【摘要】：目的:通過針刺腦梗死急性期患者左側腕骨穴,記錄針刺過程的不同時間段患者平均心率(BPM)、心率變異性時域指標(SDNN、RMSSD)以及頻域指標(TP、LF、HF、LF/HF)的變化,探討針刺左側腕骨穴對腦梗死急性期患者自主神經(jīng)功能的影響,為臨床運用針刺治療腦梗死后自主神經(jīng)功能失調選穴提供依據(jù)。方法:隨機選取41-73歲符合納入標準腦梗死急性期患者30名,平均年齡61.9±5.3歲。其中男性患者17名,女性患者13名。針刺實驗入組患者的左側腕骨穴,使用medilog(?)AR12動態(tài)心電記錄儀監(jiān)測心率變異性指標,記錄針刺腕骨穴前5 min、進針時、留針時(針刺10 min)、出針時(針刺20 min)、出針后5分鐘5個時間點的平均心率BPM以及心率變異性定量指標SDNN、RMSSD、HF、LF、LF/HF、TP,其中高頻功率HF、低頻功率LF、總功率TP、RMSSD和SDNN經(jīng)對數(shù)轉換成LgHF、LgLF、LgTP、LgRMSSD、LgSDNN,LF/HF 采用轉換過的 LgLF/LgHF。結果:1.平均心率和HRV時域指標:BPM和LgRMSSD、LgSDNN在五個時間點間比較,數(shù)值變化不明顯(P0.05)2.HRV頻域指標:LgTP在留針時、出針時與針刺前比較數(shù)值下降(P0.05);LgHF在進針時、留針時、出針時、出針后5min與針刺前相比顯著降低(P0.05);LgLF在進針時、留針時、出針時、出針后5min與針刺前比較數(shù)值下降明顯(P0.05);LgLF/LgHF在留針時、出針時、出針后5min與針刺前比較顯著升高(P0.05)。結論:1.針刺左側腕骨穴可以降低腦梗死急性期患者迷走神經(jīng)活性。2.針刺左側腕骨穴可以調整腦梗死急性期患者自主神經(jīng)張力,提高交感神經(jīng)活性為主。
[Abstract]:Objective: to record the changes of mean heart rate (BPM), heart rate variability (SDNN,RMSSD) and frequency domain index (TP,LF,HF,LF/HF) in patients with acute cerebral infarction by acupuncture at left carpal points in different time periods, and to explore the effect of acupuncture at left carpal points on autonomic nerve function in patients with acute cerebral infarction. It provides the basis for the clinical application of acupuncture in the treatment of autonomic nerve dysfunction after cerebral infarction. Methods: thirty patients (mean age 61.9 鹵5.3 years) with acute cerebral infarction were randomly selected. Among them, 17 were male and 13 were female. The heart rate variability (HRV) was monitored by medilog (?) AR12 dynamic ECG recorder at the left carpal point of the group. The average heart rate (BPM) and the quantitative index of heart rate variability (SDNN,RMSSD,HF,LF,LF/HF,TP,) were recorded at 5 min, before acupuncture and 10 min), at 10 min), (5 minutes after acupuncture at 20 min),). The high frequency power HF, low frequency power LF, was recorded. Total power TP,RMSSD and SDNN are logarithmic converted to LgHF,LgLF,LgTP,LgRMSSD,LgSDNN,LF/HF using converted LgLF/LgHF. Result: 1. Mean heart rate and HRV time domain index: BPM and LgRMSSD,LgSDNN did not change significantly among five time points (P 0.05). 2.HRV frequency domain index: when LgTP retained needle, the value of LgTP decreased compared with that before acupuncture (P 0.05); LgHF decreased significantly after acupuncture compared with that before acupuncture (P 0.05). When LgLF was injected and retained, the value of 5min decreased significantly after acupuncture (P 0.05), and the 5min of LgLF/LgHF increased significantly after acupuncture compared with that before acupuncture (P 0.05), and the value of 5min decreased significantly after acupuncture compared with that before acupuncture (P 0.05), and the value of 5min decreased significantly after acupuncture compared with that before acupuncture (P 0.05). Conclusion: 1. Acupuncture at the left carpal point can reduce vagus nerve activity in patients with acute cerebral infarction. 2. Acupuncture at left carpal point can adjust autonomic nerve tension and increase sympathetic nerve activity in patients with acute cerebral infarction.
【學位授予單位】：黑龍江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.6

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