Veränderungen der Herzratenvariabilität (HRV) während Low Level Lasernadelakupunktur: Placebokontrollierte Studie an 19 herzgesunden Probanden

Background

Experimental and clinical studies postulate a neurobiological mechanism of acupuncture by modulating central pain systems, neurohormones and -transmitters. It seems to be quite likely that the autonomic nervous system (ANS) plays an important mediating role in this neuromodulation.

Aim

In measuring heart rate variability (HRV), as a non-invasive approach to the ANS-function, the object of this study was to monitor probable acupuncture-induced changes of autonomic balance. The innovative technology of laser-needle acupuncture offers for the first time a stimulation method which fulfils the demands on a placebo-controlled acupuncture trial not requiring controversial sham acupuncture.

Method

19 healthy voluntary subjects underwent 3 treatments in randomized sequence, consisting of placebo-, 1-point- (PC 6) and simultaneous 3-point- (PC 6, LR 3, SI 3) laser-needle-stimulation over 20 minutes. Before, during and after placebo-/verum laser-needle acupuncture, HRV-data for normalized HF(high frequency)- and LF(low frequency)-Power (nHF, nLF) and their quotient nLF/nHF obtained by power spectrum analysis (FFT), were measured and analyzed statistically at 5 different time points (ANOVA repeated measures, p < 0,05).

Results

During both verum applications, the 1-point- (PC 6) as well as the simultaneous 3-point- (PC 6, LR 3, SI 3) laser-needle stimulation, significant changes of the ANS-activity were found in comparison to the placebo application. The most significant modification of HRV was an increase of nHF (p < 0,05 (PC 6), p < 0,0001 (PC 6, LR 3, SI 3)) as an expression of growing vagal activity during acupuncture.

Conclusion

Laser-needle acupuncture causes in 1-point-stimulation (PC 6) as well as in simultaneous 3-point-stimulation (PC 6, LR 3, SI 3) significant changes in HRV in comparison to placebo application. HRV-monitoring seems to be a suitable approach in exploration of acupuncture-induced changes of ANS and could possibly be established in combination with laser needle acupuncture as a standard for further scientific and clinical acupuncture investigations which are greatly needed.     

Einfluss der Akupunktur auf den Augendruck und die Compliance bei Patienten mit okulärer Hypertension oder primärem Offenwinkelglaukom: Erste Ergebnisse einer prospektiven kontrollierten Langzeitbeobachtung

Background and Aims

Primary wide-angle glaucoma (the most common form of glaucoma) is a multi-factorial disease of the optic nerve marked by the preceding loss of retinal ganglion cells, eventually leading to the atrophy of the optic nerve. Intraocular pressure (IOP) makes up the most important and most treatable risk factor.

Methods

The study examined the effect of acupuncture therapy on eye pressure and the compliance in patients suffering from primary wide-angle glaucoma (n = 21) and ocular hypertension (n = 13) against a group of test subjects not suffering from any eye complaint (n = 16). Before commencing therapy, corneal thickness was determined by 4Optics-Pachymeter. Before and after acupuncture treatment, an ophthalmologic determination of visual acuity according to DIN 58220 and a computer-aided visual field analysis were done. The IOP was measured before and immediately after acupuncture as well as 30 minutes after therapy. Changes in compliance were documented with a standardized questionnaire completed by each patient having received this treatment.

Results

It was shown that for patients with primary wide-angle glaucoma and ocular hypertension, acupuncture is able to significantly lower intraocular pressure. According to the questionnaire analysis, a subjective improvement of quality of life and better compliance of using anti-glaucomatous medication was achieved.

Conclusions

Acupuncture is an appropriate method to treat patients with primary wide-angle glaucoma in addition to lowering eye pressure by anti-glaucomatous pharmacological therapy. In patients suffering from ocular hypertension, acupuncture can significantly lower intraocular pressure and therefore reduce the rate of conversion into a manifest glaucoma. Therefore this treatment can be suggested for ocular hypertension patients with contraindications against local anti-glaucomatous medicine (e. g. beta-blocker). However, it is absolutely necessary in this treatment that patients are continuously monitored regarding visual field, retinal nerve fibre thickness and micro-morphological alterations of the disc in order to detect tissue damage of the optic nerve and functional loss caused by the onset of glaucoma.