本文選題：針刺　切入點(diǎn)：陽(yáng)陵泉穴　出處：《黑龍江中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：通過(guò)觀察針刺陽(yáng)陵泉穴前后HRV各指標(biāo)的變化,探討針刺陽(yáng)陵泉穴對(duì)腦梗死患者心率變異性的影響。方法：全部病例均來(lái)源于黑龍江中醫(yī)藥大學(xué)附屬第一醫(yī)院病房,共30例,其中男性患者13例,女性患者17例,梗死灶在左側(cè)患者16例,右側(cè)14例,平均年齡為53.77±6.00。獲得本人口頭承諾后進(jìn)行研究,其中不同性別受試者的年齡、基礎(chǔ)心率和病程經(jīng)統(tǒng)計(jì)學(xué)處理后認(rèn)為均無(wú)顯著性差異(P0.05,其中P年齡=0.581,P基礎(chǔ)心率=0.135,P病程=0.198)。實(shí)驗(yàn)條件準(zhǔn)備完成后,打開(kāi)medilog(?)AR12動(dòng)態(tài)心電記錄儀,5min后選取左側(cè)陽(yáng)陵泉穴,穴位局部常規(guī)消毒、醫(yī)者雙手清潔后進(jìn)針,行針得氣,進(jìn)針后10min行平補(bǔ)平瀉手法,進(jìn)針后20min出針,出針后繼續(xù)記錄5min后關(guān)機(jī),實(shí)驗(yàn)結(jié)束,整個(gè)操作過(guò)程30min,總留針時(shí)間為20min。對(duì)時(shí)域分析指標(biāo)和頻域分析指標(biāo)記錄后分別進(jìn)行自身針刺前后對(duì)比和不同時(shí)間點(diǎn)對(duì)比分析,討論結(jié)果并得出結(jié)論。結(jié)果：時(shí)域分析結(jié)果中,SDNN進(jìn)針后5min和進(jìn)針后15min與進(jìn)針前5min相比,數(shù)值降低,統(tǒng)計(jì)學(xué)上有極顯著性差異(P0.01)。頻域分析結(jié)果中,HF%、LF%各時(shí)間點(diǎn)與進(jìn)針前5min相比,數(shù)值降低,統(tǒng)計(jì)學(xué)上有極顯著性差異(P0.01); Log LF/HF、 ULF%、VLF%各時(shí)間點(diǎn)與進(jìn)針前5min相比,數(shù)值升高,統(tǒng)計(jì)學(xué)上有極顯著性差異(P0.01)。HF進(jìn)針后15min點(diǎn)與進(jìn)針前5min相比,數(shù)值降低,統(tǒng)計(jì)學(xué)上有顯著性差異(P0.05)；其他各時(shí)間點(diǎn),數(shù)值降低,統(tǒng)計(jì)學(xué)上有極顯著性差異(P0.01)。ULF除進(jìn)針時(shí)與進(jìn)針前5min相比無(wú)顯著性差異外,行針時(shí)與進(jìn)針前5min相比,數(shù)值升高,統(tǒng)計(jì)學(xué)上有極顯著性差異(P0.01)；其他各時(shí)間點(diǎn)與進(jìn)針前5min相比數(shù)值降低,統(tǒng)計(jì)學(xué)上有極顯著性差異。LF進(jìn)針后5min與進(jìn)針前5min相比,統(tǒng)計(jì)學(xué)上無(wú)顯著性差異,其他各時(shí)間點(diǎn)與進(jìn)針前5min相比,數(shù)值降低,統(tǒng)計(jì)學(xué)上有極顯著性差異(P0.01)。各指標(biāo)不同時(shí)間點(diǎn)相互比較結(jié)果顯示。ULF在進(jìn)針后5min和出針時(shí)相比時(shí),數(shù)值升高,統(tǒng)計(jì)學(xué)上有顯著性差異(P0.05)。ULF、VLF行針時(shí)和進(jìn)針時(shí)比較數(shù)值升高,統(tǒng)計(jì)學(xué)上有顯著性差異(p0.05)。ULF、VLF、ULF%行針時(shí)和進(jìn)針后5min比較、進(jìn)針后15min比較數(shù)值升高,統(tǒng)計(jì)學(xué)上有顯著性差異(P0.05)。LF行針時(shí)和進(jìn)針后5min比較數(shù)值降低,統(tǒng)計(jì)學(xué)上有顯著性差異(P0.05)。ULF、VLF、ULF%行針時(shí)和出針后5min比較,數(shù)值升高,統(tǒng)計(jì)學(xué)上有顯著性差異(P0.05)。結(jié)論：1、針刺陽(yáng)陵泉穴能顯著降低腦梗死患者的迷走神經(jīng)活性；2、針刺陽(yáng)陵泉穴能顯著降低腦梗死患者的自主神經(jīng)系統(tǒng)張力；3、針刺陽(yáng)陵泉穴能顯著升高腦梗死患者的交感神經(jīng)活性；4、平補(bǔ)平瀉手法可以加強(qiáng)陽(yáng)陵泉穴對(duì)腦梗死患者ULF、VLF、ULF%的影響,降低陽(yáng)陵泉穴對(duì)腦梗死患者LF%的影響；5、針刺陽(yáng)陵泉穴對(duì)腦梗死患者的心率變異性有顯著性影響,并且在出針后具有一定后遺效應(yīng)。
[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 鹵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.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.6

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