原发性高血压病中医辨证分型与心率变异性关系的探讨

Exploring the correlation of syndrome differentiation of primary hypertension and heart rate variability

目的:探讨原发性高血压病中医辨证分型与心率变异性(HRV)间的关系,为高血压病临床辨证客观化提供参考指标。方法:选择符合诊断标准的原发性高血压病患者100例,按中医辨证观察肝火亢盛型、阴虚阳亢型、肝肾阴虚型、阴阳两虚型4个类型,32例正常健康人作为对照组,检测5min短时程频域分析的有关心率变异性指标进行统计对比分析。结果:与正常对照组比,原发性高血压4型的HRV(TP、VLF、LF、HF)均有不同程度的降低,差异显著(P<0.05或P<0.001),且呈肝火亢盛型>肝肾阴虚型>阴虚阳亢型>阴阳两虚型依次降低的趋势,不同证型之间HRV各指标差异显著(P<0.05-0.001)。结论:原发性高血压病患者的自主神经功能受损害,HRV的部分指标可作为中医辨证分型的参考。

Objective： To explore the correlation of TCM syndrome differentiation of primary hypertension and heart rate variability（HRV）, provide some reference for syndrome differentiation of hypertension. Method： 100 cases of primary hypertension were differentiated into four syndromes ： liver-fire hyperactivity syndrome ,yin-deficiency and excessive yang syndrome, liver-kidney yin deficiency syndrome, yin-yang deficiency syndrome ,and 32 healthy people were observed as control group. HRV related indexes were detected. Result： Compared with the control group, HRV（TP, VLF, LF, HF） of the four syndromes of primary hypertension decreased in different degrees （ P〈0.05, P〈0.001 ） ,and the HRV（TP, VLF, LF, HF） of four syndrome decreased in sequence as below order： liver-kidney yin deficiency〉 liver-kidney yin deficiency〉 yin-deficiency and excessive yang〉 yin-yang deficiency, and there were significant difference between different syndromes （P〈0.05, P〈0.001 ） . Conclusion： The autonomic nervous system were injured in patients with primary hypertension, and some HRV indexes can be used for the reference of Chinese medical syndrome differentiation.