針刺耳神門穴對於自律神經功能的影響：受試者及評估者雙盲、隨機、偽穴對照臨床交叉研究

The Effect of Acupuncture at Ear Shenmen on Heart Rate Variability: A Subject-Assessor-Blinded, Randomized, Sham-Controlled Crossover Study

耳針是一種廣泛應用於互補醫學的臨床治療方法。其中最常被應用的耳穴之一是耳神門穴（MA-TF1），臨床經常應用於穩定情緒和減輕壓力。因此，我們推測針刺耳神門穴可以有效提高迷走神經活性和/或抑制交感神經調節功能。為了測試這一假設，我們進行受試者及評估者雙盲、隨機、偽穴對照的臨床交叉研究，觀察針刺耳神門穴對於自律神經功能的影響。二十八個婦女被隨機分成兩組：耳神門穴組和對照組。受試者在各組分別接受針刺，經過兩週後，再交換進入另組接受針刺。利用心率變異性頻譜分析儀在針刺前(N)、針刺後每隔5分鐘，連續五次(A1~A5)及取針後每隔5分鐘，連續兩次(R1~R2)的階段分別評估自律神經功能。結果顯示兩組之間在高頻 (HF, P= 0.92)、低頻 (LF%, P= 0.94)，和低頻高頻功率比 (LF/HF, P= 0.93) 沒有顯著差異。比較各組在R1與N時期的LF%及LF/HF，耳神門穴組沒有顯著差異 (adjusted P = 0.96)，偽穴對照組有顯著差異 (adjusted P = 0.0032)。比較各組在R1與N時期的HF，耳神門穴組 (adjusted P = 0.26)與偽穴組 (adjusted P = 0.96)都沒有顯著差異。綜合上述，我們的研究認為針刺耳神門穴對於自律神經活性調節沒有顯著的效果，未來還需要進一步的研究來完全確定耳神門穴的有效性。

Auricular acupuncture is an alternative medical treatment widely used in complementary clinical settings. One of the most recognized auricular acupuncture point is the Ear Shenmen (MA-TF1), which allegedly calms the mind and reduces stress. We therefore hypothesized that acupuncture at the Ear Shenmen may effectively enhance vagal nerve activity and/or suppresses cardiac sympathetic regulation. In order to test this hypothesis, we conducted a subject-assessor-blinded, randomized, sham-controlled crossover study to observe the effects of single-point acupuncture at the auricular acupoint Shenmen on autonomic nervous activity. Twenty-eight healthy women were randomly distributed into two groups: the Ear Shenmen group and the control group. Subjects entered a two weeks washout period after receiving their groups treatment. After the washout period subjects switched groups. Autonomic cardiac function was evaluated by power spectral indices of heart rate variability. The results show that there were no significant differences between the two groups in the high-frequency component (HF, P= 0.92), the normalized low-frequency component (LF%, P= 0.94), and the low-frequency power to high-frequency power ratio (LF/HF, P= 0.93). The results of our study suggest that auricular acupuncture on the Shenmen has no significant effect on autonomic cardiac modulation in healthy women. Further studies are needed to fully determine the validity of auricular acupoint Shenmen. The results of our study suggest that auricular acupuncture on the Shenmen has no significant effect on autonomic cardiac modulation in healthy women. Further studies are needed to fully determine the validity of auricular acupoint Shenmen.