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[脉搏指示连续心排血量技术评估针刺对急性左心衰竭的影响]

[Effect of acupuncture on acute left heart failure by PiCCO technique].

作者信息

Xiao Qiu-Sheng, Zhang Bin, Ma Ming-Yuan, Deng Meng-Hua, Yang Yan-Zhu

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2014 Feb;34(2):149-52.

Abstract

OBJECTIVE

To observe the clinical effect of acupuncture on acute heart failure (AHF) patients.

METHODS

Totally 60 patients who were diagnosed as AHF were assigned to the acupuncture group and the control group, 30 in each group. Those in the control group received inotropic agents, preload and afterload reducing therapy, anti-infection and so on. Besides, those in the acupuncture group received needling at relative points, once daily for 5 consecutive days. The mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), stroke volume index (SI), left ventricle working index (LCWI) were monitored by thermodilution pulse-indicated continuous cardiac output (PiCCO) technique. Changes of the aforesaid data were compared between before and after treatment. The ICU length of stay, readmission rate,and the 28-day mortality were also compared between the two groups.

RESULTS

After 5 days of the treatment, CI, SI, and LCWI increased more obviously (P < 0.01), HR and MAP decreased significantly (P < 0.05). Of them, CI, SI, and LCWI increased more obviously in the acupuncture group (P < 0.05).There was no obvious difference in HR or MAP between the two groups (P > 0.05). Compared with the first day of admission in the same group, CI, SI, and LCWI obviously increased in the acupuncture group from the second day (P < 0.05). HR started to decrease since the fourth day (P < 0.05), and MAP began to decrease until the fifth day (P < 0.05). CI, SI, and LCWI started to increase in the control group from the third day (P < 0.05); HR and MAP both began to decrease since the fifth day (P < 0.05). Compared with the control group, the ICU length of stay was obviously shortened in the acupuncture group (P < 0.05). The readmission rate and the 28-day mortality rate were lower than those of the control group (P < 0.05).

CONCLUSION

The combination of acupuncture and Western medical therapy might strengthen acute heart failure patients' heart functions, elevate the therapeutic effect, and improve the prognosis.

摘要

目的

观察针刺对急性心力衰竭(AHF)患者的临床疗效。

方法

将60例确诊为AHF的患者分为针刺组和对照组,每组30例。对照组给予强心剂、减轻前负荷和后负荷治疗、抗感染等治疗。此外,针刺组在相关穴位进行针刺,每日1次,连续5天。采用热稀释脉搏指示连续心输出量(PiCCO)技术监测平均动脉压(MAP)、心率(HR)、心脏指数(CI)、每搏量指数(SI)、左心室做功指数(LCWI)。比较两组治疗前后上述数据的变化。同时比较两组的ICU住院时间、再入院率和28天死亡率。

结果

治疗5天后,CI、SI和LCWI升高更明显(P<0.01),HR和MAP显著降低(P<0.05)。其中,针刺组CI、SI和LCWI升高更明显(P<0.05)。两组HR和MAP差异无统计学意义(P>0.05)。与同组入院第1天比较,针刺组第2天起CI、SI和LCWI明显升高(P<0.05)。HR从第4天开始下降(P<0.05),MAP直到第5天开始下降(P<0.05)。对照组第3天起CI、SI和LCWI开始升高(P<0.05);HR和MAP均从第5天开始下降(P<0.05)。与对照组比较,针刺组ICU住院时间明显缩短(P<0.05)。再入院率和28天死亡率低于对照组(P<0.05)。

结论

针刺联合西医治疗可增强急性心力衰竭患者的心功能,提高治疗效果,改善预后。

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