冠心病不同中医体质类型的心率变异性分析  

Analysis of Heart Rate Variability in Different Traditional Chinese Medicine Constitution Type of Coronary Heart Disease

作　　者：王芳芳[1] 王忠成[1] 周杨[1] 

机构地区：[1]南通市第三人民医院,江苏南通226006

出　　处：《四川中医》2017年第9期33-35,共3页Journal of Sichuan of Traditional Chinese Medicine

基　　金：江苏省中医药局资助项目(编号:LZ13167);江苏省南通市科技局资助项目(编号:HS2013047)

摘　　要：目的:探讨不同中医体质分型冠心病患者机体自主神经功能改变的特点与意义。方法:纳入210例冠心病患者,行中医体质测评与判定,并接受24小时动态心电图检查,归纳分析不同中医体质分型其心率变异性(HRV)时域指标SDNN、SDANN、SDNNI、RMSSD、PNN50的变化。结果:冠心病患者中,体质分布气虚质最多(30%),其次是血瘀质(23.3%),其余依次是痰湿质、平和质、阳虚质、湿热质、气郁质、阴虚质以及特禀质。冠心病气虚质、痰湿质、血瘀质这三种体质时阈指标HRV:SDNN、SDNNI、RMSSD、PNN50均降低,与平和质组比较,差异有统计学意义(P<0.05)SDANN指标气虚质组与平和质组比较,差异有统计学意义(P<0.05),气虚质组SDNN、SDNNI降低,与痰湿质及血瘀质比较,差异有统计学意义(P<0.05),气虚质组RMSSD、PNN50与血瘀质组比较,有所下降,差异有统计学意义(P<0.05),与痰湿质组比较也有一定的下降,但差异无统计学意义(P>0.05)。结论:冠心病患者偏颇体质与平和质比较其心率变异性降低,主要表现为交感神经张力增大,迷走神经张力降低,交感神经与迷走神经之间的协调平衡破坏,偏颇体质中以气虚质的心率变异性降低更为明显。Objective: To investigate the characteristics and significance of changes of cardiac autonomic nerve function in different types of TCM constitution patients with coronary heart disease( CHD). Methods: A total of 210 cases of patients with coronary heart disease was enrolled,TCM physique evaluation and judgment was conducted,and all the patient accepted the 24 hour ambulatory ECG,analyzed the heart rate variability( HRV) changes of different types of TCM constitution through the time domain indexes of SDNN,SDANN,SDNNI,RMSSD,PNN50. Results: Patients with coronary heart disease,the constitution distribution of Qi deficiency was the highest( 30%),followed by blood stasis( 23. 3%),the others were phlegm phlegm dampness,balance constitution,Yang deficiency,damp heat,Qi depression,Yin deficiency and special diathesis type. The indexes of HRV: SDNN,SDNNI,RMSSD and PNN50 in three kinds of constitution of Qi deficiency,phlegm dampness and blood stasis were decreased,and the difference was statistically significant compared with that in the balance constitution. Compared with phlegm and blood stasis,Qi deficiency group SDNN and SDNNI decreased,the difference was statistically significant( P< 0. 05),compared with blood stasis group,Qi deficiency group RMSSD PNN50 decreased,the difference was statistically significant( P <0. 05). There was also a certain decrease in comparison with phlegm dampness group,but the difference was not statistically significant( P>0. 05). Conclusion: Heart rate variability decreased in patient with coronary heart disease with biased constitution compared with balance constitution. Mainly manifested as sympathetic nerve tension increased,decreased vagal tone,coordination and balance between sympathetic nerve and vagus nerve damage. The decrease of heart rate variability was more obvious in the Qi deficiency of biased constitution.

关 键 词：冠心病 中医体质 心率变异性 

分 类 号：R259[医药卫生—中西医结合]