针刺左合谷穴对脑梗死患者心率变异性的影响

发布时间：2018-05-19 15:40

本文选题：针刺 + 合谷穴　；参考：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:通过观察脑梗死患者在针刺左侧合谷穴的不同时间点心率变异性各项指标的变化,研究其对脑梗死患者心率变异性的影响,探讨针刺左侧合谷穴对脑梗死患者自主神经功能的影响,为临床运用该穴治疗脑梗死合并自主神经功能失调提供依据。方法:本方法的病例来自黑龙江中医药大学附属第一医院病房,从中随机选取30例年龄在40-80岁(58.4±8.16)之间的脑梗死患者,其中男女性各15例,病程分期属恢复期或后遗症期,所纳入的观察对象在脑梗死后4-11月(7.03± 1.93)之间。操作时针刺患者左侧合谷穴,使用medilog AR12(?)动态心电记录仪监测心率变异性指标,记录针刺合谷穴前5min、针刺得气时、行针时(针刺后1Omin)、出针时、出针后5min的五个时间点心率变异性指标(MeanBPM、SDNN、RMSSD、HF、LF、TP、LF/HF),为使数据满足正态分布,将HF、LF、TP、SDNN、RMSSD经对数进行转换成LgHF、LgLF、LgTP、LgSDNN、LgRMSSD,LF/HF 转换为 LgLF/LgHF。将所得数据采用SPSS17.0软件进行统计学分析,计量资料用均数±标准差((?)±S)表示,统计方法采取重复测量数据方差分析,P0.05为具有统计学意义。结果:1.时域分析指标1.1平均心率在针刺时、行针时(针刺后10min)、出针时与针刺前比较,均明显降低,统计学意义显著(P0.01);而在出针后5min平均心率虽有所回升,但与针刺前比较仍旧降低,具有统计学意义(P0.01),提示针刺左侧合谷穴可使心率降低。1.2LgSDNN及LgRMSSD在针刺后各个时间点与针刺前相比较,虽有一定变化,但数值变化不明显,经统计学分析显示其变化结果无统计学意义(P0.05)。2.频域分析指标2.1LgTP在针刺后各个时间点与针刺前比较均无统计学意义(P0.05);2.2LgHF在针刺后各时间点与针刺前比较,其结果均具有显著统计学意义(P0.01);2.3LgLF在针刺时和行针时(针刺后10min)与针刺前比较具有显著统计学意义(P0.01),出针时及出针后5min与针刺前比较无统计学意义(P0.05);2.4LgLF/LgHF在出针后5min与针刺前比较,具有统计学意义(P0.01),但在其他时间点与针刺前比较无统计学意义(P0.05)。结论:1.针刺左侧合谷穴可使脑梗死患者的平均心率降低。2.针刺左侧合谷穴可以使脑梗死患者的迷走神经活性增高。
[Abstract]:Objective: To study the changes of the variation of the variation of the variation of the dessert rate of the patients with cerebral infarction at different time in the left Hegu acupoint and to study the effect of its effect on the heart rate variability in patients with cerebral infarction, and to explore the effect of acupuncture on the autonomic nerve function of the patients with cerebral infarction, and to use this point to treat cerebral infarction with autonomic nerve function. Methods: this method: the case of this method came from the ward of the First Affiliated Hospital of Heilongjiang University Of Chinese Medicine. 30 cases of cerebral infarction aged 40-80 years (58.4 + 8.16) were selected randomly, of which 15 cases were male and female, the course of disease was in the recovery period or sequelae, and the subjects were included in 4-11 months after cerebral infarction (7.03 + 1.93). Medilog AR12 (?) dynamic ECG recorder was used to monitor heart rate variability index, record the index of heart rate variability by Medilog AR12 (?) dynamic ECG recorder, record the 5min of acupuncture at Hegu Point, when needling got gas, when needling (after 1Omin), and when the needle was out, the five time variation index (MeanBPM, SDNN, RMSSD, HF, LF, TP, LF/HF) after the needle was out of the needle (MeanBPM, SDNN, RMSSD, HF, LF, TP, LF/HF). HF, LF, TP, SDNN, RMSSD are converted into LgHF, LgLF, LgTP, LgSDNN, LgRMSSD, LF/HF are converted to LgLF/LgHF.. Results: 1. the average heart rate of 1. time domain analysis index 1.1, while needling (after needling 10min), compared with before acupuncture, the average heart rate of the needle was significantly reduced and the statistical significance was significant (P0.01), while the average heart rate of 5min after the needle increased, but it was still lower than before acupuncture, with statistical significance (P0.01), suggesting acupuncture at the left Hegu Point on the left side of the needle. The decrease of heart rate.1.2LgSDNN and LgRMSSD in each time point after acupuncture was compared with that before acupuncture. Although there was a certain change, the numerical change was not obvious. The statistical analysis showed that there was no statistical significance (P0.05).2. frequency domain analysis index 2.1LgTP after acupuncture at every time point compared with before acupuncture was not statistically significant (P0.05); 2.2Lg The results of HF at each time point after acupuncture were compared with that before acupuncture, and the results were statistically significant (P0.01); 2.3LgLF had significant statistical significance at the time of acupuncture and needling (10min after acupuncture) and before acupuncture (P0.01). There was no statistical significance between the needle and the needle before and after the needle, 5min and before the acupuncture (P0.05); 2.4LgLF/LgHF at the end of the needle 5min and acupuncture. The previous comparison was statistically significant (P0.01), but there was no significant difference between the other time points and before acupuncture (P0.05). Conclusion: 1. acupuncture on the left Hegu acupoint can reduce the average heart rate of the patients with cerebral infarction by.2. acupuncture on the left Hegu acupoint, which can increase the activity of vagus nerve in the patients with cerebral infarction.
【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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