加味降糖补肾方对糖尿病患者心率变异性的影响

Effect of Modified Jiangtang Bushen Prescription on Heart Rate Variability in Diabetic Patients

【目的】观察加味降糖补肾方对糖尿病患者心率变异性(HRV)的影响。【方法】将确诊为糖尿病合并自主神经病变的80例患者随机分为治疗组和对照组各40例。2组的饮食治疗、运动治疗、控制血糖、改善微循环、营养神经等基础治疗一致,治疗组给予加味降糖补肾方(由狗脊、川续断、女贞子、旱莲草、地骨皮、生黄芪、生地、葛根、黄连、桑白皮、知母、三棱、莪术、苍术、茵陈等组成)治疗,2组疗程均为4周。疗程结束后观察治疗前后24h动态心电图变化情况。【结果】治疗组和对照组患者治疗后较治疗前正常R-R间期标准差(SDNN)、相邻R-R间期的均方差(rMSSD)、每5minR-R间期均值标准差(SDANN)、RR间期差值>50ms所占百分比(PNN50)均增加,低频功率(LF)与高频功率(HF)比值改善,差异有显著性意义(P<0.05)。2组患者治疗前心率变异性各项指标比较差异无显著性意义(P>0.05),但治疗后时域及频域指标比较差异均有显著性意义(P<0.05)。【结论】加味降糖补肾方对心脏自主神经系统功能有一定的改善作用。

Objective To observe the effect of Modified Jiangtang Bushen Prescription （MJBP） on heart rate variability （HRV） in diabetic patients. Methods Eighty diabetic patients complicated with autonomic neuropathy were equally randomized into control group and treatment group. The two groups were given dietary therapy, exercise therapy, and drugs for controlling blood glucose, improving microcirculation and nourishing nerve. Additionally, the treatment group was given MJBP （mainly composed of Rhizoma Cibotii, Radix Dipsaci, Fructus Ligustri Lucidi, Herba Ecliptae, Cortex Lycii, Radix Astragali, Radix Rehmanniae, Radix Puerariae, Rhizoma Coptidis, Cortex Mori, Rhizoma Anemarrhenae, Rhizoma Sparganii, Rhizoma Curcumae, Rhizoma Atractylodis, Herba Artemisiae Scopariae, etc. ）. The treatment lasted 4 weeks in the two groups. After treatment, 24-hour dynamic electrocardiogram was observed before and after treatment. Results After treatment, normal R-R interval standard deviation （SDNN）, neighbor R-R interval mean square error （rMSSD）, R-R interval mean standard deviation every 5 minutes （SDANN）, and the percentage of R-R interval difference over 50ms （PNN50） were increased, and the ratio of low frequency and high frequency （LF/HF） was improved in the two groups, the difference being significant （P 〈 0.05 ）. The differences of HRV parameters between the two groups were insignificant before treatment （P 〉 0.05 ）, but the differences of time domain and frequency domain were significant between the two groups after treatment （ P 〈 0. 05 ）. Conclusion MJBP exerts certain effect on improving the function of heart autonomic nervous system.