針刺內關穴對正常人與冠狀動脈疾病患者心率變異度之影響

陳高揚
行政院衛生
冠狀動脈疾病患者的副交感神經活性會下降，利用心率變異度分析發現其下降與預後有明顯的相關，因此多種可以改善副交感神經活性的方法廣被使用於這些病患，例如適度的運動、乙型阻斷劑、血管加壓素轉化觸 抑制劑，並且證實有改善其預後的效果。

針刺內關穴早被使用於治療心臟方面的疾病，它可以緩和冠狀動脈疾病患者心絞痛嚴重程度與發作頻率；另有研究發現針刺正常人的內關穴可以降低心率，且其生理作用可能與自律神經活性的改變有關。因此，我們計畫針對正常人與冠狀動脈疾病的患者施以針刺內關穴，並且測量其心率變異度在針刺前後的變化，藉以了解針刺內關穴後，正常人與冠狀動脈疾病的患者自律神經活性的變化及因此所引起的生理改變的可能機轉，並提供臨床上治療心絞痛的另一種合併療法之根據。
關鍵字：內關、針刺、心率變異度、冠狀動脈疾病

Effect of Acupuncture at Neiguan P6 on Heart Rate Variability in healthy subjects and patients with Coronary Artery Disease

Gau-Yang Chen, Sheng-Teng Huang
Tao-Yuan Hospital, Department of Health Executive Yuan
It has been reported that there was reduced cardiac vagal modulation in patients with coronary artery disease. By heart rate variability (HRV) analysis, the reduction in the cardiac vagal function was associated with poor prognosis. Thus, manipulations on cardiac vagal modulation were tried by using physical training, angiotensin converting enzyme inhibitors, beta-blockers and low-dose scopolamine; the results of these measures were promising.

Acupuncture at Neiguan has been prescribed in the management of cardiovascular disease for a long time. It can relieve the severity and frequency of angina pectoris and can lower heart rate in healthy subject. The mechanism was speculated to be related to its effect on autonomic nervous activity. Therefore, it is worthwhile to examine the effect of acupuncture at Neiguan on heart rate variability in healthy subjects and patients with coronary artery disease. The clarification of this effect should be helpful in the understanding of the acu
關鍵字：Neiguan, heart rate variability, acupuncture, coronary artery disease