發(fā)布時(shí)間：2018-02-03 03:42

  本文關(guān)鍵詞： 針刺 腦梗死 大陵穴 心率變異性　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

【摘要】：目的:通過(guò)對(duì)針刺30例腦梗死恢復(fù)期患者大陵穴的研究,觀察HRV在針刺左側(cè)大陵穴各個(gè)時(shí)間點(diǎn)的指標(biāo)參數(shù)變化,探討針刺大陵穴對(duì)腦梗死(CI)患者心臟自主神經(jīng)功能的影響,為臨床治療及研究提供理論依據(jù)。方法:全部研究對(duì)象均來(lái)源于黑龍江中醫(yī)藥大學(xué)第一附屬醫(yī)院針灸二科門診的患者,30例患者,女性13例,男性17例。實(shí)驗(yàn)者囑患者于安靜狀態(tài)下處于仰臥位,打開(kāi)medilog(?)AR12動(dòng)態(tài)心電記錄儀開(kāi)始記錄(第一時(shí)間觀察點(diǎn)),于5min后選取左側(cè)大陵穴,在經(jīng)過(guò)穴位局部皮膚的常規(guī)消毒及刺手雙手清潔后進(jìn)針(第二時(shí)間觀察點(diǎn)),在進(jìn)針得氣10min后行平補(bǔ)平瀉手法進(jìn)行行針(第三時(shí)間觀察點(diǎn)),在行針10min后將針起出(第四時(shí)間觀察點(diǎn)),出針后囑患者繼續(xù)平躺記錄5min(第五時(shí)間觀察點(diǎn))后實(shí)驗(yàn)結(jié)束,整個(gè)實(shí)驗(yàn)過(guò)程一共5個(gè)時(shí)間觀察點(diǎn)。在分別對(duì)30例患者觀察記錄完畢后,用SPSS17.0數(shù)據(jù)分析軟件對(duì)進(jìn)針后不同時(shí)間點(diǎn)與進(jìn)針前進(jìn)行比較分析,然后對(duì)結(jié)果進(jìn)行討論并得出最終結(jié)論。結(jié)果:針刺左側(cè)大陵穴在不同的五個(gè)時(shí)間點(diǎn)對(duì)MeanBPM、pNN50、SDNN及RMSSD的影響結(jié)果比較可知:在針刺時(shí),針刺后10min(行針時(shí)),針刺后20min(出針時(shí)),出針后5 min與針刺前5 min相比均沒(méi)有有意義的變化(P0.05);針刺左側(cè)大陵穴在針刺時(shí),進(jìn)針后10min(行針時(shí)),進(jìn)針后20min(出針時(shí))及出針后5min與針刺前5min相比,HF(高頻功率值)、LF(低頻功率值)、HF%(高頻功率百分比)、LF%(低頻功率百分比)等明顯降低,具有統(tǒng)計(jì)學(xué)差異(P0.05);針刺左側(cè)大陵穴后對(duì)不同時(shí)間點(diǎn)LogLF/HF(低頻功率高頻功率比)的影響與針刺前5 min相比,有增高趨勢(shì)(P0.05),具有統(tǒng)計(jì)學(xué)意義;針刺后10min(行針時(shí))對(duì)ULF(超低頻功率)的影響與針刺前5min相比沒(méi)有明顯變化(P0.05),不具有統(tǒng)計(jì)學(xué)意義;在進(jìn)針時(shí)、針刺20min、出針后5min對(duì)ULF的影響與針刺前5 min相比有明顯升高(P0.05),具有統(tǒng)計(jì)學(xué)意義。結(jié)論:1.針刺大陵穴可引起腦梗死患者的LF及LF%明顯降低,提示可降低患者的交感神經(jīng)功能活動(dòng)性,調(diào)節(jié)患者的心臟自主神經(jīng)功能。2.針刺大陵穴可引起腦梗死患者的HF及HF%值明顯降低,提示可降低患者的迷走神經(jīng)活動(dòng)性,調(diào)節(jié)患者心臟自主神經(jīng)功能。3.針刺大陵穴可以增高腦梗死患者的LogLF/HF值,調(diào)節(jié)腦梗死患者交感神經(jīng)和迷走神經(jīng)的張力,調(diào)節(jié)自主神經(jīng)功能。4.針刺大陵穴可以增高腦梗死患者的ULF值,調(diào)節(jié)腦梗死患者自主神經(jīng)(ANS)系統(tǒng)。
[Abstract]:Objective: to observe the changes of HRV index parameters at each time point of acupuncture at left Daling point through the study of 30 patients with cerebral infarction in convalescence stage. To investigate the effect of acupuncture at Daling point on cardiac autonomic nerve function in patients with cerebral infarction (CI). Methods: all the subjects were from 30 patients (13 females) from the second Department of Acupuncture and moxibustion Department of the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine. Male 17 cases. The experimenter told the patient to lie on his back in a quiet state and open the medilogus? The AR12 dynamic ECG recorder began to record (the first observation point was observed and the left Daling acupoint was selected 5 minutes later). After the routine disinfection of the local skin at the acupoint and the cleaning of the hands of the prickly hand, the needle was injected into the needle (the second time was observed at the point of observation), and after 10 minutes of the injection of qi, the acupuncture was performed with the technique of flat