基于针刺内关穴的冠状动脉CTA成像的研究

Study of coronary CTA based on acupuncture at Neiguan

关键词:  内关穴  冠状动脉  非创伤性血管成像技术  图像质量

Key words:  Neiguan  coronary  noninvasive vascular imaging  image quality

摘要:

[目的]探究针刺内关穴对患者冠状动脉非创伤性血管成像技术（CTA）成像质量的影响，评价其临床应用价值。[方法]选取于2018年1月至2019年12月就诊于河南中医药大学第二附属医院行宝石能谱冠状动脉CTA检查的患者，共200例。利用随机数表的方法将所有患者随机分为两组，分别为对照组和观察组，每组各100例。对照组检查前采取单纯服用倍他乐克稳定心率，观察组在此基础上配合针刺内关穴稳定患者心率，观察记录两组患者检查过程中心率变化情况，并且根据美国心脏学会制定的冠状动脉CTA成像评分标准对两组图像进行评价，比较两组成像质量。[结果]选取了200例受试人员，检查前对照组和观察组的心率分别为（65±2）次/min、（60±3）次/min，检查过程中对照组和观察组的心率分别为（69±3）次/min、（62±4）次/min，观察组检查前和检查过程中心率均显著低于对照组，且差异具有统计学意义（P<0.05），观察组的呼吸指令配合较对照组熟练，且差异具有显著性（P<0.05）。对两组图像的节段优良率比较时发现，对照组100例患者中所显示的冠状动脉总计1 078节段，图像质量为1级和2级的总计938节段，优良率为87.01%。观察组100例患者中所显示的冠状动脉总计1 102节段，图像质量为1级和2级的总计995节段，优良率为90.29%，两组图像优良率无统计学差异（P>0.05）。冠状动脉图像评分情况为对照组：4分58例，3分36例，2分6例，平均得分为（3.52±0.58）分。观察组对应评分情况为4分76例，3分24例，平均得分为（3.76±0.87）分，两组分值分布和图像均分均存在差异，且差异具有统计学意义（P<0.05）。[结论]针刺内关穴可以有效稳定行冠状动脉CTA患者的心率，减少心率波动幅度，有助于患者配合呼吸指令，可以提高冠状动脉CTA成像质量，值得在临床进行推广应用。

Abstract:

[Objective] To investigate the effect of acupuncture at Neiguan (NS) on the quality of coronary CTA (Computed tomography angiography) in patients and to evaluate its clinical value.[Methods] From January 2018 to December 2018,Second Affiliated Hospital of Henan University of traditional Chinese Medicine had 200 patients undergoing coronary CTA. All patients were randomly divided into two groups according to the random number table. They were control group and observation group,with 100 cases in each group. Before taking a simple examination,the control group took Betaloc to stabilize heart rate,while the observation group stabilized heart rate with acupuncture Neiguan on the basis of using above method. The heart rate of both two groups patients were recorded during the examination. According to the American Society of Cardiology Arterial CTA imaging scoring standard,the images of two groups were evaluated and image quality of two groups were compared.[Results] The study selected a total of 200 subjects,the heart rate of the control group and the observation group before the test were (65±2) times/min,(64±5) times/min,there was no statistical significance in two groups. During the examination,the heart rate of the control group and the observation group were (69±3) times/min and (62±4) times/min,there was a statistical significance in two groups (P<0.05). The respiratory commands of the observation group were more proficient than those of the control group and had significant differences (P<0.05). Comparing the image segment of two groups,in the control group,100 patients with coronary artery had a total of 1078 segment in the section,the image quality for level 1 and level 2 included 938 segments,excellent rate was 87.01%. In the observation group,100 patients showed a total of 1102 coronary artery segment,the image quality for level 1 and level 2 includeed 995 segments,excellent rate was 90.29%. There was no significant difference in image fine rate between two groups (P>0.05). Coronary image score:in control group,there were 58 cases which had 4 points,36 cases which had 3 points,6 cases which had 2 points,and the average score of the group were (3.52±0.58) points;in observation group,there were 76 cases which had 4 points,24 cases which had 3 points,the average score were (3.76±0.87) points. There was a significant difference in the distribution of the two components and the mean image score (P<0.05).[Conclusion] Acupuncture at Neiguan can effectively stabilize the heart rate of coronary artery CTA patients and reduce the amplitude of heart rate fluctuation. It is helpful for patients to cooperate with respiratory instructions and improve the quality of coronary CTA imaging. It is worth popularizing and applying in clinic.