本文關(guān)鍵詞：針刺左側(cè)陽池穴對腦梗死患者心率變異性的影響　出處：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 陽池穴 腦梗死恢復(fù)期 心率變異性 主神經(jīng)功能

【摘要】：目的:本實驗選取左側(cè)陽池穴,觀察針刺后心率變異性各指標(biāo)(包括時域指標(biāo)與頻域指標(biāo))的改變情況,分析針刺陽池穴對腦梗死恢復(fù)期患者HRV的影響,進(jìn)一步討論針刺陽池穴對腦梗死患者自主神經(jīng)系統(tǒng)的影響,為臨床治療提供指導(dǎo)。方法:選取腦梗死恢復(fù)期患者30例,其中男性患者17例,女性患者13例,年齡范圍45-77歲,平均年齡為65.9±7.54歲。病程27-88天,平均病程44.8±13.8天。征得本人同意后開始實驗。實驗采用medilog(?)AR12動態(tài)心電記錄儀,記錄指標(biāo)包括進(jìn)針前5min、進(jìn)針時、進(jìn)針后5min、進(jìn)針后1Omin(行針)、進(jìn)針后15min、進(jìn)針后20min(出針)和出針后5min等7個時間點。心率變異性定量指標(biāo)包括Max Bpm、Min Bpm、Mean Bpm、SDNN、RMSSD、HF、LF、HF%、LF%、ULF、ULF%。本實驗全程需 30min,其中留針時間20min。實驗所得全部數(shù)據(jù)使用SPSS 17.0統(tǒng)計學(xué)軟件采用配對重復(fù)測量數(shù)據(jù)方差分析法進(jìn)行分析,不符合正態(tài)分布的數(shù)據(jù),采用數(shù)學(xué)轉(zhuǎn)化使之符合正態(tài)分布。結(jié)果采用均數(shù)士標(biāo)準(zhǔn)差(X±S)表示,當(dāng)P＜0.05時,具有統(tǒng)計學(xué)意義。結(jié)果:1.時域指標(biāo):針刺左側(cè)陽池穴,Min BPM數(shù)值在進(jìn)針后各時間點與針刺前比較,數(shù)值均降低(P0.05),有統(tǒng)計學(xué)意義;MeanBPM在針刺時及針刺后5min數(shù)值降低(P0.05),有統(tǒng)計學(xué)意義;SDNN、RMSSD數(shù)值在針刺后各個時間點與針刺前相比無明顯變化,無統(tǒng)計學(xué)意義(P＞0.05)。2.頻域指標(biāo):針刺左側(cè)陽池穴,LogHF、HF%在進(jìn)針時、進(jìn)針后5min、行針時、進(jìn)針后15min、出針時和出針后5min與針刺前比較,數(shù)值明顯降低,有統(tǒng)計學(xué)意義(P0.01)。LogLF、LF%在進(jìn)針時、進(jìn)針后5min、行針時、進(jìn)針后15min、出針時和出針后5min較針刺前有顯著差異(P0.05)。針刺左側(cè)陽池穴,ULF%在進(jìn)針時、進(jìn)針后5min、行針時、進(jìn)針后15min、出針時和出針后5min較針刺前有顯著差異(P0.05),行針時數(shù)值達(dá)到最大。結(jié)論:1.針刺左側(cè)陽池穴會引發(fā)腦梗死恢復(fù)期患者心率的變化,對心臟自主神經(jīng)系統(tǒng)交感神經(jīng)、迷走神經(jīng)有調(diào)節(jié)作用。2.針刺左側(cè)陽池穴對腦梗死恢復(fù)期患者的迷走神經(jīng)活性有抑制作用,這一作用有后遺效應(yīng)。3.針刺左側(cè)陽池穴對腦梗死恢復(fù)期患者的交感神經(jīng)活性有抑制作用,對交感神經(jīng)的影響程度大于對迷走神經(jīng)的影響度。
[Abstract]:Objective: to observe the changes of heart rate variability (including time-domain index and frequency-domain index) after acupuncture, and to analyze the effect of acupuncture at Yangchi point on HRV in convalescent patients with cerebral infarction. To further discuss the effect of acupuncture on the autonomic nervous system in patients with cerebral infarction and provide guidance for clinical treatment. Methods: 30 patients with cerebral infarction were selected, 17 of them were male. There were 13 female patients aged 45-77 years with an average age of 65.9 鹵7.54 years. The course of disease was 27-88 days. The average course of disease was 44.8 鹵13.8 days. AR12 dynamic ECG recorder was used. The recording indexes included 5 minutes before the needle injection, 5 minutes after the needle injection, 1 Omin after the needle injection, and 15 minutes after the needle injection. The quantitative indexes of heart rate variability (HRV) including Max BpmM Min BpmM Mean BpmN SDNN were measured at 20 min after injection and 5 min after injection. The whole experiment takes 30 minutes. The needle retention time was 20 min.All the experimental data were analyzed by SPSS 17.0 statistical software using the method of variance analysis of paired repeated measurement data, which did not accord with the data of normal distribution. The mathematical transformation was used to make it accord with the normal distribution. Results the mean standard deviation X 鹵S was expressed as X 鹵S, and there was statistical significance when P < 0.05. Results: 1. Time domain index: acupuncture at the left side of Yangchi. The value of Min BPM was significantly lower than that before acupuncture at each time point after acupuncture. The value of MeanBPM decreased significantly at the time of acupuncture and 5 minutes after acupuncture. The RMSSD values of SDNNNs did not change significantly at all time points after acupuncture compared with those before acupuncture, and there was no statistical significance (P > 0.05) .2.The index of frequency domain: acupuncture at the left side of Yangchi acupoint and LogHF. The value of HF% was significantly lower than that before acupuncture at 5 min after injection, 15 min after needle entry, 5 min after needle out and 5 min after needle exit. There was statistically significant difference between P0.01U. LogLFFN LF% at the time of needle injection, 5 minutes after injection, 15 minutes after needle injection. There was a significant difference between the time of acupuncture and 5 min after acupuncture compared with that before acupuncture (P 0.05). When acupuncture was in place, 5 min after acupuncture, 15 min after acupuncture, there was a significant difference between acupuncture and acupoint ULF% at the left side of Yangchi acupoint at the time of needle entry, 5 min after injection, and 15 min after acupuncture. There was a significant difference between the time of acupuncture and 5 min after acupuncture compared with that before acupuncture. The time of acupuncture reached the maximum. Conclusion 1.Acupuncture at left Yangchi point can induce the change of heart rate in patients with cerebral infarction in convalescent period. On the sympathetic nerve of cardiac autonomic nervous system, vagus nerve has a regulatory effect .2.Acupuncture of left Yangchi point can inhibit the vagus nerve activity of patients with cerebral infarction in convalescent stage. The effect of acupuncture on the left side of Yangchi has an inhibitory effect on the sympathetic activity of patients with cerebral infarction at convalescent stage, and the degree of influence on sympathetic nerve is greater than on vagus nerve.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.6

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