基于组织多普勒成像技术探讨电针心经心包经穴对稳定性心绞痛患者心功能的影响

目的：通过比较电针手少阴心经穴、手厥阴心包经穴及同节段的非经非穴对稳定性心绞痛患者心电图和心功能的即刻效应，来观察电针心经、心包经穴的抗心肌缺血损伤作用，探讨心经、心包经与心的相关性及其差异，为临床治疗本病选经取穴提供一定临床依据。方法：将符合纳入标准的45例患者，采用单盲随机对照法分为3组：心经治疗组15例，心包经治疗组15例，非经非穴对照组15例。心经组，按经脉循行方向针刺极泉、少海、灵道、神门；心包经组，按经脉循行方向针刺天泉、曲泽、内关、大陵；非经非穴组针刺同节段非经非穴F1，F2，F3，F4。比较3组组内、组间针刺前、针刺结束后即刻及针刺结束后15 min心电图心率、ΣST值及ΣT值和心功能指标组织多普勒Tei指数值变化。结果：（1）与针刺前比较，针刺结束后即刻、针刺结束后15 min，心经组和心包经组的ΣST均无明显改变（P < 0.05），心率均明显减慢（P < 0.05），ΣT值均显著增大（P < 0.05），组织多普勒Tei指数均显著降低（P < 0.05）。而非经非穴组各指标前后无明显变化（P > 0.05）。（2）心经组与心包经组比较，两组对心电图和心功能的疗效相当（P > 0.05）。（3）与针刺结束后即刻比较，针刺结束后15 min，心经组和心包经组减慢心率，增大ΣT值及降低组织多普勒Tei指数的疗效明显更优（P < 0.05）。结论：（1）电针心经、心包经穴均能特异性减慢稳定性心绞痛患者心率，恢复T波缺血改变，降低组织多普勒Tei指数，说明针刺两经穴均具有抗心肌缺血损伤的即刻效应。（2）电针心经、心包经穴对心率，T波及组织多普勒Tei指数的疗效相当，提示针刺心经、心包经穴抗心肌缺血损伤的即刻效应大小相当。（3）电针心经、心包经穴具有一定的针刺后效应。

Function on Stable Angina Pectoris Patients on Electroacupuncture Heart Sutra and Pericardial Sutra Point

Objective: to compare the immediate effects of electroacupuncture (EA) on electrocardiogram and cardiac function in patients with stable angina pectoris by comparing the anti- myocardial ischemia effects of the EA andpericardial meridians (PC) with heart, the heart meridians (HS) and heart. To explore the correlations and differencesbetween cardio, pericardial and cardiac, and to provide some clinical basis for the clinical treatment of this disease.Methods: 45 patients who met the criteria were divided into three groups by single blind randomized reference method:15 cases of pericardial therapy group, 15 cases of pericardial therapy group, and 15 cases of non-acupoint control group.The heart group, according to the meridians following the direction of acupuncture polar spring, Shaohai, Lingdao,Shimen; Heart bag group, according to the direction of the meridians needle Tianquan, Quze, Neiguan, Daling; Non-nonpointgroup acupuncture is not non-point F1, F2, F3, F4. Compare the changes in heart rate and the value of the heartrate and the value of the heart rate of the 15min electrocardiogram, and the value of the body Doppler Tei in the groupbefore and immediately after the acupuncture and the end of the acupuncture. Results: Compared with the preacupuncture,there was no significant change in the cardiac and pericardial groups in the 15 minutes immediately afterthe acupuncture and the end of the acupuncture (P > 0.05), and the heart rate was significantly slower (P > 0.05). Thevalue of was significantly increased (P < 0.05), and the tissue Doppler Tei index was significantly reduced (P < 0.05).There was no significant change before and after the non- point group indicators (P > 0.05). Compared with thepericardial group, the two groups had the same effect on electrocardiogram and cardiac function (P > 0.05). Comparedwith the immediate after the end of acupuncture, the 15 min, cardio group and pericardial group after the end ofacupuncture slowed the heart rate, increased the T value and reduced the tissue Doppler Tei index (P < 0.05).Conclusion: Electroacupuncture and pericardial points can specifically slow the heart rate of patients with stable anginapectoris, restore the changes of T wave ischemia, and reduce the tissue Doppler Tei index, indicating that acupuncture ofboth acupuncture points has an immediate effect against myocardial ischemia. The effects of electroacupuncture andpericardial meridians on heart rate and T and tissue Doppler Tei indices are quite similar, suggesting that the immediateeffects of acupuncture and pericardial meridians against myocardial ischemic injury are comparable. Electroacupunctureheart meridians and pericardial meridians have a certain post-acupuncture effect.