Scholarly article on topic 'Comparing the Effects of Distilled Rehmannia glutinosa, Wild Ginseng and Astragali Radix Pharmacopuncture With Heart Rate Variability (HRV): A Randomized, Sham-controlled and Double-blind Clinical Trial'

Comparing the Effects of Distilled Rehmannia glutinosa, Wild Ginseng and Astragali Radix Pharmacopuncture With Heart Rate Variability (HRV): A Randomized, Sham-controlled and Double-blind Clinical Trial Academic research paper on "Medical engineering"

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{"autonomic nervous system" / " Astragali Radix " / HRV / pharmacopuncture / " Rehmannia glutinous " / " Wild Ginseng "}

Abstract of research paper on Medical engineering, author of scientific article — Yook Taehan, Yu Jungsuk, Lee Hwiyong, Song Beomyong, Kim Lakhyung, et al.

Abstract This study compared the effects of distilled Rehmannia glutinosa, Wild Ginseng and Astragali Radix pharmacopuncture on the autonomic nervous system and heart rate variability. The purpose of the trial was to observe the influence distilled Astragali Radix, Wild Ginseng and Rehmannia glutinosa pharmacopuncture have on the autonomic nervous system. 120 healthy male volunteers were divided into four groups, which consisted of three experimental groups and a control group. This study was a randomized, placebo-controlled, double-blind clinical trial. Volunteers in experimental groups were underwent pharmacopuncture at GB21 (Kyonjong), and volunteers in the control group were injected with normal saline at GB21 (Kyonjong). Heart rate variability was measured seven times: before and after injection, every 5 minutes for 30 minutes. The result was distilled Rehmannia glutinosa, Wild Ginseng and Astragali Radix pharmacopuncture in healthy adult males tended to activate the autonomic nervous system, particularly the sympathetic nervous system.

Academic research paper on topic "Comparing the Effects of Distilled Rehmannia glutinosa, Wild Ginseng and Astragali Radix Pharmacopuncture With Heart Rate Variability (HRV): A Randomized, Sham-controlled and Double-blind Clinical Trial"

J Acupunct Meridian Stud 2009;2(3):239-247

I RESEARCH ARTICLE I

ELSEVIER

Comparing the Effects of Distilled Rehmannia glutinosa, Wild Ginseng and Astragali Radix Pharmacopuncture With Heart Rate Variability (HRV): A Randomized, Sham-controlled and Double-blind Clinical Trial

Yook Taehan1*, Yu Jungsuk1, Lee Hwiyong1, Song Beomyong1, Kim Lakhyung2, Roh Jungdu1, Shin Jinchul1, Lim Sungtaek1

department of Acupuncture and Moxibustion, Woosuk University, Jeonju, South Korea 2Department of Neuropsychiatry, Woosuk University, Jeonju, South Korea

Received: Mar 19, 2009 Accepted: Jul 01, 2009

KEY WORDS:

autonomic nervous

system; Astragali Radix; HRV;

pharmacopuncture; Rehmannia glutinous; Wild Ginseng

Abstract

This study compared the effects of distilled Rehmannia glutinosa, Wild Ginseng and Astragali Radix pharmacopuncture on the autonomic nervous system and heart rate variability. The purpose of the trial was to observe the influence distilled Astragali Radix, Wild Ginseng and Rehmannia glutinosa pharmacopuncture have on the autonomic nervous system. 120 healthy male volunteers were divided into four groups, which consisted of three experimental groups and a control group. This study was a randomized, placebo-controlled, double-blind clinical trial. Volunteers in experimental groups were underwent pharmacopuncture at GB21 (Kyonjong), and volunteers in the control group were injected with normal saline at GB21 (Kyonjong). Heart rate variability was measured seven times: before and after injection, every 5 minutes for 30 minutes. The result was distilled Rehmannia glutinosa, Wild Ginseng and Astragali Radix pharmacopuncture in healthy adult males tended to activate the autonomic nervous system, particularly the sympathetic nervous system.

