针灸联合瓜蒌薤白桂枝汤对冠心病病人氧化应激及自主神经调节功能的影响  

Influences of Acupuncture Combined with Gualou Xiebai Guizhi Decoction on Oxidative Stress and Autonomic Nervous Regulation in Patients with Coronary Heart Disease

作　　者：李静[1] 张凌志[1] 冯妍[1] LI Jing;ZHANG Lingzhi;FENG Yan(Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院

出　　处：《中西医结合心脑血管病杂志》2020年第1期25-29,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金资助项目(No.81703932)

摘　　要：目的观察针灸联合瓜蒌薤白桂枝汤对冠心病病人氧化应激及自主神经调节功能的影响。方法选取2016年3月—2018年3月首都医科大学附属北京安贞医院接诊的94例冠心病病人为研究对象,将病人随机分为对照组和研究组,每组47例,对照组口服瓜蒌薤白桂枝汤治疗,研究组采用口服瓜蒌薤白桂枝汤加用针灸治疗。检测两组病人氧化应激指标如超氧化物歧化酶(SOD)、一氧化氮(NO)、丙二醛(MDA)、内皮素-1(ET-1)、谷胱甘肽过氧化物酶(GSH-Px)和8-异前列腺素F2α(8-ios-PGF2α)水平;检测自主神经调节指标,如正常R-R期间总体标准差(SDNN)、连续5 min正常R-R期间均值标准差(SDANN)、每5 min R-R期间标准差平均值(SDNN5)、相邻正常R-R期间差值均方根(rMSSD)、相邻正常R-R期间差值大于50 ms占总间距比重(PNN50)、R-R期间总数量除以R-R期间直方图高度所得的三角指数(TRIA)值。结果治疗前,两组病人8-ios-PGF2α、GSH-Px、ET-1、NO、MDA和SOD水平比较差异无统计学意义(P>0.05);与治疗前相比,两组治疗后SOD水平均升高,8-ios-PGF2α、ET-1和MDA水平均降低,研究组病人GSH-Px和NO水平升高,差异均有统计学意义(P<0.05),对照组病人GSH-Px和NO水平比较差异无统计学意义(P>0.05);研究组治疗后SOD、GSH-Px和NO水平高于对照组(P<0.05),8-ios-PGF2α、ET-1和MDA水平低于对照组(P<0.05)。治疗前,两组病人SDNN、SDNN5、SDANN、TRIA、PNN50和rMSSD水平比较差异无统计学意义(P>0.05);研究组治疗后SDANN、SDNN5和SDNN较治疗前和对照组治疗后均有明显升高(P<0.05),研究组治疗前后rMSSD、PNN50和TRIA比较差异无统计学意义(P>0.05),对照组治疗前后自主神经调节各项指标比较差异均无统计学意义(P>0.05)。结论针灸联合瓜蒌薤白桂枝汤能够明显降低冠心病病人氧化应激反应,改善病人自主神经调节功能。Objective To investigate the effects of acupuncture combined with Gualou Xiebai Guizhi Decoction on oxidative stress and autonomic nervous system in patients with coronary heart disease.Methods Ninety-four patients with coronary heart disease who were enrolled.The patients were randomly divided into control group and study group,with 47 patients in each group.The patients in control group were treated with Gualou Xiebai Guizhi Decoction,the patients in research group added acupuncture treatment on the basis of the control group.The levels of the oxidative stress indicators[superoxide dismutase(SOD),nitric oxide(NO),malondialdehyde(MDA),endothelin-1(ET-1),Glutathione peroxidase(GSH-Px),and 8-isoprostane F2α(8-ios-PGF2α)];autonomic dysregulation index[nor-mal standard deviation(SDNN)during normal RR,mean standard deviation(SDANN)during normal RR for 5 min,mean standard devi-ation(SDNN5)during 5 min RR,the resulting difference in height of the histogram during the period rms adjacent normal R-R(rMSSD),the percentage of adjacent RR intervals 50 ms apart(PNN50),normal RR intervals divided by RR intervals derived from the triangle in-dex(TRIA)]were compared between two groups.Results Before treatment,there were no significant differences in the levels of 8-ios-PGF2α,GSH-Px,ET-1,NO,MDA,and SOD between two groups(P>0.05).After treatment,the levers of SOD in two groups were higher than those before treatment,the levels of 8-ios-PGF2α,ET-1,and MDA were lower than those before treatment,and the levels of GSH-Px and NO in study group were increased(P<0.05),there was no significant difference in GSH-Px lever in control group(P>0.05).The levels of SOD,GSH-Px,and NO in study group were significantly higher than those in control group(P<0.05).The levels of 8-ios-PGF2α,ET-1,and MDA were lower than those in control group(P<0.05).There was no significant difference in the levels of SDNN,SDNN5,SDANN,TRIA,PNN50,and rMSSD between two groups before treatment(P>0.05).After treatment,the levers of SDANN,SDNN5,and SDNN were higher th

关 键 词：冠心病 针灸 瓜蒌薤白桂枝汤 氧化应激 自主神经调节功能 胸痹 

分 类 号：R541.4[医药卫生—心血管疾病] R289.5[医药卫生—内科学]