Zusammenfassung
Hintergrund und Zielsetzung
Unter Akupunktur wurden bislang verschiedene neurophysiologische Effekte beobachtet. Bislang gibt es noch keine Studie, in der die Korrelation von zentralnervösen Veränderungen mit vegetativen Effekten placebokontrolliert untersucht wurde. Unter Berücksichtigung einer verlässlichen Verblindung der Probanden war Ziel dieser Studie, spezifische zerebrale und vegetative Effekte von Verum-Akupunktur (VA) am Akupunkturpunkt Di 4 (Hegu) im Vergleich zu Placebo-Akupunktur (PA) zu untersuchen.
Methodik
Gesunde Probanden erhielten beidseits entweder Akupunktur an Di 4 mit einer Verum-Nadel oder Akupunktur an einem Nicht-Akupunkturpunkt mit einer Placebo-Nadel. Parallel dazu wurden EEG und EKG abgeleitet. Es folgte eine Befragung zu Schmerzen, Hautdurchstich und vegetativen Effekten.
Ergebnisse
Das Gefühl des Hautdurchstichs war nicht signifikant unterschiedlich (p = 0,057). Vegetative Effekte und De Qi-Gefühl traten jedoch signifikant häufiger bei VA auf (p = 0,022). Das Schmerzempfinden war bei VA-Stimulation erhöht gegenüber PA (p < 0,01). Die Verum-Stimulation führte zu einer Erhöhung der okzipitalen EEG-Alpha-Power (p < 0,03). Der Anstieg der Alpha 1-Wellen war begleitet von einem Absinken der Theta-Wellen. Der Alpha 1/Theta-Quotient verschob sich zugunsten von Alpha 1 (p < 0,04). Parallel dazu kam es zu einem kurzfristigen Anstieg des EKG-Quotienten zwischen Low-Frequency (LF) und High-Frequency (HF) (p < 0,02), gefolgt von einer Erhöhung der HF-Power (p < 0,04).
Schlussfolgerung
PA ist für die Probanden nicht von VA unterscheidbar. Die während VA-Stimulation gemessenen Veränderungen im EEG und EKG geben Hinweise auf eine Modulation der zerebralen Funktionen durch vegetative Akupunktureffekte im Unterschied zu PA.
Abstract
Background and Aims
Many neurophysiologic effects have been observed during acupuncture. So far there is no placebo-controlled trial studying the correlation between changes in the central nervous system and vegetative effects. In consideration of a reliable blinding of the volunteers, the aim of this study was to examine specific cerebral and vegetative effects of verum-acupunture (VA) compared to placebo-acupuncture (PA).
Methods
Healthy volunteers received either VA at LI 4 (Hegu) with a verum-needle or PA at a non-acupuncture point with a placebo needle. EEG and ECG recordings were performed in parallel followed by an evaluation of pain, skin penetration and vegetative effects.
Results
The feeling of skin penetration was not significantly different (p = 0.057). Vegetative effects and Deqi occurred significantly more often during VA (p = 0.022). Pain was increased during VA-stimulation compared to PA (p > 0.01). Verum stimulation markedly increased occipital EEG power (p < 0.03). The increase in the fast alpha1 waves was accompanied by a decrease in the theta frequencies and the ratio alpha1/theta was shifted to the benefit of alpha1 (p < 0.04). This was paralleled by a short increase of the ECG ratio between low frequency (LF) and high frequency (HF) (p < 0.02), followed by an increase of HF-power (p < 0.04).
Conclusions
Volunteers were unable to distinguish between VA and PA. The EEG and ECG changes measured during VA stimulation are pointing towards a modulation of cerebral functions by vegetative acupuncture effects compared to PA.
