心率變異可測量自律神經的活性變化，本研究探討自律神經活性與 青壯年周邊性顏面神經麻痺患者之針刺治療前後及對照健康青壯年男 女作比較，而結果顯示男性周邊性顏面神經麻痺有較低的交感神經頻譜
，以臨床表現有陽虛體質，推論較低的交感神經頻譜與陽虛似有相關性
；女性周圍性顏面神經麻痺有較低的交感與副交感神經頻譜，以臨床表 現有陰陽俱虛的體質，推論較低的交感神經頻譜與副交感神經頻譜與陰 陽俱虛似有相關性，心率變異可作為中醫體質測量指標之參考；至於青 壯年男女周邊性顏面神經麻痺患者經過針刺治療後，只有顯示心跳減緩 有差異性，表示針刺給予刺激並未影響心跳興奮，反而心跳減緩，顯示 針刺針感有其調整作用，至於針刺治療對於心率變異沒有改變，可能需 較長時間及大量病患的觀察。
HRV 的測量方法，簡單易行，無侵入性等優點，應用觀察自律神經 活性能量，並可應用於中醫體質等，也可作治病預後的參考。HRV 指標 與其他診斷指標的相關性有待更大量的研究確定，結果的可靠性、標準 化還需要大量資訊的檢測及臨床上觀察分析。
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Effect of Acupuncture on Heart Rate Variability In the peripheral facial palsy patients
Yuh-Chen Lee
Major professor： Yung-Hsien Chang Institute of Chinese Medical Science
China Medical College
Introduction
Autonomic nerve system includes sympathetic and parasympathetic divisions, which cooperatively regulate individual organs. By monitoring the activities of autonomic nerve system, abnormal organ motion can be detected. Heart Rate Variability (HRV) has been brought up to attention recently as a quantitative measurement for monitoring autonomic nervous activity. HRV can also be used to investigate the correlation between autonomic function and Chinese medical constitution.
Peripheral facial nerve palsy is a disease which clinical characteristics include the following: lower lip that fails to pull down on the normal side and the affected eyelid unable to close, giving the face an unbalanced appearance. It is also called facial nerve palsy. The disease can be found at any age of persons but mostly between 20 to 40 years old. The incidence of facial nerve palsy occurring on both sides of face is approximately equal.
In this study, HRV value was used as an indicator of autonomic nerve function to investigate the alteration before and after acupuncture therapy on adult patients with facial nerve palsy.
Method
Thirty adults aged from 20 to 40 with facial nerve palsy were selected into the experimental group in this study. Time domain and frequent domain of HRV was measured from individuals in both experimental and control group. The control group consists of thirty-three healthy adults within the
same age to compare the differences. Moreover, this study will evaluate the effect of acupuncture therapy on the patients with facial nerve palsy.
Results
The low frequency-LF power (msec2) of male adults with facial nerve palsy is significantly lower than healthy male adults in the control group by Mann-Whitney Testing (p<0.05). Female adult patients with facial nerve palsy compared to healthy female adults also using Mann-Whitney Testing (p<0.05) shows a lower level on the following indicators: the proportion derived by dividing NN50 by the total number of NN interval ( NN50:the number of interval differences of successive NN intervals larger than 50ms.)-pNN50％, Total Power(msec2), low frequency-LF Power(msec2), high-frequency-HF Power(msec2). It also showed that heart rates of both male and female adults with facial nerve palsy were significantly lowered after acupuncture treatment in Wilcoxon Testing (p<0.05).
Conclusion
Heart rate variability can monitor the autonomic nerve system function.
This study evaluated the autonomic nerve system activity and acupunctural therapy on adult patients with facial nerve palsy. The purpose of this study is to prove the facts of Yin-Yang balance and the balance of sympathetic and parasympathetic power spectral density of healthy males and females. In theory, that male adult patients with facial nerve palsy who has lower sympathetic power spectral density infers they are Yang vacuity constitution;
that female adult patients with facial nerve palsy who has lower sympathetic and parasympathetic power spectral density infers they have Yin-Yang vacuity constitution. The above two statements correspond with recent clinical findings which can be used as an indicator and reference for treatment. As to the results of pre and post acupunctural therapy revealing a lower heart beats on adult patients with facial nerve palsy, it express
acupuncture to stimulate pain and influence the heart rate excitement; it may assume that acupuncture sensation can accomdation and regulate the organ function.
Keywords：Autonomic nerve system, heart rate variability, peripheral facial nerve palsy, acupuncture, and Chinese medical constitution
謝辭
本研究首先感謝張永賢指導教授的細心指導及不斷鞭策，使學生能 夠不斷地學習，並感謝逢甲大學邱創乾教授提供的軟硬體測量工具和中 國醫藥學院附設醫院針灸科主治醫師：高宗桂副教授、許昇峰助理教授 的關心與指導；感謝邱晏麟碩士幫忙統計資料、黃郁智小姐幫忙整理，
還有參與研究的門診病患、實習醫師及台中縣永順國小五年級學童。最 後要感謝父母、岳父母的支持及妻玲燕在家裏幫忙照顧二個兒子：沅儒
、柏陞，使我能夠順利完成論文。謝謝！