电针内关穴对心脏瓣膜置换术患者氧化应激的影响  

Impacts on oxidative stress in the patients with cardiac valve replacement treated with electroacupuncture at Neiguan(PC 6)

作　　者：马福国[1] 张彦平[1] 陈怀龙[1] 孙立新[1] 王明山[1] 

机构地区：[1]青岛市市立医院麻醉科,山东青岛266071

出　　处：《中国针灸》2015年第7期707-710,共4页Chinese Acupuncture & Moxibustion

摘　　要：目的：观察电针内关穴对体外循环下行瓣膜置换术患者的心肌保护作用。方法：拟行心脏瓣膜置换术的风湿性心脏病患者50例,根据美国麻醉医师协会（ASA）分级为Ⅱ~Ⅲ级,纽约心脏病协会心功能分级Ⅱ~Ⅲ级,随机分为观察组和对照组,每组25例。两组患者均采用相同的麻醉及体外循环灌注技术。观察组于术前30min电针刺激双侧内关穴直至手术结束。分别于主动脉阻断前（T1）,主动脉开放后15min（T2）、30min（T3）、6h（T4）、24h（T5）5个时点采集中心静脉血,检测血清丙二醛（MDA）、超氧化物歧化酶（SOD）、心肌钙蛋白I（cTnI）浓度,并记录心脏复跳及术后血管活性药物使用总量等情况。结果：与主动脉阻断前比较,两组患者在主动脉开放后各时间点MDA、cTnI明显升高（均P〈0.05）,SOD明显下降（P〈0.05）;与对照组比较,在T3~T5时间点,观察组血清MDA、cTnI明显低于对照组（均P〈0.05）,SOD则高于对照组（P〈0.05）;血管活性药物使用量明显减少（P〈0.05）。结论：电针内关穴可减轻氧化应激损伤,对缺血再灌注心肌具有保护作用。Objective To observe the myocardial protective effect of electroacupuncture （EA） at Neiguan （PC 6） in the patients with valve replacement via extracorporeal circulation. Methods Fifty patients of rheumatic cardiac disease planned for valve replacement were graded as Ⅱ or Ⅲ level according to America Society of Anesthesiologists （ASA） and were randomized into an observation group and a control group, 25 cases in each one. The same anesthesia and valve replacement via extracorporeal circulalion were adopted in the patients of the two groups. In the observation group, 30 min before operation, EA was used to stimulate bilateral Neiguan （PC 6） till the end of operation. The venous blood was collected at 5 time points separately, named before aorta blockage （T1）, 15 min after aorta open （T2）, 30 min after aorta open （T3）, 6 h after opening （T4） and 24 h after opening （T5）. The concentrations of malondial dehyde （MDA）, superoxide dismutase （SOD） and cardiac troponin 1 （cTnl） were determined in serum. The heart re-beating and the total dosage of vasoactive drugs after operation were recorded. Results Compared with those before aorta blockage, MDA and cTnl at each time point of aorla open were all apparently increased in the patients of the two groups （all P（0.05）, and SOD was reduced appar ently （P〈0.05）. Compared with the control group, at the time points from T3 to T5, MDA and cTnL were lower apparently in the observation group as compared with those in the control group （all P〈0.05） and SOD was higher than that in the control group （P〈0.05）. The dosage of vasoaetive drugs was reduced apparently （P〈0.05）. Conclusion EA at Neiguan （PC 6） alleviates oxidative stress injury and has the protective effect on ischemic reperfusion myocardium.

关 键 词：瓣膜置换术 电针 穴 内关 氧化应激 心肌保护 

分 类 号：R246.2[医药卫生—针灸推拿学]