1. Introduction

Pharmacopuncture is herbal acupuncture. Herbal acupuncture is a unique treatment method in Korean traditional medicine which combines the benefits of herbs and acupuncture [1]. Various herbs are developed for injection on the meridian points and the most suitable herbal acupuncture points are selected depending on the patient's constitution and the state of disorder [2]. Rehmannia glutinosa (RG)

is the herb used to strengthen the heart, liver and kidney [3] and to alleviate hypertension [4] and diabetes mellitus [5]. Wild Ginseng (WG) is believed to have an anti-cancer effect [6]. Astragali Radix (AR) is used to promote the immune system [7]. Recently distilled RG, WG and AR pharmacopuncture were reported to promote human autonomic nervous system function in oriental medical clinics [8-10]. The kinds of RG, WG and AR are different, but have common effects on human autonomic nervous system [1].

'Corresponding author. Woosuk University Oriental Medicine Hospital, 2-5 Junghwasandong Wansangu, Jeonju City, South Korea. E-mail: nasiss@naver.com

This study was supported with funding from the Korean Institute of Pharmacopuncture. ©2009 Korean Pharmacopuncture Institute

In this study, we compared the effects of distilled RG, WG and AR pharmacopuncture on heart rate variability (HRV). The HRV test evaluates the functioning of the autonomic nerves by monitoring the change in heart rate. The HRV test is well known for reflecting the states of the sympathetic and parasympathetic nerves [11]. The acupoint was GB21 (Kyonjong), have the effect of descending fire of heart [12-14]. We recruited 120 healthy volunteers and divided into four groups, three experimental groups were given pharmacopuncture and one control group was injected with normal saline. We measured activity of the autonomic nervous system by measuring HRV over a period of 35 minutes. Significant results were obtained when the effect of each pharmacopuncture was compared.

2. Materials and Methods

2.1. Study design and subject selection

One hundread and twenty healthy male volunteers who were students of Woosuk University in Korea were recruited. They had no central nervous system problems including stroke, mental illness, cardiovascular disease, endocrinological disease and were not on medications that affect the autonomic nerve system. Subjects were divided into four groups which consisted of three experimental groups, RG (n=28), WG (n=31) and AR (n=31) pharmacopuncture, and a control group [injected with normal saline (NS); n=30]. Twenty one volunteers were excluded from analysis because of error during measuring HRV. At the conclusion of the study, HRV analysis for 99 volunteers was completed. This study was a randomized, placebo-controlled, double-blind clinical trial and was approved by the Institutional Review Board of Woosuk University Affiliated Hospital.

2.2. Materials

NS was purchased from Daihan Pharm (Korea). RG and AR used in this experiment were purchased by Woosuk University Affiliated Hospital (Korea). WG was estimated to be 20 to 30 years old and obtained from Mount Changbaishan in China. Each pharmacopuncture solution was made using the following process: RG, WG and AR were rinsed in running water and then decocted for 2 hours in distilled water. Remnants were then removed and the decoction was distilled before yielding the desired herbal acupuncture. The herbal acupuncture solution was then filtered three times using 0.45 |m, 0.2 |im, 0.1 |im filtering paper and kept in a container. Finally, the herbal acupuncture solution was sterilized before use.

2.3. Treatment methods

Pharmacopunctures and normal saline were injected intramuscularly using a sterile hypodermic syringe (DM Medicrat 1.0 mL, 26 Gauge, Sindongbang Medical Company, Korea) at the point of GB21 (Kyonjong) to effect the descending fire of heart [9,10,12]. Each 0.1 mL injection was performed on both sides of the GB21 point. The grade of pain experienced by the subjects was under 2 on the visual analogue scale.

2.4. Measuring HRV

The HRV was measured with electrodes attached to both wrists and ankles for 35 minutes using QECG-3: LXC3203 (Laxtha Inc., Korea). Before the experiment began, volunteers relaxed for 20 minutes. HRV was measured seven times: 5 minutes before injection and every 5 minutes during a 30-minute period after injection. The outcome measure was converted to a variation ratio for minutes. A1 was from injecting to 5 minutes, A2 was from 5 minutes to 10 minutes, A3 was from 10 minutes to 15 minutes, A4 was from 15 minutes to 20 minutes, A5 was from 20 minutes to 25 minutes and A6 was from 25 minutes to 30 minutes. The variation ratio was calculated by "variation ratio=(outcome measure - measure for first 5 minutes)/measure for first 5 minutes".

