針刺對腦中風患者血壓心率之影響及失眠療效初探

Effect of Acupuncture on Blood Pressure and Heart Rate in Patients with Stroke and Insomnia

目的：（1）探討針刺療法對腦中風與非中風失眠患者的血壓及心率影響如何？（2）評估針刺療法對失眠的療效如何？方法：台北市立聯合醫院中興院區於2014年10月至2016年11月間招募失眠受試者，分為腦中風及非中風兩組，利用匹茲堡睡眠品質量表（PSQI）及電子血壓計量測受試者針刺前後的血壓及心率，以探討針刺療法對失眠患者血壓及心率的影響，並評估其療效。結果：共招募失眠受試者79人，其中非中風組42人，腦中風組37人。無論是非中風或是腦中風失眠患者，接受針刺治療後兩組受試者的心率值皆降低，且睡眠品質亦獲得改善。兩組受試者的收縮壓及舒張壓平均值皆在正常範圍內，但脈搏壓則有偏高的現象，且腦中風組受試者歷次的脈搏壓皆顯著高於非中風組。腦中風組針刺第3、4次時收縮壓及脈搏壓有增加的情形，前者平均值增加6.2 mmHg及5.5 mmHg，後者平均值增加4.3 mmHg及4.6 mmHg。結論：針刺療法可降低失眠患者之心率，並改善其睡眠品質。失眠患者之脈搏壓有偏高的現象，可能增加血管硬化的風險；而腦中風組之脈搏壓高於非中風組，代表其血管硬化程度可能較非中風組嚴重。部分患者針刺後血壓升高，可能是因個性緊張所導致的暫時性血壓升高。針刺療法基本上是一種安全、有效的治病方法。 Objective: To explore 1. Were there different effects of acupuncture on blood pressure and heart rate between stroke patients and non-stroke patients? 2.What were the physiological or pathological features of patients who had greater variability in blood pressure and heart rate after receiving acupuncture treatment ? Methods: A trial was conducted from October 2014 to November 2016 in Zhong-Xing Branch, Taipei City Hospital, Taiwan. The participants were measured by using electronic sphygmomanometer to examine effects of acupuncture on the blood pressure and heart rate. Results: A total of 79 participants including 42 of Group non-stroke insomnia patients and 37 of Group stroke insomnia patients were enrolled. The result showed that the heart rate of both groups decreased and their sleep quality improved after receiving acupuncture treatment. The systolic and diastolic blood pressure of the two groups were within the normal range. But the pulse pressure of the two groups were abnormal and the stroke group was significantly higher than insomnia group. The systolic blood pressure and pulse pressure of the stroke group might increase after receiving acupuncture treatment. Conclusions: The decreased heart rate and improved sleep quality of both groups revealed the potential beneficial effects of acupuncture in treating insomnia. Insomnia may be related to arterial stiffness. The arterial stiffness of patients in the stroke group were more severe than in the insomnia group. Some patients had higher blood pressure after acupuncture may be due to personality stress. Acupuncture is basically a safe and effective treatment method.