针刺对脑心综合征患者血浆儿茶酚胺含量的影响

Effect of acupuncture on the plasma content of catecholamine in patients with cerebrocardiac syndromes

目的:观察针刺对脑心综合征患者血浆儿茶酚胺(catecholamine,CA)含量的影响,以明确针刺干预作用的机制。方法:将102例脑心卒中患者随机分为2组:针刺观察组52例,针刺对照组50例。观察治疗前,治疗后1周、2周急脑心综合征患者血浆CA含量的变化,及CA与心率变异性变化的相关性。结果:两组脑心卒中患者治疗前血浆中去甲肾上腺素(noradrenaline,NA)、多巴胺(dopamine,DA)含量分别为(647.56±84.81)μg/L、(77.16±30.17)μg/L和(628.96±102.78)μg/L、(71.41±31.32)μg/L与健康对照组比较差异有非常显著性意义(q=17.6～5.30,P<0.01),而两组针刺间差异无显著性意义(q=1.18,0.80,P>0.05)。针刺观察组治疗1周NA含量(525.12±136.28)μg/L与治疗前比较差异有非常显著性意义(q=7.43,10.73,P<0.01),治疗2周其含量继续减少,针刺对照组治疗1周NA含量(609.86±135.94)μg/L与治疗前比较差异无显著性意义(q=1.18,P>0.05),治疗2周NA含量(553.92±117.44)μg/L与治疗前比较差异有显著性意义(q=4.46,P<0.01),但改善程度不及针刺组明显。两患者肾上腺素(epirenan,E)含量与健康对照组比较、两组治疗前后血浆E含量比较差异均无显著性意义(F=1.18,P=0.32)。针刺观察组治疗2周后血浆DA含量(58.50±21.67)所有数据后单位均为μg/

AIM:To observe the influence of acupuncture on the catecholamine(CA)content in plasma of patients with cerebrocardiac syndromes,so as to make clear the mechanism for the intervention of acupuncture.METHODS:Totally 102 patients with cerebrocardiac syndromes were randomly divided into acupuncture observation group(n=52) and acupuncture control group(n=50).The changes of CA contents and the correlation between CA and changes of heart rate variability (HRV) were observed before,1 and 2 weeks after treatment in all the patients. RESULTS:Before treatment,the plasma contents of noradrenaline(NA)and dopamine(DA)in the acupuncture observation group[(647.56±84.81)and(77.16±30.17) μg/L]and acupuncture control group[(628.96±102.78)and(71.41±31.32) μg/mL]were very significantly different from that in the healthy control group(q=17.6-5.30,P< 0.01),while the difference between the two acupuncture group was insignificant(q=1.18,0.80,P >0.05).The NA content in the acupuncture observation group 1 after treatment[(525.12±136.28) μg/L]was very significantly different from that before treatment(q=7.43,10.73,P< 0.01),and it continued to decrease 2 weeks after treatment. The NA content in the acupuncture control group 1 week after treatment[(609.86±135.94) μg/L]was insiweek gnificantly different from that before treatment(q=1.18,P >0.05),while that of 2 weeks after treatment[(553.92±117.44)μg/L]was significantly different from that before treatment(q=4.46,P< 0.01),and the improvement was not as obvious as that in the acupuncture observation group. The content of epirenan(E)in the two acupuncture groups were not significantly different from that in the healthy control group, and there were also no significant differences before and after treatment in the tow groups (F=1.18, P=0.32). The plasma DA content 2 weeks after treatment in the acupuncture observation group [(58.50±21.67)μg/L]was significantly different from that before treatment (q=4.13,P < 0.05), while there was no significant difference in the acupuncture control group before and after treatment [(74.99±39.06)μg/L] (q=0.80,P >0.05).Linear regression and correlation analysis indicated that plasma NE content had significant negative correlation with SDNN,SDNN-i and SDANN(t=2.880,2.541,2.393,P < 0.01 or P< 0.05);plasma content of E was significantly negatively correlated with SDNN,SDNN-I,and R-MSSD(t=2.548,2.561,2.173,P< 0.05);and there was significant negative correlation between plasma DA content and PNN50(t=2.104, P< 0.05). CONCLUSION:Acupuncture can optimally regulate the plasma contents of NA and DA in patients with cerebrocardiac syndromes, maintain their neuroendocrine fluid balance and protect injured myocardium,and better curative effect has been observed in the acupuncture observation group.