冠状动脉粥样硬化心脏病患者中医辨证分型与心率变异性的研究

A study on TCM syndrome differentiation of coronary heart disease and heart rate variability

目的:通过分析不同中医症型冠状动脉粥样硬化心脏病(简称冠心病)患者心率变异,探讨中医辨证分型与心脏自主神经功能的相关性。方法:将132例冠心病患者按照不同的中医症型分为三组:心血瘀阻组(56例)、痰阻心脉组(44例)和心阴亏虚组(32例),选取同期体检健康者(60例)作为对照组,所有受试者均行24h动态心电图检查,归纳分析各组间心率变异性(Heart Rate Variability,HRV)、时域指标(SDANN、SDNN、SDNNI、PNN50、RMSSD)的变化。结果:冠心病患者各项时域指标较健康对照组均明显降低,差异具有统计学意义(P<0.05);进一步分析发现,心血瘀阻组及痰阻心脉组SDNN、SDNNI、RMSSD及PNN50较心阴亏虚组显著下降(P<0.05),但心血瘀阻组与痰阻心脉组差异无统计学意义(P>0.05)。结论:冠心病患者心率变异性显著降低,其中心血瘀阻与痰阻心脉症患者降低较心阴亏虚组更为明显。

Objective: To analyze the relationship between TCM syndrome differentiation and cardiac autonomic function by analyzing heart rate variability in patients with different TCM symptoms. Methods: 132 patients with coronary heart disease were divided into the Xinxue Yuzu group (心血瘀阻组)(56 cases), the Tanzu Xinmai group (痰阻心脉组)(44 cases) and Xinyin Kuixu group (心阴亏虚组)(32 cases) according to different TCM symptoms. The healthy subjects (60 cases) served as the control group. All subjects underwent 24-hour dynamic electrocardiography. The changes of heart rate variability time domain indicators (SDANN, SDNN, SDNNI, PNN50, RMSSD) were analyzed. Results: The time-domain indexes in patients with coronary heart disease were significantly lower than the control group (P<0.05). In the Xinxue Yuzu group and the Tanzu Xinmai group, SDNN, SDNNI, RMSSD and PNN50 were more decreased than the Xinyin Kuixu group (P<0.05). There was no significant difference between the Xinxue Yuzu group and the Tanzu Xinmai group (P>0.05). Conclusion: The heart rate variability in patients with coronary heart disease is significantly decreased, and that in the Xinxue Yuzu group and the Tanzu Xinmai group was more obvious.