I(针刺调神对高血压患者的血流动力学及焦虑状态影响的临床观察)摘要□□目的：通过对原发性高血压患者的血流动力学参数的监测，说明针刺调神方作用于患者的左心室做功、血管弹性等血流动力学指标；经评价原发性高血压患者的焦虑状态、睡眠指数等量表，表明针刺调神方能改善患者焦虑状态；反映针刺调神方对缓解原发性高血压患者的临床症状有效。方法：将67例原发性1、2级高血压患者随机分为两组，针药组33例，药物组34例。针药组给予经验西药治疗的同时联合针刺调神方治疗，针刺调神方：印堂、神庭、四神聪、百会、内关（双）、三阴交（双）、血压点（双）、中脘、天枢（双）、关元。药物组按照《中国高血压防治指南（2018）》由有经验的医生开出西药处方治疗。治疗前后均测量两组患者的ICG（无创血流动力学监测）数值范围，进行血压、高血压中医临床症状评定积分、焦虑自评量表、汉密尔顿焦虑及抑郁量表、匹兹堡睡眠质量指数等评分的记录。成果：两组治疗后ICG指标如心排量、血管阻力、收缩压等均有降低，各量表评分也均有降低，其差异具有统计学意义（P<0.05）；治疗后针药组较药物组相比，每搏外周阻力及左心室做功指标差异有统计学意义（P<0.05），在中医临床症状总积分、焦虑自评量表评分、汉密尔顿焦虑量表评分、匹兹堡睡眠指数量表评分方面，针药组较药物组均差异有统计学意义（P<0.05）。针药组高血压患者经治疗后中医临床症状改善总有效率为51.52%。药物组总有效率为17.65%，两组总有效率有显著性差异（P<0.05）。结论：针刺调神方在降低高血压患者血管阻力、减少左心室做功方面有明显作用，能改善患者的血流动力学情况；针刺调神方能改善高血压患者临床症状，改善焦虑状态及睡眠质量。关键词：原发性高血压；焦虑状态；针刺调神方；血流动力学；调神IITheclinicalstudyofregulatingthespiritwithacupunctureonthehemodynamicsandanxietystateofpatientswithessentialhypertension□□Specialty:AcupunctureandtuinaAuthor:ZishuLinTutor:HongZhangAbstractObjectiveBymonitoringthehemodynamicparametersofthepatientswithessentialhypertension,itisshownthatacupuncturewiththemethodofregulatingthespiritcanaffectthehemodynamicindexessuchascardiacoutputandvascularelasticityofthepatients;byevaluatingtheanxietystateandPSQIofthepatientswithessentialhypertension,itisshownthatacupuncturewiththemethodofregulatingthespiritcanimprovetheanxietystateofthepatients;reflectingacupuncturewiththemethodofregulatingthespiritcanalleviatetheclinicalsymptomsofthepatientswithessentialhypertension。Methods67patientswithessentialhypertensionwererandomlydividedintotwogroups:acupuncturegroup(33cases)anddruggroup(34cases).Theacupunctureandmedicinegroupwastreatedwithwesternmedicineandacupuncturewiththemethodofregulatingthespiritatthesametime.Theacupuncturewiththemethodofregulatingthespirit:Yintang（EX-HN3）,shenting(GV24),Sishencong(EX-HN1),Baihui,Neiguan(P6),Sanyinjiao(SP6),bloodpressurepoint(Double),Zhongwan（CV12）,Tianshu(S25),Guanyuan(CV4).ThedruggroupwasprescribedwesternmedicinebyexperienceddoctorsaccordingtotheChinesehypertensionpreventionandcontrolguidelines(2018).Beforeandaftertreatment,theICG(noninvasivehemodynamicmonitoring)valuerangeofthetwogroupsweremeasured,andthescoresofbloodpressure,TCMclinicalsymptomscoreofhypertension,SAS,HAMA,HAMD,PSQIwererecorded.ResultsAftertreatment,ICGindexessuchascardiacoutput,vascularresistance,systolicbloodpressure,etc.inthetwogroupswerereduced,andthescoresofeachscalewerealsoreduced,thedifferencewasstatisticallysignificant(P<0.05);aftertreatment,thedifferenceofSSVRandLSWwasstatisticallysignificant(P<0.05)intheacupunctureanddruggroupcomparedwiththedruggroup,andthedifferencewasIIIstatisticallysignificantinth...
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