本文選題：針刺 + 合谷穴��； 參考：《黑龍江中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過(guò)觀察腦梗死患者在針刺左側(cè)合谷穴的不同時(shí)間點(diǎn)心率變異性各項(xiàng)指標(biāo)的變化,研究其對(duì)腦梗死患者心率變異性的影響,探討針刺左側(cè)合谷穴對(duì)腦梗死患者自主神經(jīng)功能的影響,為臨床運(yùn)用該穴治療腦梗死合并自主神經(jīng)功能失調(diào)提供依據(jù)。方法:本方法的病例來(lái)自黑龍江中醫(yī)藥大學(xué)附屬第一醫(yī)院病房,從中隨機(jī)選取30例年齡在40-80歲(58.4±8.16)之間的腦梗死患者,其中男女性各15例,病程分期屬恢復(fù)期或后遺癥期,所納入的觀察對(duì)象在腦梗死后4-11月(7.03± 1.93)之間。操作時(shí)針刺患者左側(cè)合谷穴,使用medilog AR12(?)動(dòng)態(tài)心電記錄儀監(jiān)測(cè)心率變異性指標(biāo),記錄針刺合谷穴前5min、針刺得氣時(shí)、行針時(shí)(針刺后1Omin)、出針時(shí)、出針后5min的五個(gè)時(shí)間點(diǎn)心率變異性指標(biāo)(MeanBPM、SDNN、RMSSD、HF、LF、TP、LF/HF),為使數(shù)據(jù)滿(mǎn)足正態(tài)分布,將HF、LF、TP、SDNN、RMSSD經(jīng)對(duì)數(shù)進(jìn)行轉(zhuǎn)換成LgHF、LgLF、LgTP、LgSDNN、LgRMSSD,LF/HF 轉(zhuǎn)換為 LgLF/LgHF。將所得數(shù)據(jù)采用SPSS17.0軟件進(jìn)行統(tǒng)計(jì)學(xué)分析,計(jì)量資料用均數(shù)±標(biāo)準(zhǔn)差((?)±S)表示,統(tǒng)計(jì)方法采取重復(fù)測(cè)量數(shù)據(jù)方差分析,P0.05為具有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.時(shí)域分析指標(biāo)1.1平均心率在針刺時(shí)、行針時(shí)(針刺后10min)、出針時(shí)與針刺前比較,均明顯降低,統(tǒng)計(jì)學(xué)意義顯著(P0.01);而在出針后5min平均心率雖有所回升,但與針刺前比較仍舊降低,具有統(tǒng)計(jì)學(xué)意義(P0.01),提示針刺左側(cè)合谷穴可使心率降低。1.2LgSDNN及LgRMSSD在針刺后各個(gè)時(shí)間點(diǎn)與針刺前相比較,雖有一定變化,但數(shù)值變化不明顯,經(jīng)統(tǒng)計(jì)學(xué)分析顯示其變化結(jié)果無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2.頻域分析指標(biāo)2.1LgTP在針刺后各個(gè)時(shí)間點(diǎn)與針刺前比較均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);2.2LgHF在針刺后各時(shí)間點(diǎn)與針刺前比較,其結(jié)果均具有顯著統(tǒng)計(jì)學(xué)意義(P0.01);2.3LgLF在針刺時(shí)和行針時(shí)(針刺后10min)與針刺前比較具有顯著統(tǒng)計(jì)學(xué)意義(P0.01),出針時(shí)及出針后5min與針刺前比較無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);2.4LgLF/LgHF在出針后5min與針刺前比較,具有統(tǒng)計(jì)學(xué)意義(P0.01),但在其他時(shí)間點(diǎn)與針刺前比較無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.針刺左側(cè)合谷穴可使腦梗死患者的平均心率降低。2.針刺左側(cè)合谷穴可以使腦梗死患者的迷走神經(jīng)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.
【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】：2017
【分類(lèi)號(hào)】：R246.6

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