针刺对稳定性冠心病患者心电信号影响的研究概况  

Overview of Research of Acupuncture on Electrocardiogram Signal in Patients with Stable Coronary Artery Disease

作　　者：廖彬珺 蒋永亮[3] 俞婕[2] 涂明琦 何晓芬[3] 方剑乔[3] LIAO Binjun;JIANG Yongliang;YU Jie;TU Mingqi;HE Xiaofen;FANG Jianqiao(Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine,Hangzhou,310003;Zhejiang Chinese Medical University;The Third Clinical Medical College,Zhejiang Chinese Medical University)

机构地区：[1]浙江省中西医结合医院,浙江杭州310003 [2]浙江中医药大学 [3]浙江中医药大学第三临床医学院

出　　处：《中医杂志》2023年第16期1715-1720,共6页Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划(2018YFC1704600)。

摘　　要：针刺治疗稳定性冠心病的临床研究取得一定成果,其中心电图疗效评价指标从定性分析向对心电信号的定量分析转变。从普通心电图[心率、ST段、QT间期离散度(QTd)]、运动平板状态下心电图、心肌缺血总负荷(TIB)、心率变异性(HRV)四个方面总结针刺对稳定性冠心病患者心电信号的影响。发现针刺即刻状态下可升高患者心率,但针刺一段时间后患者心率反而降低;针刺可改善ST段压低情况,降低QTd值及TIB。针刺治疗后,运动平板状态下心电图ST段下移的发生时间推迟,其持续时间与程度也显著减少。针刺还可以改善HRV,从而调节自主神经系统并存在双向调节的现象。进一步提示针刺能调节稳定性冠心病患者心电信号,改善心肌缺血缺氧状况,保护心脏植物神经的均衡性,改善心功能。Recently,certain achievements have been made in clinical studies on acupuncture for stable coronary artery disease(SCAD).The evaluation of electrocardiogram(ECG) has changed from qualitative analysis to quantitative analysis through ECG signal.This paper described the effect of acupuncture on ECG signal when treating SCAD from four aspects,which were normal ECG including heart rate,ST segment and QT dispersion(QTd),exercise ECG through treadmill test,total ischemic burden(TIB),and heart rate variability(HRV).The results showed that the heart rate increased immediately after acupuncture,but then decreased after a while;acupuncture could improve ST segment depression,reduce QTd and TIB.After acupuncture,the time to ST segment depression under treadmill exercise test was delayed;the duration time and the severity were significantly reduced.Moreover,acupuncture can improve HRV,thereby improving the autonomic nervous system and obtaining bidirectional regulation.It is further suggested that acupuncture can regulate ECG signal,improve the condition of myocardial ischemia and hypoxia,maintain the balance of cardiac autonomic nerve,and improve cardiac function when treating SCAD.

关 键 词：稳定性冠心病 针刺 心电图 心肌缺血总负荷 心率变异性 

分 类 号：R246.1[医药卫生—针灸推拿学]