内关、郄门埋针对冠心病患者围手术期心脏动力学的影响  

Effects of embedding needle at Neiguan (PC6) and Ximen (PC4) on cardiac dynamics in perioperative patients with coronary 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,杭州310006

出　　处：《中华中医药杂志》2013年第10期3134-3136,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：浙江省中医药科学研究基金计划项目(No.2012ZB045)~~

摘　　要：目的:观察内关、郄门埋针对冠心病患者围手术期心脏动力学的影响并探讨其意义。方法:60例冠心病患者随机分成对照组、硝酸甘油组和针灸组。硝酸甘油组麻醉前微泵持续输注硝酸甘油至术后24h停用。针灸组在麻醉前,取患者左侧内关、郄门穴,消毒后将灭菌揿针埋在穴位上留置24h。对照组不进行任何干预措施。3组均进行PICCO监护仪监测,于术前、术中1h、术后第1天记录动力学指标并观察室性心律失常情况。结果:同对照组相比,硝酸甘油组平均动脉压(MAP)、系统血管阻力指数(SVRI)、全心舒张末期容量指数(GEDI)有所减少,针灸组每搏输出量指数(SVI)、心输出量(CO)增加而SVRI、GEDI减少;对照组室性心律失常(8例)也较硝酸甘油组(1例)、针灸组(2例)容易发生。结论:内关、郄门埋针可减少室性心律失常发生,同硝酸甘油不同,它机制可能主要通过增加SVI和CO,减少GEDI所至。Objective： To observe the effect and significance of embedding needle at Neiguan（PC6） and Ximen（PC4） on cardiac dynamics in perioperative patients with cornary heart disease. Methods： Sixty patients were randomly divided into three groups as control group, Nitroglycerin group and acupuncture group. Nitroglycerin was micro pump infused before anesthesia until 24 hours after the surgery in the Nitroglycerin group. Before anesthesia, aseptic needles were embedded at Neiguan（PC6） and Ximen（PC4） for 24 hours after disinfection in the acupuncture group. No intervention was given in the control group. All groups were monitored with the PICCO system. Cardiac dynamics was recorded before operation, during one hour of operation, and at the first day after operation, and ventricular arrhythmia was observed for three groups. Results： Compared with the control group, mean arterial pressure（MAP）, systemic vascular resistance index（SVRI） and global end-dilution volume index（GEDI） were decreased in the nitroglycerin group while stoke volume index（SVI）, cardiac output（CO） increased and SVRI, GEDI decreased in the acupuncture group. Ventricular arrhythmia was easier to happen in the control group（8 cases） than that in the nitroglycerin group（1 cases） and the acupuncture group（2 cases）. Conclusion： Embedding needle at Neiguan（PC6） and Ximen（PC4） could reduce ventricular arrhythmia. It might be related to decrease of GEDI and increase of SVI and CO which was different from nitroglycerin.

关 键 词：内关 郄门 冠心病 心脏动力学 室性心律失常 

分 类 号：R246[医药卫生—针灸推拿学]