2.5. Statistical analysis

To compare the HRV values (A0, being defined as the value 5 minutes before the injection, with A1-6) of the four groups, we performed paired f-tests and differences between groups were analyzed using one-way ANOVA. When a significant overall effect was observed, post hoc comparison between groups was performed using the Duncan's method. We used SPSS for Windows (version 13.0) for the statistics, and examined these data in the significance level of 5%.

3. Results

3.1. The comparison of mean HRV

Mean HRV of RG and WG decreased at A1, and AR decreased at A1 -4 and 6. Differences between groups were not significant (Table 1, Figure 1).

3.2. The comparison of standard deviation of all normal R-R intervals

Standard deviation of all normal R-R intervals (SDNN) of the NS group increased at A4-6, WG and

Table 1 Comparison of Mean-HRV

Mean-HRV A0 A1 A2 A3 A4 A5 A6

Normal saline 0 -0.87 + 3.72 -0.47+3.75 -0.07+5.03 -0.65+4.67 -0.37+4.77 -3.81+ 10.91

Rehmannia glutinosa 0 -1.37 + 3.03* -0.83 + 3.77 -0.65+4.75 -0.64 + 5.52 -0.96 + 7.07 -1.74 + 7.30

Wild Ginseng 0 -2.11+ 2.73* -1.90+2.67 -1.57+3.65 -2.32+4.37 -0.64+6.73 -2.12+4.14

Astragali Radix 0 -2.11+ 2.81* -0.95+3.94* -1.21+ 4.46* -0.97+4.71* 0.27+6.50 -1.20+ 5.48*

Values shown are mean ± SD (cycle/min), *p < 0.05 (by paired t-test).

-0.5-1.0-1.5-2.0-2.5-3.0-3.5-4.0-

Figure 1 Comparison of Mean-HRV.

Normal saline Wild Ginseng

■ Rehmannia glutinosa

■ Astragali Radix

Figure 2 Comparison of SDNN.

Table 2 Comparison of standard deviation of all normal R-R intervals (SDNN)

SDNN A0 A1 A2 A3 A4 A51" A6

Normal saline 0 6.35+19.04 10.29+25.52 11.55+28.80 15.28+28.12* 11.94+23.69* 10.94+22.08*

Rehmannia 0 10.42 + 18.45* 13.16+20.70* 24.38+30.79* 25.15+27.00* 30.28+31.84* 28.43 + 38.05*

glutinosa

Wild Ginseng 0 8.96+22.84 13.74+23.71* 10.93+22.09* 20.48+30.69* 17.98+24.04* 23.75+31.67*

Astragali Radix 0 11.64+28.97 16.36+23.05* 22.08+20.65* 20.83+24.32* 36.40+42.93* 22.85+23.32*

Values shown are mean ± SD (cycle/min), *p < 0.05 (by paired t-test), 1p < 0.05 (by ANOVA and Duncan post hoc test).

Table 3 Comparison of complexity

Complexity A0 A1 A2 A3 A4 A5 A6

Normal saline 0 0.73+28.34 -2.84 + 18.84 -2.13 + 34.28 -3.75+31.40 -2.63+25.92 0.75+27.00

Rehmannia 0 0.94+19.88 1.50+30.66 0.45+38.40 -0.46+29.15 -1.60+57.10 3.78+45.26

glutinosa

Wild Ginseng 0 -3.56+22.69 -4.85+16.25 -4.29+21.10 -8.32 + 19.84* -8.84 + 18.91* -8.68+21.97*

Astragali Radix 0 -1.15+21.09 -5.89+17.16 -8.29+20.75 -8.13 + 16.44* -13.68+22.70* -8.07+14.83

Values shown are mean ± SD (cycle/min), *p < 0.05 (by paired t-test).

AR group increased at A2-6 and the RG group increased at A1-6. Differences between groups were significant at A5 and NS group differed from the WG group following a post hoc test (Table 2, Figure 2).

