针刺大陵穴对脑梗死患者心率变异性的影响

发布时间：2018-02-03 03:42

本文关键词： 针刺脑梗死大陵穴心率变异性　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:通过对针刺30例脑梗死恢复期患者大陵穴的研究,观察HRV在针刺左侧大陵穴各个时间点的指标参数变化,探讨针刺大陵穴对脑梗死(CI)患者心脏自主神经功能的影响,为临床治疗及研究提供理论依据。方法:全部研究对象均来源于黑龙江中医药大学第一附属医院针灸二科门诊的患者,30例患者,女性13例,男性17例。实验者嘱患者于安静状态下处于仰卧位,打开medilog(?)AR12动态心电记录仪开始记录(第一时间观察点),于5min后选取左侧大陵穴,在经过穴位局部皮肤的常规消毒及刺手双手清洁后进针(第二时间观察点),在进针得气10min后行平补平泻手法进行行针(第三时间观察点),在行针10min后将针起出(第四时间观察点),出针后嘱患者继续平躺记录5min(第五时间观察点)后实验结束,整个实验过程一共5个时间观察点。在分别对30例患者观察记录完毕后,用SPSS17.0数据分析软件对进针后不同时间点与进针前进行比较分析,然后对结果进行讨论并得出最终结论。结果:针刺左侧大陵穴在不同的五个时间点对MeanBPM、pNN50、SDNN及RMSSD的影响结果比较可知:在针刺时,针刺后10min(行针时),针刺后20min(出针时),出针后5 min与针刺前5 min相比均没有有意义的变化(P0.05);针刺左侧大陵穴在针刺时,进针后10min(行针时),进针后20min(出针时)及出针后5min与针刺前5min相比,HF(高频功率值)、LF(低频功率值)、HF%(高频功率百分比)、LF%(低频功率百分比)等明显降低,具有统计学差异(P0.05);针刺左侧大陵穴后对不同时间点LogLF/HF(低频功率高频功率比)的影响与针刺前5 min相比,有增高趋势(P0.05),具有统计学意义;针刺后10min(行针时)对ULF(超低频功率)的影响与针刺前5min相比没有明显变化(P0.05),不具有统计学意义;在进针时、针刺20min、出针后5min对ULF的影响与针刺前5 min相比有明显升高(P0.05),具有统计学意义。结论:1.针刺大陵穴可引起脑梗死患者的LF及LF%明显降低,提示可降低患者的交感神经功能活动性,调节患者的心脏自主神经功能。2.针刺大陵穴可引起脑梗死患者的HF及HF%值明显降低,提示可降低患者的迷走神经活动性,调节患者心脏自主神经功能。3.针刺大陵穴可以增高脑梗死患者的LogLF/HF值,调节脑梗死患者交感神经和迷走神经的张力,调节自主神经功能。4.针刺大陵穴可以增高脑梗死患者的ULF值,调节脑梗死患者自主神经(ANS)系统。
[Abstract]:Objective: to observe the changes of HRV index parameters at each time point of acupuncture at left Daling point through the study of 30 patients with cerebral infarction in convalescence stage. To investigate the effect of acupuncture at Daling point on cardiac autonomic nerve function in patients with cerebral infarction (CI). Methods: all the subjects were from 30 patients (13 females) from the second Department of Acupuncture and moxibustion Department of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine. Male 17 cases. The experimenter told the patient to lie on his back in a quiet state and open the medilogus? The AR12 dynamic ECG recorder began to record (the first observation point was observed and the left Daling acupoint was selected 5 minutes later). After the routine disinfection of the local skin at the acupoint and the cleaning of the hands of the prickly hand, the needle was injected into the needle (the second time was observed at the point of observation), and after 10 minutes of the injection of qi, the acupuncture was performed with the technique of flat tonifying and reducing the air (the third time observation point). After 10 minutes of acupuncture, the needle was lifted out (4th hours observation point), and the patient was told to continue to lie down and record the observation point for 5 minutes (5th time observation point). After 30 patients were observed and recorded, SPSS17.0 data analysis software was used to compare the different time points after the needle injection and before the needle injection. Then the results were discussed and the final conclusion was drawn. Results: acupuncture at the left side of Daling point at different time points on the mean BPMPN50. The results of SDNN and RMSSD showed that: 10 minutes after acupuncture, 20 minutes after acupuncture, 10 minutes after acupuncture and 20 minutes after acupuncture. There was no significant change of P0.05 in 5 min after acupuncture compared with 5 min before acupuncture. In the period of acupuncture on the left side of Daling point, HFH (high frequency power value) was 10 minutes after acupuncture, 20 minutes after acupuncture, 20 minutes after injection and 5 min after exiting the needle compared with 5 min before acupuncture. LF( low frequency power value) HFR (high frequency power percentage) obviously decreased (low frequency power percentage), there was statistical difference (P 0.05); The effect of acupuncture at left Daling point on the low frequency power / high frequency power ratio of LogLFR at different time points was significantly higher than that of the first 5 min acupuncture points (P 0.05). The effect of ultralow frequency power (ULF) on ulf (ultra low frequency power) at 10 min after acupuncture had no significant change compared with that of 5 min before acupuncture (P 0.05), and there was no significant difference between the two groups. The effect of acupuncture on ULF at 20 min and 5 min after acupuncture was significantly higher than that at 5 min before acupuncture (P 0.05). Conclusion Acupuncture at Daling point can significantly reduce LF and LF% in patients with cerebral infarction, suggesting that it can reduce the sympathetic nerve activity of patients. Regulation of cardiac autonomic nerve function .2.Acupuncture at Daling point can significantly reduce HF and HF% in patients with cerebral infarction, suggesting that it can reduce vagus nerve activity in patients with cerebral infarction. Regulation of cardiac autonomic nerve function .3.Acupuncture at Daling point can increase the LogLF/HF value of patients with cerebral infarction and regulate the tension of sympathetic nerve and vagus nerve in patients with cerebral infarction. Regulating autonomic nervous function .4.Acupuncture at Daling point can increase the ULF value of cerebral infarction patients and regulate the autonomic nervous ANSs system of cerebral infarction patients.
【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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