應用心臟何磁共振造影對電針貓內關穴之心臟生理功能變化之研究

Abstract

獸醫針灸學是我國固有的傳統動物醫學之一門，由於術簡效宏，已獲現代獸醫學所接受。但在以針灸治療疾病的案例中，雖可見病畜臨床症狀之改善，卻少有科學數據證明針灸之臨床治療功效。因此，本研究目的除了建立正常貓之心臟生理參數值外，並將分析電針對心臟生理之影響。研究設計為結合中醫針灸與醫學科技資訊，以體型較為一致的貓為研究對象，並利用心臟磁振造影(CMR)建立正常貓心臟各方位之解剖影像，以及麻醉不同分期之生理參數值。在電針部分，穴位選用內關穴（PC 6,Neiguan），因其主治心臟疾病並對心血管功能有極顯著的影響。本研究於電針內關穴後之各時間點，進行心臟造影掃描並建立心臟生理參數值，以探討麻醉與電針對正常貓血壓之影響，同時建立貓心臟各方位之解剖影像與心臟相關參數。結果顯示，電針組會比純麻醉組的血壓變化小，且較快恢復為正常血壓值。CMR可精確地區別在進入麻醉穩定期與麻醉一小時後，二者之正常貓心臟功能參數方面之差異，兩者在各參數之表現值；左心室心舒張終點體積 ( nEDV)之平均加減一個標準差，為4.26±0.67與2.7±0.37、左心室心收縮終點體積(nESV)為1.75±0.434與0.82±0.08、心臟輸出功率(EF)為0.56±0.058與 0.73±0.07。心臟舒張充血速率參考值(nPFR)為-7.26±0.16與-9.94±1.27，而心臟收縮射血速率(nPER)為10.98±0.51與13.19±0.88。此外研究也發現電針內關穴，的確會對心臟生理參數造成影響，nEDV為2.61±0.46、nESV為0.83±0.05、EF為0.71 ±0.09、nPER為-9.75 ±1.44以及nPFR為12.27±2.21。在臨床上具有降低血壓、提高心臟工作效率與功能。本研究已成功建立正常貓心功能參數指標。寄望本研究可以提供動物電針之心臟疾病基礎研究與臨床應用之重要參考。

Veterinary acupuncture is an important part of Chinese traditional animal medicine. The work of many scientists and clinicians over the past 20 years has confirmed the therapeutic values of acupuncture in treating animal diseases. Nowadays, many veterinarians wish to integrate acupuncture therapy into their routine practice. The magnetic resonance imaging (MRI) developed recently may provide a very useful technique to explore the animal body’s confirmation and function. After anesthetized, we used CMR (Cardiac MRI) to gather the cardiac anatomy imaging and functional data in normal cats and acupuncture cats. The acupoint of study is Neiguan, which has been believed to affect cardiovascular function, and used to improve or treat a wide range of health conditions and diseases. Owing to the fast speed and strong data analysis of MRI machine, can establish the basic cardiac function index of cats including cardiac output, major vessel velocity, myocardium thickness and myocardium oxygen consumption phenomenon. And measurement of heart rate, breath rate, electrocardiogram and pulse are performed in the same time to explore the function of autosomal nerve system and cardiovascular system. Results projected the blood pressure values after electroacupuncture are less than single anesthetics and soon recovery to normal. In normal cat, the parameters of heart in anesthetics and one hour later after anesthetics include nEDV(4.26±0.67；2.7±0.37)、nESV(1.75±0.434；0.82±0.08)、EF(0.56±0.058；0.73±0.07)、LVPFR (10.89±0.51；13.19±0.88)、LVPER(-7.26±0.16；-9.94±1.27). EA could shorten the animal’s recovery time: nEDV(2.61±0.46)、nESV(0.83±0.05)、EF(0.71±0.09)、LVPFR (12.27±2.21)、LVPER(-9.75±1.44).Meanwhile, we also showed the special anatomic figures around the points and all data provide very crucial information for feline acupuncture practice. We intend to provide the important platform for further biomedical study related to pharmaceutical and therapeutical fields.