针刺神门穴对脑梗死患者心率变异性影响的研究

发布时间：2018-02-26 00:26

本文关键词： 针刺神门脑梗死心率变异性　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:在神门穴的针刺过程中对脑梗死患者心率变异性各个指标变化加以分析,讨论神门穴是否能影响脑梗死患者自主神经功能,从而为临床治疗提出新的方法。方法:随机选取在黑龙江中医药大学附属第一医院针灸二科门诊治疗30例脑梗死患者作为研究对象,其中男性16人,女性14人,年龄40-70岁,平均年龄53.33±8.55岁。所有患者均选取左侧神门穴,嘱患者平卧,保持安静。针刺之前对该穴和操作者双手给予日常清洁,实验仪器为AR12动态心电记录仪,以5分钟为时间间隔,对针刺前5分钟、针刺时、针刺后5分钟、行针时、行针后5分钟、出针时和出针后5分钟,共7个时间点进行数据记录,实验完成并关机后,将全部数据导出,录入SPSS17.0后采用统计学处理,选择 meanBPM、SDNN、RMSSD、LF、HF、VLF、LF%、HF%、LF/HF作为观察指标,观察各指标在不同时间的的变化规律,并分别与针刺前5分钟进行比较,分析实验结果并得出结论。结果:1.mean BPM的数值在针刺时与针刺前5分钟比较,稍有减小,P0.05有统计学意义;mean BPM在针刺后5分钟、行针时、行针后5分钟这三个点的数值与针刺前5分钟比较,有所减小,P0.01有显著的统计学意义;其余各点与针刺前5分钟比较,数值虽然减小,但P0.05无统计学意义。2.RMSSD在针刺时、针刺后5分钟、行针时、行针后5分钟、出针时、出针后5分钟与针刺前5分钟比较,数值有所增大,但P0.05无统计学意义。3.SDNN在针刺时、行针时、出针时、出针后5分钟与针刺前5分钟比较,数值有所增大,但P0.05无统计学意义;其余时间点与针刺前5分钟比较,数值有所减小,但P0.05也无统计学意义。4.HF、LF的数值在各个时间点与针刺前5分钟比较,明显减小P0.01有显著统的计学意义。5.VLF的数值在针刺时、行针时与针刺前5分钟比较,略微减小,P0.05无统计学意义;其余时间点与针刺前5分钟比较,数值有所增大,但P0.05也无统计学意义。6.LF/HF的数值在针刺时、行针时与针刺前5分钟比较,明显增大,P0.01有显著的统计学意义;LF/HF的数值在针刺后5分钟、行针后5分钟、出针后5分钟与针刺前5分钟比较,有所增大,P0.05有统计学意义;LF/HF的数值在出针时与针刺前5分钟比较,虽有所增大,但P0.05无统计学意义。7.HF%的数值在针刺后5分钟与针刺前5分钟比较,略有减小,P0.05有统计学意义;HF%的数值在行针时、行针后5分钟、出针时、出针后分钟与针刺前5分钟比较,明显减少,P0.01有显著的统计学意义;HF%的数值在针刺时与针刺前5分钟比较,虽然有所减小,但P0.05无统计学意义。8.LF%的数值在针刺时、针刺后5分钟、行针后5分钟、出针时、出针后5分钟与针刺前5分钟比较,有所减小,P0.01有显著的统计学意义;LF%的数值在行针时与针刺前5分钟比较,有所减小,P0.05有统计学意义。结论:1、针刺神门穴降低脑梗死患者HF、HF%的数值,提示针刺神门穴可以使迷走神经的兴奋性加以抑制。2、针刺神门穴降低脑梗死患者LF、LF%的数值,提示针刺神门穴可以使交感神经的兴奋性加以抑制。3、针刺神门穴增大脑梗死患者LF/HF的比值,提示针刺神门穴使交感神经和迷走神经的张力平衡加以调节。4、针刺神门穴对脑梗死患者心率变异性有显著影响,而且有一定的后遗效应。
[Abstract]:Objective: in the process of acupuncture Shenmen on cerebral infarction in patients with heart rate variability of each index change to analyze, discuss whether Shenmen can affect the autonomic nerve function in patients with cerebral infarction, so as to put forward a new method for clinical treatment. Methods: Acupuncture in the First Affiliated Hospital of Heilongjiang University Of Chinese Medicine two out-patient treatment of 30 cases of cerebral infarction patients as research the object, of which 16 were male, 14 female, age 40-70 years, mean age 53.33 + 8.55 years. All patients were selected on the left Shenmen, ask the patient supine, keep quiet. Give daily cleaning of the hole and the operator hands before acupuncture, experimental instrument for AR12 dynamic ECG recorder, in 5 minute intervals on 5 minutes, before acupuncture, acupuncture, acupuncture needle, after 5 minutes, 5 minutes after the needle, 5 minutes out of the needle and the needle, a total of 7 time points according to the number of records, and complete the experiment After the shutdown, all data will be derived, input using SPSS17.0 statistical processing, meanBPM, SDNN, RMSSD, LF, HF, VLF, LF%, HF%, LF/HF as observation index, observation indexes changes at different time, and separately with acupuncture 5 minutes before the comparison, analysis of experimental results and draw conclusions results: 1.mean BPM numerical in acupuncture and acupuncture before 5 minutes, slightly decreased, there was statistical significance in P0.05; mean BPM in 5 minutes after acupuncture, acupuncture, acupuncture and acupuncture for 5 minutes after the value of the three points in