3.3. The comparison of complexity

Complexity of the WG group decreased at A4-6 and the AR group decreased at A4-5. Differences between groups were not significant (Table 3, Figure 3).

3.4. The comparison of HRV index

HRV index of the NS group increased at A4-5, the RG group at A1, 3-6, the WG group at A3-6, and the AR group at A2-6. Differences between groups were not significant (Table 4, Figure 4).

3.5. The comparison of the proportion derived by dividing NN50 by the total number of NN intervals

The Proportion Derived by Dividing NN50 by The Total Number of NN Intervals (pNN50) of the NS group decreased at A4, at A1 -6 for the RG group, at A2-6 for the WG group and at A2, 4-6 for the

AR group. Differences between groups were significant at A6 and the NS group differed from the RG, WG, and AR groups following a post hoc test (Table 5, Figure 5).

3.6. The comparison of the square root of the mean of the sum of the squares of differences between adjacent normal R-R intervals

The square root of the mean of the sum of the squares of differences between adjacent normal R-R intervals (RMSSD) of the RG group increased at A4 and at A2-4, and 6 for the AR group. Differences between groups were not significant (Table 6, Figure 6).

Table 4 Comparison of HRV-index

HRV-index A0 A1 A2 A3 A4 A5 A6

Normal saline 0 4.94 + 17.06 5.16 + 21.28 7.35 + 21.04 11.86 + 24.67* 11.18 + 18.96* 0.53+28.77

Rehmannia 0 20.13 + 44.27* 23.55+63.60 26.67+ 59.57* 30.95+61.31* 32.74+62.59* 25.12 + 47.46*

glutinosa

Wild Ginseng 0 6.63 + 25.18 9.62+21.63 14.59 + 25.31* 16.99 + 27.46* 13.18 + 24.66* 22.67+ 29.71*

Astragali Radix 0 6.78+23.77 4.12 + 21.88* 12.81 ± 19.92* 17.68 + 29.43* 20.98 + 32.67* 16.85 + 25.60*

Values shown are mean ± SD (cycle/min), *p < 0.05 (by paired t-test).

Table 5 Comparison of the proportion derived by dividing NN50 by the total number of NN intervals (pNN50)

pNN50 A0 A1 A2 A3 A4 A5 A6T

Normal saline 0 -1.90 + 13.52 -4.48 + 13.34 -3.24+ 17.73 -7.34 + 16.82* -4.80+ 12.53 -0.72 ± 23.83

Rehmannia 0 -7.45 + 11.62* -7.61 ± 16.05* -12.39 + 14.74* -14.14 + 13.96* -16.21 ± 18.42* -12.56 + 16.70*

glutinosa

Wild Ginseng 0 -4.94 + 12.99 -6.29 + 14.45* -5.49 + 17.27* -10.42 + 16.04* -9.80+ 14.40* -13.12 + 15.49*

Astragali Radix 0 -3.75 + 19.01 -7.03 + 16.03* -12.26 + 10.58 -11.40 + 13.60* -15.58+19.28* -12.94+ 15.85*

Values shown are mean ± SD (cycle/min), *p < 0.05 (by paired t-test), Tp < 0.05 (by ANOVA and Duncan post hoc test).

3.7. The comparison of the standard deviations difference between adjacent normal to normal intervals

The standard deviations difference between adjacent normal to normal intervals (SDSD) of the RG group increased at A1, 3-5, at A3-5 for the WG group, and at A2 for the AR group. Differences

d0 d1 d2 d3 d4 d5 d6

Figure 5 Comparison of pNN50.

between groups were significant at A3 and the RG group differed from the AR and NS groups following a post hoc test (Table 7, Figure 7).

3.8. The comparison of the log normalized transformation value of total power

The log normalized transformation value of total power (Ln(TP)) of the NS group increased at A4-5, at A1-6 for the RG group and at A2-6 for both the WG and AR groups. Differences between groups were significant at A5 and the NS group differed from the WG group following a post hoc test (Table 8, Figure 8).

