针刺内关穴治疗低脉压综合征31例临床观察

目的：探讨低脉压综合征的心血管功能状态和针刺内关穴对心血管功能的影响。方法：将49例患者随机分为针刺组和药物组，针刺组针刺双侧内关穴，连针3天；药物组静脉滴注参麦注射液，每日20m1，连用6天。治疗前后观察血压、脉压的变化；无创检测心搏出量(SV)、每分钟心搏出量(CO)、左心搏动指数(LVWL)、平均动脉压(MAP)、血管总周围阻力(TPR)、冠状动脉灌注压(CCP)、肺动脉楔压(PAWP)、有效血容量(BV)、血液粘度(N)、微循环半更新率(MHR)、心肌血流灌注量(CMBV)指标，并与23例健康人对照。结果：治疗前患者脉压明显较健康人变小(P＜0．01)，治疗后均显著增大(P＜0．01)；SV、CO、LVWL、PAWP、BV、MHR、CMBV均较健康人显著降低(P＜0．01)，两组治疗后均较前明显升高(P＜0．01)；而CCP、TPR、N3项指标治疗前较健康人显著升高(P＜0．01)，治疗后则明显降低(P＜0．01)。两组间比较，针刺组疗效略优于药物组(部分指标P＜0．05)。MAP治疗前后与健康人比较无明显差异(P＞0．05)。结论：针刺内关穴可以增强心脏泵血功能，降低外周阻力，改善微循环代谢，增大脉压差。

Clinical Observation on 31 Cases of Low Pulse Pressure Syndrome Treated with Acupuncture at Neiguan (PC 6)

To explore the effect of acupuncture at Neiguan (PC 6) on the cardiovascular functions in the patient with low pulse pressure syndrome. Methods: 49 cases were randomly divided into acupuncture group and medicine group. Acupuncture group was treated by acupuncture at bilateral Neiguan (PC 6) for 3 consecutive days, and the medicine group was given intravenous drip of Shenmai Injectio for 6 consecutive days. 20ml each day. Blood pressure, pulse pressure. SV, CO. LVWL, MAP, TPR. CCP, PAWP, BV, MHR and CMBV were examined before and after treatment. 23 healthy subjects were observed as controls. Results: The pulse pressure of patients before treatment was significantly lower than that of controls (P<0. 01), and after treatment it was raised (P<0.01.SV, CO. LVWL. PAWP, BV. MHR and CMBV of patient were significantly lower than those of healthy subjects (P<0. 01), but after treatment they raised in both groups (P<0. 01). CCP and TPR of patients before treatment were significantly higher than those of healthy subjects (P<0. 01), and after treatment decreased significantly (P<0. 01). The therapeutic effect of acupuncture treatment was slightly better than that of medicine group (P<0. 05 for part of the indexes). There was no significant difference in MAP between the two groups. Conclusion: Acupuncture at Neiguan (PC 6) can strengthen pumping blood function of the heart. decrease the peripheral resistance. improve microcirculation and increase difference of pulse pressure.