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基于组织多普勒成像技术探讨电针心经心包经穴对稳定性心绞痛患者心功能的影响 预览

Function on Stable Angina Pectoris Patients on Electroacupuncture Heart Sutra and Pericardial Sutra Point
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摘要 目的:通过比较电针手少阴心经穴、手厥阴心包经穴及同节段的非经非穴对稳定性心绞痛患者心电图和心功能的即刻效应,来观察电针心经、心包经穴的抗心肌缺血损伤作用,探讨心经、心包经与心的相关性及其差异,为临床治疗本病选经取穴提供一定临床依据。方法:将符合纳入标准的45例患者,采用单盲随机对照法分为3组:心经治疗组15例,心包经治疗组15例,非经非穴对照组15例。心经组,按经脉循行方向针刺极泉、少海、灵道、神门;心包经组,按经脉循行方向针刺天泉、曲泽、内关、大陵;非经非穴组针刺同节段非经非穴F1,F2,F3,F4。比较3组组内、组间针刺前、针刺结束后即刻及针刺结束后15 min心电图心率、∑ST值及∑T值和心功能指标组织多普勒Tei指数值变化。结果:(1)与针刺前比较,针刺结束后即刻、针刺结束后15 min,心经组和心包经组的∑ST均无明显改变(P <0.05),心率均明显减慢(P <0.05),∑T值均显著增大(P <0.05),组织多普勒Tei指数均显著降低(P <0.05)。而非经非穴组各指标前后无明显变化(P> 0.05)。(2)心经组与心包经组比较,两组对心电图和心功能的疗效相当(P> 0.05)。(3)与针刺结束后即刻比较,针刺结束后15 min,心经组和心包经组减慢心率,增大∑T值及降低组织多普勒Tei指数的疗效明显更优(P <0.05)。结论:(1)电针心经、心包经穴均能特异性减慢稳定性心绞痛患者心率,恢复T波缺血改变,降低组织多普勒Tei指数,说明针刺两经穴均具有抗心肌缺血损伤的即刻效应。(2)电针心经、心包经穴对心率,T波及组织多普勒Tei指数的疗效相当,提示针刺心经、心包经穴抗心肌缺血损伤的即刻效应大小相当。(3)电针心经、心包经穴具有一定的针刺后效应。 Objective: to compare the immediate effects of electroacupuncture(EA) on electrocardiogram and cardiac function in patients with stable angina pectoris by comparing the anti-myocardial ischemia effects of the EA and pericardial meridians(PC) with heart, the heart meridians(HS) and heart. To explore the correlations and differences between cardio, pericardial and cardiac, and to provide some clinical basis for the clinical treatment of this disease.Methods: 45 patients who met the criteria were divided into three groups by single blind randomized reference method:15 cases of pericardial therapy group, 15 cases of pericardial therapy group, and 15 cases of non-acupoint control group.The heart group, according to the meridians following the direction of acupuncture polar spring, Shaohai, Lingdao,Shimen;Heart bag group, according to the direction of the meridians needle Tianquan, Quze, Neiguan, Daling;Non-nonpoint group acupuncture is not non-point F1, F2, F3, F4. Compare the changes in heart rate and the value of the heart rate and the value of the heart rate of the 15 min electrocardiogram, and the value of the body Doppler Tei in the group before and immediately after the acupuncture and the end of the acupuncture. Results: Compared with the preacupuncture, there was no significant change in the cardiac and pericardial groups in the 15 minutes immediately after the acupuncture and the end of the acupuncture(P > 0.05), and the heart rate was significantly slower(P > 0.05). The value of was significantly increased(P < 0.05), and the tissue Doppler Tei index was significantly reduced(P < 0.05).There was no significant change before and after the non-point group indicators(P > 0.05). Compared with the pericardial group, the two groups had the same effect on electrocardiogram and cardiac function(P > 0.05). Compared with the immediate after the end of acupuncture, the 15 min, cardio group and pericardial group after the end of acupuncture slowed the heart rate, increased the T value and reduced the tissue Doppler Tei i
作者 潘江 刘继生 刘智 石文英 李里 章薇 Pan Jiang;Liu Jisheng;Liu Zhi;Shi Wenying;Li Li;Zhang Wei(The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 41007,China;TCM College of GuiYang,GuiYang 550000,China)
出处 《世界科学技术:中医药现代化》 CSCD 北大核心 2018年第9期1564-1570,共7页 Modernization of Traditional Chinese Medicine and Materia Medica--WORLD SCIENCE AND TECHNOLOGY
基金 国家自然科学基金委面上基金项目(81473754):从DNA甲基化修饰途径研究电针心经心包经穴对MCAO大鼠神经修复的调控机制,负责人:章薇 国家自然科学基金委面上基金项目(81273861):基于TGF-β/smads信号通路及rfMRI技术探讨电针心经心包经穴抗心脑缺血损伤及心脑关系的研究,负责人:章薇.
关键词 心经 心包经 心电图 TEI指数 电针 Heart sutra pericardial meridians electrocardiogram Tei index electroacupu-ncture (EA)
作者简介 通讯作者:刘继生,博士,讲师,主要研究方向:针灸治病机理与临床研究;通讯作者:章薇,医学博士,教授,主任医师,博士生导师,主要研究方向:针灸治疗疾病的临床及机理研究;.
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