3.9. The comparison of the log normalized transformation value of very low frequency oscillation power

The log normalized transformation value of very low frequency oscillation power (Ln(VLF)) of NS group increased at A4, 6, RG group increased at A1-6, and WG and AR group increased at A2-6. Differences between groups were significant at A5 and NS group differed to RG and WG groups by post hoc test (Table 9, Figure 9).

3.10. The comparison of the log normalized transformation value of low frequency oscillation power

The log normalized transformation value of low frequency oscillation power (Ln(LF)) of the NS group increased at A2-6, at A1 -6 for the RG group, at A2-6 for the WG group, and at A2, 4-6 for the AR group. Differences between groups were not significant (Table 10, Figure 10).

3.11. The comparison of the log normalized transformation value of high frequency oscillation power

Differences between groups were not significant (Table 11, Figure 11).

Table 6 Comparison of the square root of the mean of the sum of the squares of differences between adjacent

normal R-R intervals (RMSSD)

RMSSD A0 A1 A2 A3 A4 A5 A6

Normal saline 0 2.75 + 13.56 1.95 + 13.25 1.14 + 14.10 2.41+ 18.21 -1.36 + 16.10 -7.18+26.62

Rehmannia 0 12.81 ± 34.34 10.11 ± 35.32 13.38 + 36.73 17.31 ± 42.01* 13.84+37.92 15.14 + 39.32

glutinosa

Wild Ginseng 0 5.90 + 18.67 5.61±9.59 5.83 + 12.39 8.11+ 14.99 3.98 + 16.74 7.26 + 15.92

Astragali Radix 0 5.58 + 23.28 2.03 + 20.50* 2.91±29.76* 6.08+21.31* 2.80+29.51 7.08+28.65*

Values shown are mean ± SD (cycle/min), *p < 0.05 (by paired t-test).

Figure 7 Comparison of SDSD. Figure 8 Comparison of Ln(TP).

Table 7 Comparison of the standard deviations difference between adjacent normal to normal intervals (SDSD)

SDSD A0 A1 A2 A31" A4 A5 A6

Normal saline 0 1.77+ 14.14 1.06 + 14.75 1 .32 + 12.95 6.34+23.63 6.47 + 33.68 4.14 + 17.81

Rehmannia 0 8.64+ 19.75* 7.51 + 23.24 16.00+26.10* 1 8. 75 + 36. 84* 15.29+35.43* 31.23+79.90

glutinosa

Wild Ginseng 0 4.11 + 19.91 6.08 + 13.29 2.48 + 18.32* 6.29+20.95* 2.32+20.05* 6.87 + 22.11

Astragali Radix 0 10.49 + 30.40 10.63 + 27.79* 9.43+21.04 9.69+22.37 20.98+46.11 10.65+26.61

Values are mean ± SD (cycle/min), *p < 0.05 (by paired t-test), Tp=difference between groups were significant.

Table 8 Comparison of the log normalized transformation value of total power (Ln(TP))

TP A0 A1 A2 A3 A4 A51 A6

Normal saline 0 1.88 + 5.43 3.00 + 7.16 2.66 + 8.00 3.60+6.91* 3.01+ 5.74* 2.90+7.93

Rehmannia 0 3.17 + 5.95* 3.73 + 6.18* 6.07+7.93* 6.50+7.09* 7.42 + 8.34* 6.83+7.74*

glutinosa

Wild Ginseng 0 1.95+6.55 3.28+6.15* 3.07+7.12* 4.90+8.36* 4.44+7.02* 5.71+ 8.22*

Astragali Radix 0 1.78+7.76 3.78+6.14* 5.71+ 5.03* 4.88+6.05* 8.87+9.14* 5.74+5.54*

Values shown are mean ± SD (cycle/min), *p < 0.05 (by paired t-test), Tp < 0.05 (by ANOVA test and Duncan post hoc test).