the first 5 minutes, decreased, there was statistical significance of P0.01; the rest of the 5 minutes before acupuncture point and numerical comparison, although reduced, but there was no statistical significance of P0.05.2.RMSSD in acupuncture, acupuncture after 5 minutes, 5 minutes after the needle, needle, needle, a needle for 5 minutes and 5 minutes before acupuncture, numerical increase, but no statistical P0.05 Significance of.3.SDNN in acupuncture, needle, needle, a needle for 5 minutes and 5 minutes before acupuncture, the value has increased, but there was no statistical significance of P0.05; the rest of the time point and acupuncture 5 minutes before the comparison, numerical decreases, but P0.05 has no statistical significance of.4.HF, LF values at each time acupuncture point and 5 minutes before the comparison, P0.01 has significantly reduced significantly the numerical statistically significant.5.VLF in acupuncture, acupuncture and acupuncture before 5 minutes, slightly decreased, P0.05 was not statistically significant; the rest of the time point and acupuncture 5 minutes before the comparison, the numerical increase, but P0.05 has no numerical statistical significance.6.LF/HF in acupuncture, needle and acupuncture before 5 minutes, significantly increased, there was a statistically significant difference P0.01; LF/HF value after acupuncture in 5 minutes, 5 minutes after the needle, the needle for 5 minutes and 5 minutes before acupuncture, increased, P0.05 system In terms of meaning; the value of LF/HF in the needle and acupuncture before 5 minutes, although increased, but P0.05 had no statistical significance in numerical.7.HF% acupuncture after 5 minutes and 5 minutes before acupuncture, slightly decreased, there was statistical significance in P0.05; the HF% value in 5 minutes after the needle, needle, needle when the needle and acupuncture minutes after 5 minutes before the comparison, significantly reduced, there was a statistically significant difference P0.01; HF% value in acupuncture and acupuncture before 5 minutes, although somewhat reduced, but P0.05 had no statistical significance in numerical.8.LF% acupuncture, acupuncture after 5 minutes, 5 minutes after the needle, a needle when the needle for 5 minutes and 5 minutes before acupuncture, decreased, there was a statistically significant difference P0.01; LF% value in 5 minutes before the needle and acupuncture, decreased, P0.05 was statistically significant. Conclusion: 1, Shenmen decreased HF in patients with cerebral infarction, the value of HF%. Show Shenmen can make the excitability of the vagus nerve to inhibit.2, Shenmen decreased LF in patients with cerebral infarction, the value of LF%, it is suggested that acupuncture Shenmen can make sympathetic nerve excitability by inhibiting.3, the ratio of Shenmen increased LF/HF in patients with cerebral infarction, acupuncture Shenmen sympathetic tension balance and the vagus nerve to adjust.4, Shenmen acupuncture has significant effect on heart rate variability in patients with cerebral infarction, and residual effects.

【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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