中药脾肾并补方对交感型颈椎病临床疗效及心率变异性的影响

Clinical Efficacy of Pishen Bingbu Recipe in Patients with Sympathetic Cervical Spondylosis and Its Impact on Heart Rate Variability

目的观察中药脾肾并补方对交感型颈椎病(气血两虚型)临床疗效及心率变异性(HRV)的影响。方法将50例患者随机分为治疗组和对照组各25例,两组同时服用甲钴胺、维生素B1、神经妥乐平;并均采用坐位枕颌牵引;治疗组加服自拟中药脾肾并补方,总疗程均为60天。观察两组患者治疗后临床疗效(包括中医证候)及HRV指标变化。结果中医证候临床疗效治疗组临床痊愈5例(20%),显效12例(48%),有效7例(28%),无效1例(4%);对照组依次分别为2例(8%)、4例(16%)、18例(72%)及1例(4%),治疗组疗效高于对照组(P<0.05)。治疗前两组HRV各项指标比较差异无统计学意义(P>0.05),治疗后两组HRV时域指标比较,治疗组SDNN(单位时间RR间期标准差)为(133.41±8.61)ms,SDANN(单位时间每5min平均RR间期标准差)为(126.90±9.99)ms,HRVTI(HRV三角指数)为35.10±4.48;对照组分别依次为(115.61±13.49)ms、(106.20±8.84)ms、25.51±2.24;治疗组治疗后频域指标LF(低频)为(379.90±159.07)ms2,HF(高频)为(157.10±28.18)ms2,LF/HF为2.37±0.52;对照组分别为(477.70±396.91)ms2、(122.10±101.90)ms2、4.27±2.84;以上两组比较差异均有统计学意义(P<0.05),治疗组优于对照组。结论中药脾肾并补方对交感型颈椎病有明显的临床疗效,对交感型颈椎病患者的自主神经功能活动有明显改善作用。

Objective To investigate the clinical effect of Pishen Bingbu Recipe （PBR） in treating patients with sympathetic cervical spondylosis （SCS） of qi-blood deficient syndrome type and its impact on heart rate variability （HRV）. Methods Fifty patients were randomized into the control group and the treatment group equally. Both were treated with mecobalamin, vitamin B1, neurotropin, and occipital-jaw band traction in the sitting posture, but to patients in the treatment group, PBR was given additionally. The course of treatment was 60 days. Therapeutic effect and changes of HRV indexes were observed. Results After treatment, in the treatment group, 5 patients （20%） were clinically cured, treatment was markedly effeetive in 12 patients （48%）, effective in 7 （28%） and ineffective in 1 （4%） , while the corresponding data in the control group were 2 （8%） , 4 （16%） , 18 （72%） and 1 （4%） respectively, demonstrating the efficacy in the treatment group was superior to that in the control group （P 〈 0.05）. Before treatment, the HRV indexes in the two groups were insignificantly different respectively （P 〉 0.05 ）. But after treatment, difference between groups was observed in terms of either time domain or frequency domain. Those of time domain were： standard deviation of NN intervals （SDNN, ms） 133.41 ± 8.61 vs 115.61 ± 13.49, average standard deviation of 5 min NN intervals （SDANN, ms） 126.90 ±9.99 vs 106.20 ± 8.84, HRV trigonometric index （HRVTI） 35.10 ± 4.48 vs 25.51±2.24; and those of frequency domain： low frequency （LF, ms^2 ） 379.90 ± 159.07 vs 477.70 ± 396.91 high frequency （ HF, ms^2 ） 157. 10 ± 28. 18 vs 122. 10 ± 101.90, and LF/HF ratio 2.37 ±0.52 vs 4.27 ±2.84. All were superior in the treatment group （P 〈 O. 05）. Conclusion PBR shows evidently clinical efficacy on SCS, it can significantly improve the functional activities of sympathetic nerve in patients.