针刺阳陵泉穴对脑梗死患者心率变异性的影响

发布时间：2018-04-06 03:37

  本文选题：针刺　切入点：阳陵泉穴　出处：《黑龙江中医药大学》2016年硕士论文

【摘要】：目的：通过观察针刺阳陵泉穴前后HRV各指标的变化,探讨针刺阳陵泉穴对脑梗死患者心率变异性的影响。方法：全部病例均来源于黑龙江中医药大学附属第一医院病房,共30例,其中男性患者13例,女性患者17例,梗死灶在左侧患者16例,右侧14例,平均年龄为53.77±6.00。获得本人口头承诺后进行研究,其中不同性别受试者的年龄、基础心率和病程经统计学处理后认为均无显著性差异(P0.05,其中P年龄=0.581,P基础心率=0.135,P病程=0.198)。实验条件准备完成后,打开medilog(?)AR12动态心电记录仪,5min后选取左侧阳陵泉穴,穴位局部常规消毒、医者双手清洁后进针,行针得气,进针后10min行平补平泻手法,进针后20min出针,出针后继续记录5min后关机,实验结束,整个操作过程30min,总留针时间为20min。对时域分析指标和频域分析指标记录后分别进行自身针刺前后对比和不同时间点对比分析,讨论结果并得出结论。结果：时域分析结果中,SDNN进针后5min和进针后15min与进针前5min相比,数值降低,统计学上有极显著性差异(P0.01)。频域分析结果中,HF%、LF%各时间点与进针前5min相比,数值降低,统计学上有极显著性差异(P0.01); Log LF/HF、 ULF%、VLF%各时间点与进针前5min相比,数值升高,统计学上有极显著性差异(P0.01)。HF进针后15min点与进针前5min相比,数值降低,统计学上有显著性差异(P0.05)；其他各时间点,数值降低,统计学上有极显著性差异(P0.01)。ULF除进针时与进针前5min相比无显著性差异外,行针时与进针前5min相比,数值升高,统计学上有极显著性差异(P0.01)；其他各时间点与进针前5min相比数值降低,统计学上有极显著性差异。LF进针后5min与进针前5min相比,统计学上无显著性差异,其他各时间点与进针前5min相比,数值降低,统计学上有极显著性差异(P0.01)。各指标不同时间点相互比较结果显示。ULF在进针后5min和出针时相比时,数值升高,统计学上有显著性差异(P0.05)。ULF、VLF行针时和进针时比较数值升高,统计学上有显著性差异(p0.05)。ULF、VLF、ULF%行针时和进针后5min比较、进针后15min比较数值升高,统计学上有显著性差异(P0.05)。LF行针时和进针后5min比较数值降低,统计学上有显著性差异(P0.05)。ULF、VLF、ULF%行针时和出针后5min比较,数值升高,统计学上有显著性差异(P0.05)。结论：1、针刺阳陵泉穴能显著降低脑梗死患者的迷走神经活性；2、针刺阳陵泉穴能显著降低脑梗死患者的自主神经系统张力；3、针刺阳陵泉穴能显著升高脑梗死患者的交感神经活性；4、平补平泻手法可以加强阳陵泉穴对脑梗死患者ULF、VLF、ULF%的影响,降低阳陵泉穴对脑梗死患者LF%的影响；5、针刺阳陵泉穴对脑梗死患者的心率变异性有显著性影响,并且在出针后具有一定后遗效应。
[Abstract]:Objective: to investigate the effect of acupuncture on heart rate variability of patients with cerebral infarction by observing the changes of HRV indexes before and after acupuncture at Yanglingquan.Methods: all the patients came from the ward of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine, including 13 male and 17 female, 16 patients with left and 14 patients with right, with an average age of 53.77 卤6.00.After obtaining my oral commitment, the study showed that there was no significant difference in age, basal heart rate and course of disease among subjects of different genders (P 0.05), in which P age was 0.581g / P and the course of basic heart rate was 0.135p (P = 0.198).After the experimental conditions were completed, the left Yanglingquan acupoint was selected 5 minutes after the medilog(?)AR12 dynamic ECG recorder was turned on, the local routine disinfection was done at the acupoint, the hands were cleaned and the needle was obtained by the needle, and the 10min was given the technique of flat nourishing and reducing after the needle, and the needle was given out of the 20min after the needle was put in.Continue to record the 5min and shut down the machine after the needle out, the experiment is finished, the whole operation process is 30 minutes, the total needle retention time is 20 minutes.The time domain analysis index and frequency domain analysis index were recorded and compared before and after acupuncture and at different time points, the results were discussed and the conclusion was drawn.Results: in the time domain analysis, the value of 5min and 15min after needle injection was lower than that of 5min before needle injection, and there was statistically significant difference (P 0.01).The results of frequency domain analysis showed that the value of 5min at each time point was lower than that before injection, and there was a statistically significant difference (P < 0.01). Compared with 5min before injection, the value of Log LFR / HF, ULF% at each time point was higher than that before injection.There was statistically significant difference in the 15min point after the injection of P0.01g 路HF, which was significantly lower than that before the injection, and the difference was statistically significant (P 0.05), while at other time points, the value decreased.There was very significant difference in statistics (P 0.01). There was no significant difference in 5min between the needle and the needle before injection. The value of 5min in the needle was higher than that before the needle, and there was a significant difference in the statistics (P 0.01). The value of 5min was decreased at other time points compared with the 5min before the needle injection.There was no significant difference in 5min between LF needle and 5min before injection. The value of 5min at other time points was lower than that before needle injection, and there was a significant difference in statistics between LF and 5min before needle injection (P 0.01).The results of comparison at different time points showed that the value of ULF increased when 5min was in and out of the needle, and there was significant difference in statistics (P < 0.05). The value of ULF was increased when the needle was in and out of the needle, and the value of ULF was higher than that when the needle was put in and out of the needle, and there was a significant difference in statistics between the two groups.There was statistically significant difference in the value of 15min between the two groups: p0.05U. ULFULF% and 5min after injection. There was a statistically significant difference in the value of 15min between the two groups. There was a significant difference between the two groups. The value of 5min was decreased during and after the injection of LF, and there was a significant difference between the two groups.There was a significant difference in 5min between the two groups (P0.05U. ULFULF%), and there was a significant difference (P0.05) between the two groups (P0.05%, P0.05%, P0.05%, P0.05%, P0.05%, P0.05%, P0.05%, P0.05%).Conclusion acupuncture at Yanglingquan can significantly reduce vagus nerve activity in cerebral infarction patients, acupuncture at Yanglingquan point can significantly reduce the tension of autonomic nervous system of cerebral infarction patients and acupuncture at Yanglingquan point can significantly increase the activity of vagus nerve in patients with cerebral infarction.The effect of Yanglingquan point on ULFFV FULF% in patients with cerebral infarction could be enhanced by the treatment of sympathetic nerve activity 4 and Pingbu Pingxiao, and the effect of Yanglingquan on ULFV FULF% in patients with cerebral infarction.Reducing the effect of Yanglingquan point on LF% of cerebral infarction patients. Acupuncture at Yanglingquan point had significant effect on heart rate variability of cerebral infarction patients, and had a certain posthumous effect after acupuncture.
【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】：2016
【分类号】：R246.6

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