内关、郄门埋针对冠心病患者围手术期QT离散度的影响  

Effect of Needle Embedding in Neiguan and Ximen on QT Dispersion after Operation on Patients with Cornary Heart Disease

作　　者：郑冬明[1] 张海峰[1] 袁新旺[1] 张娟[1] 郭小文[1] 

机构地区：[1]浙江省中医院,浙江杭州310006

出　　处：《中华中医药学刊》2013年第5期1060-1061,共2页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省中医药科学研究基金计划项目(2012ZB045)

摘　　要：目的:观察内关、郄门埋针对冠心病患者围手术期QT离散度(QTd)的影响并探讨其意义。方法:选择60例冠心病患者随机分成对照组(Ⅰ组)、硝酸甘油组(Ⅱ组)和针灸组(Ⅲ组)。硝酸甘油组(Ⅱ组)在麻醉前微泵持续输注0.25～1μg/(kg.min),直至术后24 h停止使用。针灸组(Ⅲ组)在麻醉前,取患者左侧内关、郄门穴,常规消毒后,将规格为0.22 mm×1.5 mm灭菌揿针埋在上述穴位上,留置24 h后取掉。对照组(Ⅰ组)麻醉方法同前,但不进行任何干预措施。3组均于术前、术中1 h、术后第1、2天记录同步12导联心电图,测量QTd并观察室性心律失常。结果:3组QTd术中、术后与术前相比均有所增加(P<0.05或P<0.01),但Ⅰ组增加明显多于Ⅱ组和Ⅲ组(P<0.01),Ⅰ组室性心律失常也较Ⅱ组、Ⅲ组容易发生,Ⅱ组和Ⅲ组在术前、术中、术后的QT离散度及心律失常发生均无明显差别(P>0.05)。结论:内关、郄门埋针可相对缩短QTd,减少室性心律失常发生。Objective：To observe the change and significance of QT dispersion（QTd）in perioperative patients using needle embedding with cornary heart disease.Methods：Sixty patients were randomly divided into three groups as control group（Ⅰ）,Nitroglycerin group（Ⅱ）and acupuncture group（Ⅲ）.0.25~1 μg/（kg·min）of nitroglycerin was infused with micro pump before anesthesia and discontinued after 24 hours when the surgery stoped in group（Ⅱ）.Needles（0.22 mm×1.5 mm）were embeded in Neiguan and Ximen and taken out after 24 hours.The control group was given no intervention measures.Electrocardiograms were recorded before operation,during one hour of operation,and on first and second day after operation.QTd was measured and cardiac arrhythmia was observed for three groups.Results：QTd of three groups were increased after operation（P0.05 or P0.01）,but QTd of groupⅡ and group Ⅲ increased more than that of groupⅠ（P0.01）,and in groupⅠventricular arrhythmia was easier to happen.There was no difference between groupⅡand group Ⅲ.Conclusion：Needle embedding in Neiguan and Ximen can shorten QTd and reduce ventricular arrhythmia.

关 键 词：内关郄门 冠心病 QT离散度 室性心律失常 

分 类 号：R244.8[医药卫生—针灸推拿学]