Article PDF
Literatur
Witt C, Brinkhaus B, Jena S et al. Acupuncture in patients with osteoarthritis of the knee: a randomised trial. Lancet. 2005; 366,9480:136–143
Linde K, Streng A, Jurgens S et al. Acupuncture for patients with migraine: a randomized controlled trial. Jama. 2005; 293,17:2118–2125
Kaptchuk TJ. Acupuncture: theory, efficacy, and practice. Ann Intern Med. 2002; 136,5:374–383
Yan B, Li K, Xu J et al. Acupoint-specific fMRI patterns in human brain. Neurosci Lett. 2005; 383,3:236–240
Tanaka Y, Koyama Y, Jodo E et al. Effects of acupuncture to the sacral segment on the bladder activity and electroencephalogram. Psychiatry Clin Neurosci. 2002; 56,3:249–250
Rosted P, Griffiths PA, Bacon P et al. Is there an effect of acupuncture on the resting EEG? Complement Ther Med. 2001; 9,2:77–81
Huang K, Xia L, Wu Q et al. The effects of needling acupoint, nonpain and pain stimulation on electroencephalogram (EEG) of somatosensory area analysed by computer. Zhen Ci Yan Jiu. 1990; 15,2:126–129
Biella G, Sotgiu ML, Pellegata G et al. Acupuncture produces central activations in pain regions. Neuroimage. 2001; 14,1 Pt 1:60–66
Agelink MW, Sanner D, Eich H et al. Does acupuncture influence the cardiac autonomic nervous system in patients with minor depression or anxiety disorders? Fortschr Neurol Psychiatr. 2003; 71,3:141–149
Haker E, Egekvist H, Bjerring P. Effect of sensory stimulation (acupuncture) on sympathetic and parasympathetic activities in healthy subjects. J Auton Nerv Syst. 2000; 79,1:52–59
Wang JD, Kuo TB, Yang CC. An alternative method to enhance vagal activities and suppress sympathetic activities in humans. Auton Neurosci. 2002; 100,1-2:90–95
Shinohara M. Decreasing heart rate and shortening of the arterial pulse propagation time by acupuncture in the spectral analyses. Masui. 1997; 46,2:213–221
Schneider A, Enck P, Streitberger K et al. Acupuncture treatment in irritable bowel syndrome. Gut. 2006; 55(5): 649–54
Streitberger K, Kleinhenz J. Introducing a placebo needle into acupuncture research. Lancet. 1998; 352,9125:364–365
Streitberger K, Vickers A. Placebo in acupuncture trials. Pain. 2004; 109,1-2:195; author reply 197–199
White P, Lewith G, Hopwood V et al. The placebo needle, is it a valid and convincing placebo for use in acupuncture trials? A randomised, singleblind, cross-over pilot trial. Pain. 2003; 106,3:401–409
Streitberger K, Steppan J, Maier Ch, Hill H, Backs J, Plaschke K. Effects of Verum acupuncture Compared to Placebo Acupuncture on Quantitative EEG and Heart Rate Variability in Healthy Volunteers. J Altern Complement Med. 2008 Jun; 14(5):505–13
Jasper H. Progress and problems in brain research. J Mt Sinai Hosp N Y. 1958; 25,3:244–253.
Wei H, Kong J, Zhuang D et al. Early-latency somatosensory evoked potentials elicited by electrical acupuncture after needling acupoint LI-4. Clin Electroencephalogr. 2000; 31,3:160–164
Knardahl S, Elam M, Olausson B et al. Sympathetic nerve activity after acupuncture in humans. Pain. 1998; 75,1:19–25
Terkelsen AJ, Molgaard H, Hansen J et al. Acute pain increases heart rate: Differential mechanisms during rest and mental stress. Auton Neurosci. 2005; 121(1-2): 101–9
Bäcker M, Hammes MG, Valet M et al. Different modes of manual acupuncture stimulation differentially modulate cerebral blood flow velocity, arterial blood pressure and heart rate in human subjects. Neurosci Lett. 2002; 333,3:203–206
Hausmann B. Veränderungen der Herzratenvariabilität (HRV) während Low Level Lasernadelakupunktur. Dt Ztschr f Akup. 2008; 51,1:17–23
Sebastiani L, Simoni A, Gemignani A et al. Relaxation as a cognitive task. Arch Ital Biol. 2005; 143,1:1–12
Li Z, Wang C, Mak AF et al. Effects of acupuncture on heart rate variability in normal subjects under fatigue and non-fatigue state. Eur J Appl Physiol. 2005
Kleinhenz J, Streitberger K, Windeler J et al. Randomised clinical trial comparing the effects of acupuncture and a newly designed placebo needle in rotator cuff tendinitis. Pain. 1999; 83,2:235–241
Guerra de Hoyos JA, Andres Martin Mdel C, Bassas y Baena de Leon E et al. Randomised trial of long term effect of acupuncture for shoulder pain. Pain. 2004; 112,3:289–298
Vas J, Mendez C, Perea-Milla E et al. Acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee: randomised controlled trial. BMJ. 2004; 329,7476:1216
Streitberger K, Diefenbacher M, Bauer A et al. Acupuncture compared to placebo-acupuncture for postoperative nausea and vomiting prophylaxis: a randomised placebo-controlled patient and observer blind trial. Anaesthesia. 2004; 59,2:142–149
Streitberger K, Friedrich-Rust M, Bardenheuer H et al. Effect of acupuncture compared with placebo-acupuncture at P6 as additional antiemetic prophylaxis in high-dose chemotherapy and autologous peripheral blood stem cell transplantation: a randomized controlled single-blind trial. Clin Cancer Res. 2003; 9,7:2538–2544
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Streitberger, K., Steppan, J., Plaschke, K. et al. Placebokontrollierte Untersuchung zerebraler und vegetativer Effekte von Akupunktur an Di 4. Dtsch Z Akupunkt 51, 12–19 (2008). https://doi.org/10.1016/j.dza.2008.10.002
Published:
Issue Date:
DOI: https://doi.org/10.1016/j.dza.2008.10.002