针刺经穴对慢性稳定性心绞痛患者心率变异性的影响

发布时间：2018-05-12 01:22

本文选题：针刺 + 经穴　；参考：《中华中医药杂志》2017年04期

【摘要】：目的:观察针刺经穴对慢性稳定性心绞痛(CSAP)患者心率变异性(HRV)的影响,探索针刺经穴对心脏自主神经功能的调整效应。方法:采用多中心、随机、对照的方法,选取符合纳入标准的148例患者,包括循经取穴组(A组)37例、他经取穴组(B组)37例、非经非穴组(C组)38例和等待治疗组(D组)36例。4组均给予基础治疗。其中循经取穴组取双侧内关、通里;他经取穴组取双侧孔最、太渊;非经非穴组取双侧非穴1、非穴2;各组均为隔日针刺1次,每周3次,共治疗4周。D组无针刺干预。采用24h动态心电图评价受试者治疗前后HRV(SDNN-24小时、SDNN Index、SDANN Index、rMSSD、pNN50、频域功率-24小时、最小频域功率小时、最大频域功率小时)值的变化。结果:与治疗前比较,针刺经穴(包括A组和B组)HRV时域及频域参数值普遍呈增高趋势,但是治疗前后HRV时域及频域参数值,差异无统计学意义。与D组比较,经穴组(包括A组和B组)在SDNN Index、频域功率-24小时及最小频域功率小时指标上有显著差异(P0.05)。而C组在HRV时域及频域指标方面与D组相比差异无统计学意义。结论:与针刺前比较,针刺经穴组患者HRV增高,提示针刺后CSAP预后趋优。针刺经穴结合基础治疗,优于单纯基础治疗,可以使CSAP患者HRV增高,具有显著改善心脏自主神经系统张力作用,提示这可能会减少CSAP患者的急性心脏事件和心源性猝死的发生。
[Abstract]:Objective: to observe the effect of acupuncture on heart rate variability (HRV) in patients with chronic stable angina pectoris (CSAP) and to explore the effect of acupuncture on cardiac autonomic nerve function. Methods: a multicenter, randomized, controlled method was used to select 148 patients, including 37 patients in group A and 37 patients in group B, who met the inclusion criteria. Group C (38 cases) and group D (36 cases) were given basic treatment. The two sides of Neiguan, Tongli were taken in the group of acupoints along the meridian; the group of acupoints taken by his meridian took the most of bilateral foramen, Taiyuan; the group of non-meridian and non-acupoints took 1 and 2 of the bilateral non-acupoints; each group was needled once every other day, 3 times a week, and there was no acupuncture intervention in group D for 4 weeks. 24 h ambulatory electrocardiogram was used to evaluate the changes of HRV(SDNN-24 hour SDNN IndexSDANN Index rMSSDN 50, frequency domain power -24 hours, minimum frequency domain power hour and maximum frequency domain power hour before and after treatment. Results: compared with before treatment, the time-domain and frequency-domain parameters of acupuncture at acupoints (including group A and group B) showed an increasing trend, but there was no significant difference in the parameters of time domain and frequency domain of HRV before and after treatment. Compared with group D, there were significant differences in SDNN index, frequency-domain power -24 hours and minimum frequency-domain power hours in meridian acupoint group (group A and group B). There was no significant difference between group C and group D in HRV in time domain and frequency domain. Conclusion: compared with before acupuncture, the HRV in acupuncture acupoint group is higher than that before acupuncture, suggesting that the prognosis of CSAP after acupuncture is better. Acupuncture of acupoints combined with basic treatment is superior to simple basic treatment, which can increase HRV in patients with CSAP and can significantly improve the tension of cardiac autonomic nervous system, suggesting that this may reduce the occurrence of acute cardiac events and sudden cardiac death in patients with CSAP.
【作者单位】：成都中医药大学针灸推拿学院;呼和浩特市蒙医中医医院;贵阳中医学院;陕西中医药大学;湖南中医药大学针灸推拿学院;

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