针刺左侧阳池穴对脑梗死患者心率变异性的影响

发布时间：2018-01-17 13:15

本文关键词：针刺左侧阳池穴对脑梗死患者心率变异性的影响　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本实验选取左侧阳池穴,观察针刺后心率变异性各指标(包括时域指标与频域指标)的改变情况,分析针刺阳池穴对脑梗死恢复期患者HRV的影响,进一步讨论针刺阳池穴对脑梗死患者自主神经系统的影响,为临床治疗提供指导。方法:选取脑梗死恢复期患者30例,其中男性患者17例,女性患者13例,年龄范围45-77岁,平均年龄为65.9±7.54岁。病程27-88天,平均病程44.8±13.8天。征得本人同意后开始实验。实验采用medilog(?)AR12动态心电记录仪,记录指标包括进针前5min、进针时、进针后5min、进针后1Omin(行针)、进针后15min、进针后20min(出针)和出针后5min等7个时间点。心率变异性定量指标包括Max Bpm、Min Bpm、Mean Bpm、SDNN、RMSSD、HF、LF、HF%、LF%、ULF、ULF%。本实验全程需 30min,其中留针时间20min。实验所得全部数据使用SPSS 17.0统计学软件采用配对重复测量数据方差分析法进行分析,不符合正态分布的数据,采用数学转化使之符合正态分布。结果采用均数士标准差(X±S)表示,当P＜0.05时,具有统计学意义。结果:1.时域指标:针刺左侧阳池穴,Min BPM数值在进针后各时间点与针刺前比较,数值均降低(P0.05),有统计学意义;MeanBPM在针刺时及针刺后5min数值降低(P0.05),有统计学意义;SDNN、RMSSD数值在针刺后各个时间点与针刺前相比无明显变化,无统计学意义(P＞0.05)。2.频域指标:针刺左侧阳池穴,LogHF、HF%在进针时、进针后5min、行针时、进针后15min、出针时和出针后5min与针刺前比较,数值明显降低,有统计学意义(P0.01)。LogLF、LF%在进针时、进针后5min、行针时、进针后15min、出针时和出针后5min较针刺前有显著差异(P0.05)。针刺左侧阳池穴,ULF%在进针时、进针后5min、行针时、进针后15min、出针时和出针后5min较针刺前有显著差异(P0.05),行针时数值达到最大。结论:1.针刺左侧阳池穴会引发脑梗死恢复期患者心率的变化,对心脏自主神经系统交感神经、迷走神经有调节作用。2.针刺左侧阳池穴对脑梗死恢复期患者的迷走神经活性有抑制作用,这一作用有后遗效应。3.针刺左侧阳池穴对脑梗死恢复期患者的交感神经活性有抑制作用,对交感神经的影响程度大于对迷走神经的影响度。
[Abstract]:Objective: to observe the changes of heart rate variability (including time-domain index and frequency-domain index) after acupuncture, and to analyze the effect of acupuncture at Yangchi point on HRV in convalescent patients with cerebral infarction. To further discuss the effect of acupuncture on the autonomic nervous system in patients with cerebral infarction and provide guidance for clinical treatment. Methods: 30 patients with cerebral infarction were selected, 17 of them were male. There were 13 female patients aged 45-77 years with an average age of 65.9 卤7.54 years. The course of disease was 27-88 days. The average course of disease was 44.8 卤13.8 days. AR12 dynamic ECG recorder was used. The recording indexes included 5 minutes before the needle injection, 5 minutes after the needle injection, 1 Omin after the needle injection, and 15 minutes after the needle injection. The quantitative indexes of heart rate variability (HRV) including Max BpmM Min BpmM Mean BpmN SDNN were measured at 20 min after injection and 5 min after injection. The whole experiment takes 30 minutes. The needle retention time was 20 min.All the experimental data were analyzed by SPSS 17.0 statistical software using the method of variance analysis of paired repeated measurement data, which did not accord with the data of normal distribution. The mathematical transformation was used to make it accord with the normal distribution. Results the mean standard deviation X 卤S was expressed as X 卤S, and there was statistical significance when P < 0.05. Results: 1. Time domain index: acupuncture at the left side of Yangchi. The value of Min BPM was significantly lower than that before acupuncture at each time point after acupuncture. The value of MeanBPM decreased significantly at the time of acupuncture and 5 minutes after acupuncture. The RMSSD values of SDNNNs did not change significantly at all time points after acupuncture compared with those before acupuncture, and there was no statistical significance (P > 0.05) .2.The index of frequency domain: acupuncture at the left side of Yangchi acupoint and LogHF. The value of HF% was significantly lower than that before acupuncture at 5 min after injection, 15 min after needle entry, 5 min after needle out and 5 min after needle exit. There was statistically significant difference between P0.01U. LogLFFN LF% at the time of needle injection, 5 minutes after injection, 15 minutes after needle injection. There was a significant difference between the time of acupuncture and 5 min after acupuncture compared with that before acupuncture (P 0.05). When acupuncture was in place, 5 min after acupuncture, 15 min after acupuncture, there was a significant difference between acupuncture and acupoint ULF% at the left side of Yangchi acupoint at the time of needle entry, 5 min after injection, and 15 min after acupuncture. There was a significant difference between the time of acupuncture and 5 min after acupuncture compared with that before acupuncture. The time of acupuncture reached the maximum. Conclusion 1.Acupuncture at left Yangchi point can induce the change of heart rate in patients with cerebral infarction in convalescent period. On the sympathetic nerve of cardiac autonomic nervous system, vagus nerve has a regulatory effect .2.Acupuncture of left Yangchi point can inhibit the vagus nerve activity of patients with cerebral infarction in convalescent stage. The effect of acupuncture on the left side of Yangchi has an inhibitory effect on the sympathetic activity of patients with cerebral infarction at convalescent stage, and the degree of influence on sympathetic nerve is greater than on vagus nerve.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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