经皮穴位电刺激对心率变异性影响的Meta分析

Effects of transcutaneous electrical acupoint stimulation on heart rate variability:a meta-analysis

目的 系统评价经皮穴位电刺激(TEAS)对心率变异性(HRV)的影响。方法 计算机检索PubMed、Embase、Ovid MEDLINE、Cochrane Library、CNKI、WanFang Data、VIP和CBM数据库,搜集TEAS影响心率变异性的随机对照试验(RCT),检索时限均为建库至2023年2月28日。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。结果 共纳入14个RCT,包括719例患者。Meta分析结果显示:TEAS组的SDNN[MD=12.95,95%CI(9.18,16.72),P<0.01]、RMSSD[MD=1.81,95%CI(0.10,3.53),P=0.04]、pNN50[MD=1.75,95%CI(1.02,2.48),P<0.01]、HF[SMD=0.27,95%CI(0.01,0.52),P=0.04]、LF/HF[MD=-0.07,95%CI(-0.12,-0.03),P<0.01]、ln-LF[MD=0.63,95%CI(0.25,1.01),P<0.01]、ln-HF[MD=1.05,95%CI(0.60,1.49),P<0.01]、RR间期[MD=-11.86,95%CI(-21.77,-1.96),P=0.02]和HR[SMD=-0.43,95%CI(-0.66,-0.20),P<0.01]均较对照组有改善,而两组在LF[SMD=0.15,95%CI(-0.10,0.40),P=0.23]、LF norm[SMD=0.24,95%CI(-0.10,0.58),P=0.16]和HF norm[SMD=0.25,95%CI(-0.47,0.97),P=0.50]的差异无统计学意义。取穴PC6的TEAS组的SDNN、pNN50、HF、LF/HF、LF norm、HF norm、lnLF、ln-HF和HR均较对照组有改善,而两组在RMSSD、LF和RR间期的差异无统计学意义。结论 本研究结果支持TEAS和取穴内关的TEAS对心率变异性的改善作用。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。

ObjectiveeTo systematically review the effect of percutaneous acupoint electrical stimulation(TEAS)on heart rate variability(HRV).Methods The PubMed,Embase,Ovid MEDLINE,Cochrane Library,CNKI,WanFang Data,VIP,and CBM databases were electronically searched to collect randomized controlled trials(RCTs)on the effects of percutaneous acupoint electrical stimulation on heart rate variability from inception to February 28,2023.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Meta-analysis was then performed using RevMan 5.4 software.ResultsA total of 14 RCTs involving 719 patients were included.The results of meta-analysis showed that SDNN(MD=12.95,95%CI 9.18 to 16.72,P<0.01),RMSSD(MD=1.81,95%CI 0.10 to 3.53,P=0.04),pNN50(MD=1.75,95%CI 1.02 to 2.48,P<0.01),HF(SMD=0.27,95%CI 0.01 to 0.52,P=0.04),LF/HF(MD=-0.07,95%CI-0.12 to-0.03,P<0.01),n-LF(MD=0.63,95%CI 0.25 to 1.01,P<0.01),ln-HF(MD=1.05,95%CI 0.60 to 1.49,P<0.01),mean RR(MD=-11.86,95%CI-21.77 to-1.96,P=0.02),and HR(SMD=-0.43,95%CI-0.66 to-0.20,P<0.o1)all showed improvement compared with the control group.However,there were no significant differences between the two groups in LF(SMD=0.15,95%CI-0.10 to 0.40,P=0.23),LF norm(SMD=0.24,95%CI-0.10 to 0.58,P=0.16)or HF norm(SMD=0.25,95%CI-0.47 to 0.97,P=0.5).TEAS on PC6:SDNN,pNN50,HF,LF/HF,LF norm,HF norm,In-LF,In-HF,and HR all showed improvement compared with the control group.However,there were no significant differences between the two groups in RMSSD,LF,or RR interval.ConclusionThis study supports the improvement of heart rate variability by transcutaneous acupoint electrical stimulation and PC6 acupoint selection.Due to the limited quantity and quality of the included studies,more high-quality studies are needed to verify the above conclusion.