stimulation by the two techniques. No subject gender or age bias was encountered and previous exposure to acupuncture had no effect on outcome. Power spectral analysis of heart rate variability (HRV) made on data from a small subset (n=10) of this cohort also showed no significant differences in autonomic response.
Point injection and traditional acupuncture seem to provoke similar physiological responses, although the greater needle sensation seen with point injection might indicate it could have more powerful clinical effects. Further studies of repeated point injection are necessary to indicate whether this technique may provide a method of increased strength of point stimulation, as an alternative to traditional needling in acupuncture research.
穴位注射作为一种治疗技术已有充分记载,但其生理效应尚未与传统针刺进行正式比较。本研究的一个目的是比较这两种技术在一个穴位上的效果,以此作为理解穴位注射作用方式并验证其临床应用的第一步。第二个目的是探讨在同一部位重复进行穴位注射是否可能提供一种增加刺激剂量的方法,以期确定一条剂量反应曲线,这可能是在证明针刺生物学效应时替代安慰剂对照的一种策略。
69名健康受试者(年龄范围18 - 56岁,平均29.9岁;48名女性)完成了本研究,该研究采用了一种平衡实验设计,对合谷穴进行两次刺激,间隔约一周。一半参与者先接受穴位注射,另一半先接受传统针刺。记录基线生理数据,然后在刺激前、刺激期间和刺激后进行测量;每位受试者还报告针感(得气)。测量指标为心率、压力心率乘积和平均动脉压。
尽管穴位注射报告的得气感更强,但两种技术刺激前后的平均心率(HR)、压力心率乘积(PRP)和平均动脉压(MAP)均未发现显著差异。未发现受试者性别或年龄偏差,既往针刺经历对结果也无影响。对该队列一小部分(n = 10)数据进行的心率变异性(HRV)功率谱分析也显示自主反应无显著差异。
穴位注射和传统针刺似乎引发相似的生理反应,尽管穴位注射时更强的针感可能表明其临床效果更强。有必要对重复穴位注射进行进一步研究,以表明该技术是否可提供一种增强穴位刺激强度的方法,作为针刺研究中传统针刺的替代方法。