心率变异性三态变化与中医寒热虚实辨证的相关性研究  

Relationship Between Heart Rate Variability in Three States and Cold-Heat and Deficiency-Excess Pattern Identification in TCM

作　　者：孔祥亮[1] 何新慧[1] 

机构地区：[1]上海中医药大学基础医学院,上海201203

出　　处：《上海中医药大学学报》2009年第4期38-42,共5页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市教委博士点基金资助项目(2006SZY006);上海高校选拔培养优秀青年教师科研专项基金资助项目(200619001)

摘　　要：目的:研究心率变异性(HRV)在仰卧平静、仰卧心算与直立平静三种状态下的变化特点及与中医寒热虚实辨证的关系。方法:通过比较233例中西医学诊断明确,不同中医证型患者HRV在三种状态下的频域综合变化,分析实热证组(64例)、虚寒证组(16例)、寒热错杂证组(38例)、阴虚火旺证组(67例)、阴阳两虚证组(48例)HRV各指标的变化特点。结果:反映交感神经活动的低频功率值(LF)、低频功率归化值(LFNU)增大与阳证、热证明显相关,反映副交感神经活动的高频功率(HF)、高频功率归化值(HFNU)增大与阴证、寒证明显相关;LF/HF增大反映阳证、热证,LF/HF减小反映阴证、寒证;心算状态对阳证、热证的诊断有加权作用;直立状态对虚证、寒证的诊断有加权作用。结论:HRV三态变化规律对中医寒热虚实辨证具有一定参考价值。Objective：To investigate the characteristics of heart rate variability （HRV） in different three states including supine position and calm state, supine position and mental calculating state, upstanding position and calm state, and its relationship with pattern of cold-heat and deficiency-excess. Methods： By comparing the general changes of frequency domain of HRV of 233 patients with definite western medicine diagnosis and of different TCM patterns under three conditions, the variation of HRV indexes among excess heat pattern group （64 eases）, deficiency cold pattern group （16 cases）, cold-heat complex pattern group （38 eases）, yin deficiency with effulgent fire pattern group （67 eases） and dual deficiency of yin and yang pattern group （48 cases） were analyzed. Results：The augment of LF and LFNU was related to yang pattern and heat pattern; the augment of HF and HFNU was related to yin pattern and cold pattern. The increased LF/HF signifies yang pattern and heat pattern ; while decreased LF/HF reflects yin pattern and cold pattern. The state of mental calculating has a weighing influence on the diagnosis of yang pattern and heat pattern; while the state of upstanding plays a weighing role in identification of deficiency pattern and cold pattern. Conclusion：The changes law of HRV under three conditions is of certain referential value to identification of cold-heat and deficiency-excess pattern in TCM.

关 键 词：心率变异性 心算状态 体位变化 寒热虚实 辨证分型 

分 类 号：R259[医药卫生—中西医结合]