桃红四物汤对2型糖尿病患者心率变异性的影响

Effect and Mechanism of Taohong Siwu Tang on Heart Rate Variability of Type 2 Diabetes

目的:观察桃红四物汤对2型糖尿病患者心率变异性的影响,并探讨其作用机制。方法:60例2型糖尿病患者随机分为对照组和观察组,每组30例。对照组在常规治疗基础上服用曲美他嗪,每次20 mg,3次·d-1。观察组在对照组基础上加用桃红四物汤治疗,每日1剂,煎汤400 m L,2次·d-1。两组均以4周为1个疗程,共治疗5个疗程。比较治疗前后心率变异性(heart rate variability,HRV)时域指标、空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白及超氧化物歧化酶(superoxide dismutase,SOD)、谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)及丙二醛(malonaldehyde,MDA)的变化。结果:1治疗后观察组治疗后HRV时域各参数:24 h全部窦性R-R间期的标准差(SDNN),24 h内每5 min窦性R-R间期平均值的标准差(SDANN),24 h内全部窦性RR间期差值的均方根(r MSSD),24 h内相邻两正常窦性R-R间期差值大于50 ms的个数所占的百分比(PNN50)均显著高于对照组,差异有统计学意义(P<0.05);2治疗后两组FBG、糖化血红蛋白均明显降低(P<0.05),与对照组治疗后比较,观察组FBG、糖化血红蛋白降低更加明显(P<0.05);3与治疗前比较,治疗后对照组SOD、GSHPx以及MDA比较,差异无统计学意义(P>0.05);与治疗前比较,治疗后观察组SOD、GSH-Px明显升高,MDA明显降低,差异有统计学意义(P<0.05);与对照组治疗后比较,观察组治疗后SOD、GSH-Px明显升高,MDA明显降低,差异有统计学意义(P<0.05)。结论:桃红四物汤能够显著改善2型糖尿病患者的心率变异性,其机制除了与血糖控制有关外,还可能与显著抑制氧化应激反应有关。

Objective：To observe the effect of Taohong Siwu Tang on heart rate variability of type 2 diabetes and to explore its action mechanism. Methods：60 patients with type 2 diabetes were randomly divided into the control group and the observation group,30 cases in each group. The control group was given Trimetazidine based on conventional treatment,20 mg each time,three times a day. The treatment group was given Taohong Siwu Tang based on control group,1 agent,decoct soup 400 mL,2 times a day. Both two groups took 4 weeks for a period of treatment,a total of five courses of treatment. Compared the heart rate variability（HRV）time domain index, fasting blood glucose（FBG）,glycosylated hemoglobin,superoxide dismutase（SOD）,glutathione peroxidase（gsh-px）and malonalde-hyde（MDA）before and after the treatment. Results：①All 24 h period of standard deviation between sinus R-R（SDNN）,every 5 min sinus within 24 h R-R interphase average standard deviation（SDANN）,sinus RR all within 24 h of the phase difference between the root mean square（rMSSD）,adjacent within 24 h phase difference between the two normal sinus R-R value greater than the percentage of 50 ms（PNN50）were significantly higher than that of control group,the difference was statistically significant（P ﹤ 0. 05）. ②The FBG and glycosylated hemoglobin of two groups after treatment were significantly lower（P ﹤ 0. 05）. Compared with the control group, treatment group was more obvious（P ﹤ 0. 05）. ③Compared SOD,gsh-px and MDA of control group after treatment with before treat-ment,differences had no statistical significance（P ﹥ 0. 05）. Compared with before treatment,the SOD and gsh-px of treatment group was obviously higher,MDA decreased obviously,the difference was statistically significant（P ﹤ 0. 05）. Compared with the control group after treatment,the SOD and gsh-px of treatment group increased obviously,MDA decreased obviously. The difference was statistically significant（P ﹤ 0. 05）. Conclusion：Taohong Siwu Tang can significantly improve heart rate variability of type 2 diabetes,its mechanism besides related to blood sugar control,may also be related to inhibit oxidative stress reaction.