留针与否对心脏自主神经功能调节作用的影响

Effects of retained needling and non-retained needling on regulation of the cardiac autonomic nerve

目的:探讨留针与不留针对健康人心脏自主神经的生理调节作用机制。方法:将60例健康志愿者随机分为留针组和非留针组,每组30例。两组均直刺内关、间使,留针组留针20 min,非留针组不留针。观察两组的心率变异性(HRV)指标,即R-R间期、低频峰(LF)、高频峰(HF)、交感-迷走比值(LF/HF)。结果:与针刺前比较,留针组R-R间期在留针过程中和取针后均明显升高,尤以留针过程升高最明显(均P<0.01);非留针组取针后5 min、10 min亦明显升高(P<0.01,P<0.05),随后立即恢复到针刺前水平;在10 min时,留针组较非留针组升高明显(P<0.05)。与针刺前比较,两组在5 min时HF值明显升高、LF/HF显著降低(P<0.01,P<0.05),而LF值无明显变化。结论:刺激内关、间使留针和不留针均能引起健康人心迷走神经短暂兴奋,然后针刺效应逐渐减弱直至消失,而心交感神经活动无明显变化。留针和不留针均可减慢心率,留针减慢心率的作用时间长于不留针。

Objective To investigate the mechanism of retained needling and non-retained needling on the phy siologic regulating effect of the cardiac autonomic nerve in healthy persons. Methods Sixty volunteers were randomly divided into a retained needling group and a non retained needling group, 30 cases in eacb group. They were all received perpendicular needling at Neiguan （PC 6） and Jianshi （PC 5） retaining for 20 min in the retained nee- dling group and without retaining in the non-retained needling group. Tbe heart rate variability （HRV） indices, i. e. , R-R interval, low frequency （LF）, high frequency （I-IF） and I.F/HF were observed. Results Compared with before acupuncture, the R-R interval were significant increased during the stimulation period and during the post-stimulation period in the retained needling group, especially during the stimulation period （all P〈0.01 ）, and during the post-stimulation period of 5 min and 10 min in the non-retained needling group （P〈0.01, P〈0.05）, then returned to pre-acupuncture level quickly, and the R R interval in the retained needling group was significant ly higher than that in the non-retained needling group at 10 min （P〈C0.05）. At 5 min, the HF were significantly higher, and the LF/HF were significantly lower than those before acupuncture （P〈0.01, P〈0.05）, and there was no obvious change in LF in both groups. Conclusion Retained needling and non retained needling at Neiguan （PC 6） and Jianshi （PC 5） can both excite cardiac vagus nerve briefly and then the acupuncture effects reduce gradually until disappearance, while no obvious changes can be found with cardiac sympathetic activity. Both of needling can reduce heart rate and the action time of heart rate decrease by retained needling is longer than nonretained needling.