Bhavanani Ananda Balayogi, Sanjay Zeena
Program Co-ordinator, ACYTER, JIPMER, Puducherry, India.
Int J Yoga. 2012 Jul;5(2):108-11. doi: 10.4103/0973-6131.98221.
Recent studies have reported differential physiological and psychological effects produced by exclusive right and left nostril breathing and clinical research is required to prove immediate and sustained efficacy of these techniques in various psychosomatic conditions such as hypertension (HT). The present study was designed to determine immediate effects of 27 rounds of exclusive left nostril breathing, a yogic pranayama technique known as chandra nadi pranayama (CNP) on cardiovascular parameters in patients of essential HT.
Twenty two patients of essential HT under regular standard medical management were individually taught to perform CNP by a qualified yoga instructor with a regularity of 6 breaths/min throughout a performance of 27 rounds of CNP. Pre and post intervention heart rate (HR) and blood pressure (BP) measurements were recorded using non-invasive semi-automatic BP monitor and Students t test for paired data used to determine significant differences.
Twenty seven rounds of CNP produced an immediate decrease in all the measured cardiovascular parameters with the decrease in HR, systolic pressure (SP), pulse pressure, rate-pressure product and double product being statistically significant. Further, gender-based sub-analysis of our data revealed that our male participants evidenced significant reductions in HR and SP with an insignificant decrease in diastolic pressure, while in female participants only HR decreased significantly with an insignificant decrease in SP.
It is concluded that CNP is effective in reducing HR and SP in hypertensive patients on regular standard medical management. To the best of our knowledge, there are no previously published reports on immediate effects of left UFNB in patients of HT and ours is the first to report on this beneficial clinical effect. This may be due to a normalization of autonomic cardiovascular rhythms with increased vagal modulation and/or decreased sympathetic activity along with improvement in baroreflex sensitivity. Further studies are required to enable a deeper understanding of the mechanisms involved as well as determine how long such a BP lowering effect persists. We recommend that this simple and cost effective technique be added to the regular management protocol of HT and utilized when immediate reduction of BP is required in day-to-day as well as clinical situations.
最近的研究报告了单侧左右鼻孔呼吸所产生的不同生理和心理效应,需要进行临床研究来证明这些技巧在各种身心疾病(如高血压)中的即时和持续疗效。本研究旨在确定27轮单侧左鼻孔呼吸(一种名为月脉调息法(CNP)的瑜伽呼吸法)对原发性高血压患者心血管参数的即时影响。
22名接受常规标准医疗管理的原发性高血压患者由一名合格的瑜伽教练单独教授进行CNP,在整个27轮CNP练习过程中,呼吸频率保持为每分钟6次。使用无创半自动血压监测仪记录干预前后的心率(HR)和血压(BP)测量值,并使用配对数据的学生t检验来确定显著差异。
27轮CNP使所有测量的心血管参数立即下降,心率、收缩压(SP)、脉压、率压乘积和双乘积的下降具有统计学意义。此外,基于性别的数据亚分析显示,男性参与者的心率和收缩压显著降低,舒张压下降不显著,而女性参与者只有心率显著下降,收缩压下降不显著。
得出的结论是,CNP对接受常规标准医疗管理的高血压患者降低心率和收缩压有效。据我们所知,以前没有关于单侧左鼻孔呼吸法对高血压患者即时影响的报道,我们是第一个报道这种有益临床效果的。这可能是由于自主心血管节律正常化,迷走神经调节增加和/或交感神经活动减少,以及压力反射敏感性提高。需要进一步研究以更深入地了解其中涉及的机制,以及确定这种血压降低效果能持续多久。我们建议将这种简单且具有成本效益的技术添加到高血压的常规管理方案中,并在日常以及临床情况下需要立即降低血压时使用。