tonifying and reducing the air (the third time observation point). After 10 minutes of acupuncture, the needle was lifted out (4th hours observation point), and the patient was told to continue to lie down and record the observation point for 5 minutes (5th time observation point). After 30 patients were observed and recorded, SPSS17.0 data analysis software was used to compare the different time points after the needle injection and before the needle injection. Then the results were discussed and the final conclusion was drawn. Results: acupuncture at the left side of Daling point at different time points on the mean BPMPN50. The results of SDNN and RMSSD showed that: 10 minutes after acupuncture, 20 minutes after acupuncture, 10 minutes after acupuncture and 20 minutes after acupuncture. There was no significant change of P0.05 in 5 min after acupuncture compared with 5 min before acupuncture. In the period of acupuncture on the left side of Daling point, HFH (high frequency power value) was 10 minutes after acupuncture, 20 minutes after acupuncture, 20 minutes after injection and 5 min after exiting the needle compared with 5 min before acupuncture. LF( low frequency power value) HFR (high frequency power percentage) obviously decreased (low frequency power percentage), there was statistical difference (P 0.05); The effect of acupuncture at left Daling point on the low frequency power / high frequency power ratio of LogLFR at different time points was significantly higher than that of the first 5 min acupuncture points (P 0.05). The effect of ultralow frequency power (ULF) on ulf (ultra low frequency power) at 10 min after acupuncture had no significant change compared with that of 5 min before acupuncture (P 0.05), and there was no significant difference between the two groups. The effect of acupuncture on ULF at 20 min and 5 min after acupuncture was significantly higher than that at 5 min before acupuncture (P 0.05). Conclusion Acupuncture at Daling point can significantly reduce LF and LF% in patients with cerebral infarction, suggesting that it can reduce the sympathetic nerve activity of patients. Regulation of cardiac autonomic nerve function .2.Acupuncture at Daling point can significantly reduce HF and HF% in patients with cerebral infarction, suggesting that it can reduce vagus nerve activity in patients with cerebral infarction. Regulation of cardiac autonomic nerve function .3.Acupuncture at Daling point can increase the LogLF/HF value of patients with cerebral infarction and regulate the tension of sympathetic nerve and vagus nerve in patients with cerebral infarction. Regulating autonomic nervous function .4.Acupuncture at Daling point can increase the ULF value of cerebral infarction patients and regulate the autonomic nervous ANSs system of cerebral infarction patients.
【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
【分類號(hào)】：R246.6

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