心力衰竭常见中医证型与心率变异性及心功能的相关性研究

The study on the relationship among the heart rate variability and the heart function index and the common Chinese medicine syndromes of heart failure

目的研究慢性心力衰竭(CHF)常见中医证型与心率变异性(HRV)及心功能的关系,为CHF辨证客观化提供参考指标。方法筛选80例慢性心力衰竭患者,中医辨证分为以下四个证型:气虚血瘀证、气阴两亏证、心肾阳虚证、阳虚水泛证,健康体检者20例作为正常对照,两组患者进行12导联动态心电图检查,检测HRV时域指标SDNN、SDANN、rMSSD、PNN50,超声心动图检测左心室射血分数(LVEF)。结果 CHF患者常见中医证型的LVEF、SDNN、SDANN与正常对照组比较差异均有统计学意义(P<0.05),气阴两亏证、气虚血瘀证、心肾阳虚证、阳虚水泛证各证型间的LVEF、SDNN、SDANN逐渐降低,差异均有统计学意义(P<0.05)。rMSSD、PNN50在CHF各证型中差异无统计学意义(P>0.05)。结论 CHF不同中医证型与HRV和心功能具有显著相关性,HRV可以为CHF中医辨证分型的客观化提供参考指标。

Objective Study the Relationship among the Heart Rate Variability and the Heart Function and the Com- mon Chinese Medicine Syndromes of chronic heart failure（CHF）,To provide objective index for different Traditional Chinese Medicine of CHF. Methods Eighty CHF patients were divided into four groups which included qi asthenia causing blood stasis syndrome group, deficiency of Qi and Yin syndrome group, yang deficiency syndrome group , heart and kidney yang deficiency syndrome group.The normal control group was health people. All of them were per- formed dynamic electrocardiogram, Detecting HRV parameters： SDNN, SDANN, rMSSD, PNNS0,and measuring LVEF by doppler ultrasound diagnostic instrument. Results The discrepancy of LVEF and SDNN,SDANN between the different Traditional Chinese Medicine syndromes of CHF patients and control group were statistical absolutely （P 〈 0.05）.The trend of those index was decreasing absolutely in those groups ： deficiency of Qi and Yin syndrome group, qi asthenia causing blood stasis syndrome group, heart and kidney yang deficiency syndrome group ,yang deficien- cy syndrome group （P 〈 0.05）.There is no statistical significance in indexse of rMSSD,PNN50 between thedifferent Traditional Chinese Medicine syndromes of CHF patients and control group （P 〉 0.05）. Conclusion HRV and heart function was significantly correlated with different TCM syndrome of CHF , and HRV can provide a reference index for the objective of TCM syndrome type of CHF