Pengaruh Penusukan Tunggal Titik Akupunktur Telinga Ciao Kan terhadap Tekanan Darah dan Frekuensi Denyut Jantung

Dalam praktek klinis kedokteran gigi, seringkali pasien datang dengan tekanan darah yang tinggi meskipun ia tidak memiliki riwayat hipertensi sebelumnya. Pada kondisi ini, tingginya tekanan darah seringkali dipengaruhi oleh tingkat kecemasan pasien yang nantinya akan mempengaruhi sistem saraf otonom. Akupunktur merupakan suatu metode pengobatan dengan penusukan jarum tanpa memasukkan bahan kimia ke dalam tubuh pasien. Penelitian ini bertujuan untuk mengkaji pengaruh penusukan tunggal titik akupunktur telinga Ciao Kan terhadap tekanan darah dan frekuensi denyut jantung. Hipotesis yang diajukan adalah penusukan tunggal titik akupunktur telinga Ciao Kan menyebabkan terjadinya penurunan tekanan darah dan frekuensi denyut jantung. Penelitian ini merupakan penelitian eksperimental dengan mempergunakan rancangan penelitian pre-post test design. Subjek penelitian adalah laki-laki berusia 25–35 tahun dengan tekanan sistolik lebih atau sama dengan 130 mmHg yang memenuhi kriteria inklusi dan eksklusi. Subjek menjalani orthostatic stress test, penusukan titik akupunktur telinga Ciao Kan, pengukuran tekanan darah dan frekuensi denyut jantung. Metode statistik yang dipergunakan adalah uji t, uji korelasi Pearson, dan uji ANOVA satu jalur. Uji t dilakukan pada data yang telah ditransformasi. Tekanan sistolik turun signifikan pada subyek penelitian selama perlakuan (p<0,05) namun kemudian naik kembali. Frekuensi denyut jantung juga mengalami penurunan signifikan (p<0,05) selama perlakuan dan naik kembali. Uji korelasi Pearson dilakukan untuk melihat korelasi antara tekanan arteri rata-rata dengan frekuensi denyut jantung. Hasil uji korelasi menunjukkan adanya korelasi positif antara tekanan arteri rata-rata dan frekuensi denyut jantung (r =0,373). Uji ANOVA satu jalur menunjukkan tidak adanya perbedaan nilai tekanan sistolik, tekanan diastolik, tekanan arteri rata-rata, dan frekuensi denyut jantung antar kelompok dengan respon terhadap orthostatic stress test normal, hipertonus, maupun hipotonus (p >0,05). Dengan demikian dapat dikatakan bahwa penusukan tunggal titik akupunktur telinga Ciao Kan menyebabkan terjadinya penurunan tekanan darah dan frekuensi denyut jantung. The Effect of Single Acupuncture on Ciao Kan Ear Acupoint on Blood Pressure and Heart Rate In dental clinical practice. Patient sometime come with high blood pressure even though they have no history of hypertension. In this condition, high blood pressure could be influenced by anxiety that will have an effect on autonomic nerve system. Acupuncture is a healing method with needle puncture without giving chemical substance to patient’s body. This research aimed at evaluating the effect of a single acupuncture on Ciao Kan ear acupoint on blood pressure and heart rate. Hypothesis of this research was single acupuncture on Ciao Kan ear acupoint could decrease blood pressure and heart rate. This was a pre-post test design experiment. Subjects were men, 25 – 35 years old with systolic blood pressure equal or more than 130 mmHg who met the inclusion and exclusion criteria. Subject did orthostatic stress test, acupuncture on Ciao Kan ear acupoint, blood pressure measurement, and heart rate measurement. T test was done on the transformed data. Systolic blood pressure decreased significantly (p < 0.05) during acupuncture and then increased afterward. Heart rates also decreased significantly (p < 0.05) during acupuncture and then increased afterward. Pearson correlation test was done to see the correlation between mean arterial pressure and heart rate. The results showed a positive correlation between mean arterial pressure and heart rate (r = 0.373). One way ANOVA showed no systolic, diastolic, mean arterial pressure, and heart rate differences between groups in response to orthostatic stress test normal, hyper tone, or hypo tone (p > 0.05). It could be said that single acupuncture on Ciao Kan ear acupoint could decrease blood pressure and heart rate.

Effects of head-up tilting on baroreceptor control in subjects with different tolerances to orthostatic stress

During orthostatic stress, an increase in peripheral vascular resistance normally results in arterial blood pressure being well maintained, despite a decrease in cardiac output. The present study was undertaken to determine whether the sensitivity of the carotid baroreceptor reflex was increased during orthostatic stress and whether failure to develop this increase was associated with poor orthostatic tolerance. Three groups of subjects were studied: asymptomatic controls; patients investigated for suspected posturally related syncope but who had normal responses to an orthostatic stress test (normal patients); and patients who were shown to have low orthostatic tolerance (early fainters). We determined responses of R–R interval and forearm vascular resistance (mean arterial pressure/brachial artery velocity by Doppler ultrasonography) to the loading and unloading of carotid baroreceptors by application of pressures of -30 and +30mmHg to a chamber fitted over the neck. Responses were determined after 20min of supine rest and after 10min of head-up tilt at 60°. Responses of cardiac interval were not significantly different between the three groups, and they were not altered by the postural change. Vascular responses also did not differ between the groups during supine rest. However, in healthy volunteers and in normal patients, responses to both neck suction and pressure were significantly enhanced during head-up tilt. In controls, responses to suction were increased by tilt from 0.04±0.1 to -1.01±0.2%·mmHg-1 (means±S.E.M.; P<0.001) and those to neck pressure from -0.6±0.3 to -3.1±1.1%·mmHg-1 (P<0.05). In the normal patients, the corresponding changes were: during suction, from -0.2±0.1 to -0.7±0.1%·mmHg-1 (P<0.05); during pressure, from -0.7±0.1 to -1.5±0.3%·mmHg-1 (P<0.05). In contrast, in patients with low orthostatic tolerance, posture had no effect on the reflex (neck suction, from -0.3±0.1 to -0.3±0.1%·mmHg-1; neck pressure, from -1.0±0.3 to -0.9±0.2%·mmHg-1). We suggest that an increase in the sensitivity of the carotid baroreceptor/vascular resistance reflex may be important in the maintenance of blood pressure during orthostatic stress, and that failure of this to occur in patients with posturally related syncope may go some way towards explaining their poor orthostatic tolerance.

Rheoencephalographic observations in migraine

The pathophysiological concept of migraine presently held attributes the major changes to vascular factors. Therefore, it seemed appropriate to use rheoencephalography to test cerebral hemodynamics in cases of migraine. This very harmless and well suited method revealed: (1) on routine tracings during the painless intervall only 1/7 of the cases showed significant changes, while more than 2/3 could be classified with the help of an orthostatic stress test under REG-observation; (2) REG is more often correct for diagnosis than EEG and this does not surprise since REG monitors cerebral hemodynamics directly while EEG records activity for parenchyma and thus only secondarily depends on circulation; (3) similar conditions were previously seen in Meniere's disease where EEG also is less efficient than REG. According to the results of this study, it should be interesting to include REG in the work-up of migrainous patients. In these and under similar conditions, REG will be of diagnostic value.