针刺天井穴、曲泽穴对中风患者心率变异性频域指标的影响

Effect of acupuncture at Tianjing and Quze on frequency-domain indexes of heart rate variability in stroke patients

目的观察针刺天井穴、曲泽穴对中风患者心率变异性(HRV)的影响,探讨针刺过程中自主神经张力变化的规律。方法将2018年6月—12月黑龙江中医药大学附属第一医院收治的60例中风患者随机分为天井穴组和曲泽穴组,治疗过程中用medilog AR12动态心电记录仪进行监测,记录2组针刺前5 min、针刺得气时、留针后5 min、留针后10 min(行针时)、留针后15 min、留针后20 min(出针时)、出针后5 min共7个时间段高频(HF)、低频(LF)、logLF/HF参数值并判断HRV的变化。结果天井穴组、曲泽穴组logLF、logHF、logLF/HF均存在差异(P<0.05);logLF、logHF、logLF/HF在不同时间点差异均显著(P<0.05);除logLF/HF外,2组logLF和logHF时间效应趋势相同。结论针刺天井穴、曲泽穴可调节中风患者的logLF、logHF、logLF/HF,除logLF/HF外,穴位间时间效应趋势相似。

Objective It is to observe the effect of acupuncture at Tianjing and Quze points on heart rate variability(HRV)in patients with stroke,and to explore the law of changes in autonomic nerve tension during acupuncture.Methods Sixty stroke patients treated in the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from May to December 2018 were randomly divided into two groups(Tianjing point group and Quze point group),and their index values were monitored with medilog AR12 dynamic electrocardiograph.The high frequency(HF),low frequency(LF),logLF/HF parameter values at a total of 7 periods including 5 minutes before acupuncture,the time of acupuncture Deqi,5 minutes after manipulating the needle in acupuncture,10 minutes manipulating the needle in acupuncture(when needle is performed),15 minutes after manipulating the needle in acupuncture,20 minutes after manipulating the needle in acupuncture(when the needle was pull out),and 5 minutes after needle pulling out were recorded and analyzed in the two groups,then the change of HRV was judged.Results The HRV indexes were different in logLF,logHF,logLF/HF between Tianjing point group and Quze point group(P<0.05);logLF,logHF,logLF/HF were significantly different at different time points(P<0.05);logLF and logHF except logLF/HF had the same time effect trend.Conclusion Acupuncture at Tianjing and Quze points can adjust the logLF,logHF,logLF/HF indexes of stroke patients.Except for logLF/HF,the time effect trend between acupoints is similar.