Table 9 Comparison of the log normalized transformation value of very low frequency oscillation power (Ln(VLF))

VLF A0 A1 A2 A3 A4 A51 A6

Normal saline 0 4.06 + 10.93 4.54 + 12.96 5.72+15.55 5.32+11.51* 4.37 + 12.54 6.84+ 14.45*

Rehmannia 0 6.86 + 12.48* 8.46+12.21* 9.95+12.93* 11.40+ 12.52* 13.35+13.84* 11.19 + 12.94*

glutinosa

Wild Ginseng 0 4.17+11.42 5.69+12.64* 6.36+12.22* 8.74 + 14.12* 8.22+13.84* 8.52+13.61*

Astragali Radix 0 2.29 + 12.59 6.15+10.94* 8.26+10.93* 7.57+ 10.87* 13.72+13.44* 6.64+10.85*

Values shown are mean ± SD (cycle/min), *p < 0.05 (by paired t-test), Tp < 0.05 (by ANOVA and Duncan post hoc test).

Figure 9 Comparison of Ln(VLF).

3.12. The comparison of normalized low frequency

Normalized low frequency (LF) of NS group increased at A2-6, at A2-4, 6 for the RG group, A2-6 for the WG group, and at A4-6 in the AR group. Differences between groups were not significant (Table 12, Figure 12).

3.13. The comparison of normalized high frequency

Normalized high frequency (HF) from the NS group decreased at A2-6, at A3-4, 6 in the RG group, at A2, 4-6 in the WG group, at A5-6 in the AR group.

Figure 10 Comparison of Ln(LF).

Differences between groups were not significant (Table 13, Figure 13).

4. Discussion

Analyzed time data revealed that mean HRV reflected an activation of the autonomic nervous system. The RG and WG group was activated for first 5 minutes but the AR group was activated for a longer time. The WG and AR groups increased at A5 for the mean time, but this increase was not significant, because WG and AR have a "hot" character, while RG has a "cold" character. The SDNN result indicates an activation of the autonomic

Table 10 Comparison of the log normalized transformation value of low frequency oscillation power (Ln(LF))

Ln(LF) AO A1 A2 A3 A4 A5 A6

Normal saline 0 2.06+9.00 5.18 + 8.91* 4.45 + 10.19* 6.30+8.33* 7.14+8.38* 5.40+ 10.40*

Rehmannia 0 3.54 + 8.19* 5.49+9.82* 8.29+11.32* 7.87+ 10.44* 8.56+11.84* 10.06+10.59*

glutinosa

Wild Ginseng 0 1.12 + 7.02 3.08 + 7.06* 2.62+7.11* 5.0 + 10.68* 6.15 + 7.94* 8.38+9.68*

Astragali Radix 0 1.91+ 12.00 4.62 + 8.60* 6.67 + 5.91 6.09+7.91* 9.73+11.12* 9.87+ 10.39*

Values shown are mean ± SD (cycle/min), *p < 0.05 (by paired t-test).

Table 11 Comparison of the log normalized transformation value of high frequency oscillation power (Ln(HF))

Ln(HF) A0 A1 A2 A3 A4 A5 A6

Normal saline 0 1.60 + 5.30 1.03+6.25 -0.74+4.92 1.67+7.90 0.31 + 14.47 -1.81+ 10.59

Rehmannia 0 0.61+ 5.98 0.38 + 8.06 2.97+8.19 2.80+10.38 4.02 + 10.75 3.03+9.45

glutinosa

Wild Ginseng 0 0.21+ 8.04 1.85+6.36 0.02+9.09 0.37+9.40 0.60 + 8.60 0.89+10.61

Astragali Radix 0 1.25 + 10.33 0.05 + 8.25 2.27+7.35 1.03+8.59 1.85 + 11.30 1.26+10.50

Values shown are mean ± SD (cycle/min), p < 0.05 (by paired t-test).

5 -i 4321 -0

-1 --2-3-

Normal saline ■ Rehmannia glutinosa

Wild Ginseng Astragali Radix

■ Normal saline

■ Rehmannia glutinosa

■ Wild Ginseng

■ Astragali Radix

Figure 11 Comparison of Ln(HF).

4.5 4 3.5 3 2.5 2 1.5 1

d0 di d2 d3 d4 d5 d6 Figure 12 Comparison of normalized low frequency.

