| Objective:This study took chronic neck pain,a common clinical disease of acupuncture and moxibustion,as the research object.Designed a randomized controlled trial.The treatment group:acupunctured at the points and got the feeling of deqi.The control group: acupunctured shallowly at the non-acupuncture points and avoided deqi.Observed the effect of acupuncture deqi or non-deqi on the clinical effect and heart rate variability of patients with chronic neck pain.Methods:In this study,random numbers were generated by the computer.The 66 selected patients with chronic neck pain were divided into 2 groups randomly and evenly :33cases in treatment group and 33 cases in control group.The study period was 3 weeks:the baseline period was 1 week;the treatment period was 1 week,all the patients received 5 times of acupuncture treatment during this week,30 minutes each time;follow-up period was 1 week.The treatment group:acupunctured at Dazhui(GVl4),Jingbailao(EX-HN15),Tianzhu(BL10),Jianzhongshu(SI15),Jianjing(GB21),every10 minutes twisted lifted and thrusted needles to get the feeling of deqi.The control group: first selected the same acupoints as the treatment group,and then acupunctured at the points which were 1cm away from the outside of the selected acupoints,acupunctured shallowly without any acupuncture techniques to avoid deqi.At end of the baseline period,at the end of treatment and at the end of follow-up,the datas of Northwick Park Neck Pain Questionnaire score,VAS score,pain threshold,days of neck pain,and average onset time of neck pain were recorded in order to analyze the difference in clinical efficacy of acupuncture deqi or non-deqi.In the first treatment:in the treatment group,acupunctured at EX-HN15 for the first 10 minutes,and then acupunctured other acupoints in the next 20 minutes,every10 minutes twisted lifted and thrusted needles to get the feeling of deqi.In the control group,acupunctured at 1 cm outside from EX-HN15 for the first 10 minutes,and then acupunctured at 1 cm outside from other acupuncture points in the next 20 minutes,acupunctured shallowly without any acupuncture techniques to avoid deqi.A mini ECG recorder was used to collect ECG datas of the patients before and after acupuncture at EX-HN15(or 1 cm outside from EX-HN15)for observing the difference in heart rate variability of deqi and non-deqi in the state of single-point acupuncture.Results:1.A total of 66 patients with chronic neck pain were recruited,and 6 cases were excluded.Finally completed the treatment of 60 patients with chronic neck pain: 30 in the treatment group and 30 in the control group.2.Baseline period: There were no statistical differences between the two groups in gender,age,body mass index,respiration,heart rate,body temperature,blood pressure,course of disease,days of neck pain,average onset time of neck pain,VAS,NPQ score,and pain threshold(P >0.05).The baseline condition between the two groups was balanced and comparable.3.Comparison within the two groups of treatment period about clinical efficacy indexes :(1)Treatment group: The days of neck pain,VAS,average onset time of neck pain,and NPQ score were lower than the baseline period,and the pain threshold was higher than the baseline period(P<0.05).(2)Control group: There were no statistical differences between the days of neck pain and the average onset time of neck pain compared with the baseline period(P >0.05).The scores of VAS,NPQ and pain threshold were lower than the baseline period(P<0.05).4.Comparison between the two groups of treatment period about clinical efficacy indexes: There were no statistical differences in the days of neck pain,VAS,average onset time of neck pain,and NPQ score(P >0.05).The pain threshold of the treatment group was significantly higher than that of the control group(P <0.01).5.Comparison within the two groups of follow-up period about clinical efficacy indexes:(1)Treatment group: The days of neck pain,VAS,average onset time of neck pain,and NPQ score during the follow-up period were significantly lower than the baseline period,and the pain threshold was significantly higher than the baseline period(P <0.01).(2)Control group: There were no statistical differences between VAS with the baseline period(P >0.05).The days of neck pain,the average onset time of neck pain,and the NPQ score were significantly higher than those in the baseline period(P<0.01).The pain threshold was significantly lower than the baseline period(P<0.01).6.Comparison between the two groups of follow-up period about clinical efficacy indexes: The average onset time of neck pain in the treatment group was lower than that in the control group(P <0.05),the days of neck pain,VAS and NPQ scores were significantly lower than those in the control group(P <0.01),and the pain threshold was significantly higher than the control group(P <0.01).7.Comparison of the heart rate variability of the two groups of patients before acupuncture EX-HN15(1 cm outside from EX-HN15)at the first treatment: There were no statistical differences in the heart rate variability between the two groups before acupuncture(P >0.05).8.Comparison of the heart rate variability of the two groups of patients after acupuncture EX-HN15(1 cm outside from EX-HN15)at the first treatment:(1)Comparison within the group:(1)Treatment group: There were no statistical differences between after acupuncture and before acupuncture in STD HR,TINN,VLF(ms~2),LF(ms~2),LF(n.u.)and HF(n.u.)(P >0.05);Mean RR,SDNN,RMSSD,NN50,p NN50,triangle index,HF(ms~2),Total(ms~2),LF/HF(ms~2),SD1,SD2 were statistically different from those before acupuncture(P <0.05),the LF/HF(ms~2)after acupuncture was lower than before acupuncture,and the other indexes were higher than before acupuncture.(2)Control group: There were no statistical differences between after acupuncture and before acupuncture in SDNN,STD HR,RMSSD,triangle index,TINN,VLF(ms~2),LF(ms~2),LF(nu),HF(ms~2),HF(nu),Total(ms~2),LF/HF(ms~2),SD1 and SD2(P>0.05);There were statistical differences between after acupuncture and before acupuncture in Mean RR,NN50,p NN50(P <0.05),Mean RR,NN50 and p NN50 were all higher than before acupuncture.(2)Comparison between groups:There were no statistical differences in heart rate variability between the two groups after acupuncture(P >0.05).Conclusion:1.Acupuncture deqi and non-deqi could reduce the pain of patients with chronic neck pain during the treatment period.2.Acupuncture with Deqi could still maintain the clinical effect within 1 week after the end of the treatment.Acupuncture without deqi could not maintain the clinical effect within 1 week after the end of the treatment.3.In the state of acupuncture at a single point,the effects of deqi and non-deqi on the heart rate variability of patients with chronic neck pain are similar.Both can enhance the autonomic nerve activity of patients with chronic neck pain,and mainly excite the vagus nerve activity. |
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