Evidence-Based Complementary and Alternative Medicine / 2014 / Article / Tab 3

Review Article

Effect of Acupuncture on Heart Rate Variability: A Systematic Review

Table 3

Summary of extracted RCTs.

Authors (year)
and origin
Design sample size ConditionsIntervention (regimen)Heart rate variabilityMain results of intergroup differencesRisk of bias

Kwak et al. [22],
South Korea
Parallel; 42 healthy students with examination stress(A) AT ( );
(B) sham Tx ( relaxation therapy, );
(C) Co (no Tx, )
(1) HRT (beats/min);
(2) SDNN (ms);
(3) SDSD (ms);
(4) LF norm (n.u.);
(5) HF norm (n.u.);
(6) LF/HF
(1) A→, B→, C when comparing between examination and normal time: ;
(1), (4), and (6) A, B→, C→ before and after examination: ;
(2) A↑, B→, C→ at normal time: ;
(5) A↑, B→, C→ before and after examination:
U, U, U, U, U

Huang et al. [23],
Taiwan
Parallel; 111 healthy subjects(A) AT (P6, 20 min on both forearms, );
(B) sham AT ( sham acupuncture at dummy points, 20 min, );
(C) Co: no Tx, )
(1) Mean RR interval (ms);
(2) SD of RR interval (ms);
(3) coefficient of variation (%);
(4) HF norm (nu);
(5) LF norm (nu);
(6) LF/HF
(1) A↑, B↑, C→: ;
(4) A↑, B→, C→:
U, N, N, N, N

Chang et al. [24],
Taiwan
Crossover, 15 healthy subjects(A) EA (2 Hz, 30 min, );
(B) Sham EA (minimal penetration on nonacupuncture point, no electric stimulation, );
(C) EA plus atropine injection;
sessions A, B, C in a randomized order with 3 days between sessions
(1) LF/HF;
(2) LF;
(3) HF
(1) A↑, B→: NS;
(2), (3) A→, B→: NS
U, N, Y, U, U

Chang et al. [25],
Taiwan
Crossover, 15 healthy subjects(A) EA (2 Hz at Zusanli, 30 min, );
(B) EA (2 Hz at Shousanli, 30 min, );
(C) EA (100 Hz at Zusanli, 30 min, );
(D) EA (100 Hz at Shousanli, 30 min, );
(E) sham EA (minimal penetration on nonacupuncture point, no electric stimulation, );
Sessions in a randomized order with 3 days between sessions
(1) LF/HF;
(2) LF;
(3) HF
(1) A↑ during and after EA, B→, C→, D→, E→: NS;
(2) A↑ during and after EA, B→, C→, D→, E→: NS;
(3) A during and after EA, B→, C→, D→, E→: NS
U, N, Y, U, U

Hsu et al. [26],
Taiwan
Crossover, 10 healthy subjects(A) EA (2 Hz at BL15, 10 min, );
(B) sham EA ( )
(1) LF norm;
(2) HF norm;
(3) LF/HF;
(4) HRT
(1)–(4) A, B→: U, N, U, U, U

Hsu et al. [27],
Taiwan
Crossover, 10 healthy subjects(A) AT (scalp-Sishencong, 10 min, );
(B) AT (Auricular-Shenmen, 10 min, );
(C) sham AT ( )
(1) LF norm;
(2) HF norm;
(3) LF/HF;
(4) HRT
(1)–(4) A, B↑, C→: U, N, U, U, U

Kim et al. [28],
South Korea
Crossover, 38 female subjects with regular menstrual cycle(A) AT (LI4 and SP6, 15 min, );
(B) sham AT (minimal penetration on the same acupoints, 15 min, );
One-month washout between Tx
(1) LF;
(2) HF;
(3) LF/HF
(1) A↑, B↑: NS;
(2) A↑, B↑: and <0.005;
(3) A, B: and NS
U, N, Y, U, U

Streitberger et al. [16],
Germany
Crossover, 20 healthy subjects(A) AT (LI4, 5 min and 15 sec manual stimulation, );
(B) sham AT (blunted placebo needle with no penetration on the same acupoints, 5 min and 15 sec manual stimulation, )
(1) LF;
(2) HF;
(3) LF/HF
(1) and (2) A→, B→: NS;
(3) A→, B→: NS, but A↑ during stimulation: NS
Y, N, Y, Y, U

Li et al. [29],
China
Parallel, 29 male healthy subjects (after 3 hr driving workout)(A) AT (15 min, );
(B) sham AT (minimal penetration on nonacupuncture points, );
(C) Co (with driving, 15 min, )
(1) LF/HF;
(2) LF norm;
(3) HF norm
(1)-(2) A, B→: ;
(3) A↑, B→:
U, N, Y, U, U

Chang et al. [30],
Taiwan
Parallel, 12 male healthy subjects with no neurological diseases(A) AT (PC6, 3 sessions with one-week washout, 30 min, );
(B) sham AT (minimal penetration on nonacupuncture points, 3 sessions with one-week washout, 30 min, )
(1) VLF;
(2) LF;
(3) HF;
(4) LF/HF
NS for all casesU, N, U, U, U

Kurono et al. [31],
Japan
Crossover, 14 male healthy subjects (A) AT (epifascial stimulation at CV17 and CV16, needle inserted for 1s only, );
(B) sham AT (AT on nonacupoints, )
(1) LF;
(2) HF;
(3) LF/HF
(1)-(2) A↑ in CV17, but not CV16;
(3) NS for both CV17 and CV16
U, N, Y, U, U

Liu et al. [32],
USA
1st phase (acute); Crossover, 27 patients with functional dyspepsia (Rome II)(A) TEA (25 Hz, PC6 and ST36, 30 min, 2 sessions, );
(B) Sham TEA (TEA was performed on sham acupoints, 30 min, 2 sessions, );
(C) Co (electrodes were placed in the acupoints but not turned on, )
(1) HF;
(2) LF/HF
(1) A↑ during 1st 30 min Tx, B→, C→: ;
(2) A, B→, C→:
Y, N, U, U, U

Liu et al. [32],
USA
2nd phase (chronic); Crossover, 27 patients with functional dyspepsia (Rome II)(A) TEA for 2 weeks (twice daily, 30 min), 1 week-wash-out, sham TEA for 2 weeks;
(B) viceversa
(1) HF;
(2) LF/HF
(1) A↑ after 2 weeks, B→, C→: ;
(2) A, B→, C→:
Y, N, Y, Y, U

Shi et al. [33],
China
Crossover, 20 patients with coronary heart disease(A) AT (30 min, );
(B) EA (30 min, );
(C) Co (no Tx, )
(1) LF;
(2) HF;
(3) LF/HF
(1) A, B, C→: ;
(2) NS for all groups;
(3) A→, B, C→:
U, N, U, U, U

AT: acupuncture treatment; EA: electroacupuncture; TEA: transcutaneous electroacupuncture; Co: control; Tx: treatment.
Risk of bias (1) sequence generation; (2) incomplete data; (3) patient-blinded; (4) assessor blinded; (5) allocation concealment performed.

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