Table 12 Comparison of normalized low frequency

norm-LF A0 A1 A2 A3 A4 A5 A6

Normal saline 0 0.27 ± 5.47 1.92 ± 3.95* 2.44 ± 5.25* 2.34±3.89* 3.65 ± 5.58* 3.74 ± 5.24*

Rehmannia 0 1.44 ± 3.85 2.56±5.63* 2.49 ± 5.15* 2.49 ± 5.07* 2.24 ± 5.59 3.33 ±4.66*

glutinosa

Wild Ginseng 0 0.55 ± 3.36 0.72 ± 4.09* 1.40 ± 3.50* 2.25±5.39* 2.72 ± 3.92* 3.63 ± 5.28*

Astragali Radix 0 0.33 ± 6.31 2.32 ± 4.44 2.22 ± 5.00 2.55 ± 4.75* 3.87 ± 5.65* 4.15 ± 6.81*

Values shown are mean ± SD (cycle/min), *p < 0.05 (by paired t-test).

Table 13 Comparison of normalized high frequency

norm-HF A0 A1 A2 A3 A4 A5 A6

Normal saline 0 0.10 ± 6.11 -1.93 ± 4.22* -2.32±5.30* -2.10 ± 3.98* -3.45 ± 5.93* -3.54 ± 5.46*

Rehmannia 0 -1.29±3.89 -2.28 ± 5.90 -2.32±5.50* -2.34 ± 5.17* -1.95±5.99 -3.23±4.69*

glutinosa

Wild Ginseng 0 -0.45 ± 3.49 -0.44 ± 4.34* -1.33±3.69 -2.24 ± 5.72* -2.69 ± 4.58* -3.65±5.72*

Astragali Radix 0 -0.13 ± 6.57 -2.15 ± 4.40 -2.09±5.00 -2.42 ± 4.87 -3.72±5.66* -4.08 ± 7.07*

Values shown are mean ± SD (cycle/min), *p < 0.05 (by paired t-test).

-0.5-1 --1.5-2-2.5-3-3.5-4-4.5-

Normal saline

■ Rehmannia glutinosa

■ Wild Ginseng

■ Astragali Radix

Figure 13 Comparison of normalized high frequency.

nervous system and an increase in stress resistance. The RG group was fastest than the other groups to activate. The WG and AR groups were faster to activate than the NS group. The WG group showed the largest increase among the groups at A5 highest, revealing a significant difference with the NS group. Complexity results show a decrease in the disillusion. The NS, RG and AR groups tended to increase at A6, meaning that disillusion recovered after 25 minutes in these groups. HRV index and the pNN50 demonstrate the activation of the autonomic nervous system and functions of the heart. The pNN50 of the RG, WG and AR groups is significantly higher than that of the NS group at A6. The RMSSD and SDSD data reveal that the RG, WG and

AR groups tend to activate function of the heart to be a stable state. However, the RMSSD and SDSD of the RG group are higher than those of the other groups at A3. This may indicate that the RG has more special effects on the activation of the heart.

Frequency data was also analyzed. Ln(TP), Ln(VLF), Ln(LF) and Ln(HF) analysis reveal that all groups activated the autonomic nervous system, particularly the sympathetic nervous system. Ln(TP) of the WG group was significantly higher than that of the NS group at A5 and Ln(VLF) of the RG and WG groups was significantly higher than that of the NS group at A5. Ln(TP), Ln(VLF), Ln(LF) of the RG group were higher and more quickly activated than other groups, but these changes were not significant. RG is able to activate the autonomic nervous system from the first 5 minutes and WG is able to powerfully activate the autonomic nervous system from 20 to 25 minutes as WG has a "hot" character that reveals itself from 20 to 25 minutes. Data from the analysis of normalized LF and HF, demonstrate that all groups were able to activate the sympathetic nervous system and restrain of parasym-pathetic nervous system. The AR group, however, tended to show a delayed restraint of parasympathetic nervous system than the other groups.

We have demonstrated that distilled RG, WG and AG pharmacopuncture in healthy adult males tends to activate the autonomic nervous system, and in particular the sympathetic nervous system. This study did not however obtain significant results as the number of subjects was small and the period of the experiment was short.

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