Regulation of Autonomic Nervous System by Acupuncture: A Heart Rate Variability Study on Physical Stress

Lun Li¹Sha Liang¹Jinfeng Bai¹Yun Zeng¹Mengzhen Zhang¹Zhongwen Li¹Dingshang Yan¹Yangming Hu¹Liang He¹Yizhe Liu²Qi Liu^3*Zhang Yingjun^4*Min Feng^1*

• ¹School of Traditional Chinese medicine, Hunan University of Medicine, Huaihua, China
• ²School of Rehabilitation Medicine and Health, Hunan University of Medicine, Huaihua, China
• ³College of Acupuncture-Moxibustion and Tuina, Shaanxi University of Chinese Medicine, Xian, China
• ⁴Department of Medical Imaging, Hunan University of Medicine, Huaihua, China

Introduction: This study aimed to investigate the effects of acupuncture and moxibustion, as well as various acupoints, on human autonomic nervous system (ANS) function and physical stress. The research further to identify effective intervention strategies for stress management and health maintenance. Methods: A Self-comparison design was conducted with healthy volunteers. Thirty-five volunteers received sequential 15-minute interventions of moxibustion at ST36, acupuncture at CV12, and acupuncture at ST36, with a one-day washout period between interventions. Heart rate variability (HRV) was measured to assess autonomic function, and heart rate (HR) and the physical stress index (PSI) were measured to assess stress levels. Results: Compared with the baseline, acupuncture at ST36 increased the high-frequency power (HF), root mean square of the successive interval difference (RMSSD), instantaneous standard deviation of the R‒R interval (SD1), long-term standard deviation of the R‒R intervals (SD2), total power (TP), and standard deviation of the normal‒normal interval (SDNN). Acupuncture at CV12 increased RMSSD, SD1, SD2, TP and SDNN, with sustained effects for RMSSD and SD1 post-acupuncture, SD1/SD2 were increased post-acupuncture. The HRs of all three interventions decreased during the intervention, and remained sustained effects post-intervention. The PSI decreased during acupuncture and the stimulation at CV12 remained sustained effects post-acupuncture. Conclusion: Acupuncture alleviates physical stress by regulating ANS activity, with distinct modulatory effects observed across different acupoints, indicating potential applications in stress management and health maintenance. Moxibustion demonstrates marked efficacy in reducing HR. Trial registration: This trial is registered on the International Traditional Medicine Clinical Trials Registry with the identifier ITMCTR2025001289.