不同中医体质糖尿病患者自主神经系统交感神经活性与迷走神经活性及其平衡协调的关系

来源期刊：广州医药 | 80-83 发布时间：2021-12-17 收稿时间：2025/11/13 17:30:19 阅读量：14

作者：: 黄家桓,

朱文欣,

夏清,

李建强,

关键词：: 中医体质糖尿病心率变异性自主神经功能; Chinese medicine constitution Diabetes mellitus Heart rate variability Autonomic nervous function

DOI：: 10.3969/j.issn.1000-8535.2019.03.021

收稿时间：: 2019-03-01
修订日期：
接收日期：
引用总数：: 0

目的探讨不同中医体质老年糖尿病患者心率变异性与自主神经功能的关系。方法选取2016年3月—2017年4月在我院治疗的老年糖尿病患者250例,检测各中医体质患者SDNN、SDANN、SDNNI、RMSSD、PNN50%、LF、HF、LF/HF以及空腹血糖(FBG)、糖化血红蛋白(HbA1c)。结果总偏颇体质患者SDNN、SDANN、SDNNI、RMSSD、PNN50%、LF和HF分别为(88.37±10.02)ms、(78.82±9.44)ms、(41.14±11.43)ms、(22.28±6.53)ms、(10.03±4.33)ms、(203.38±78.23)ms²和(122.21±80.03)ms²,低于平和质患者(P＜0.05),而LF/HF为(1.68±0.43),高于平和质患者(P＜0.05);血瘀质患者SDNN、SDANN、SDNNI、RMSSD和PNN50低于气虚质、阴虚质、痰湿质、湿热质和其他型患者(P＜0.05);阴虚质患者LF、HF低于气虚质、血瘀质、痰湿质、湿热质和其他型患者(P＜0.05);阴虚质患者LF/HF低于气虚质、血瘀质、痰湿质、湿热质患者(P＜0.05);其他型患者SDNN、SDANN、SDNNI、RMSSD、PNN50、LF、HF高于气虚质、阴虚质、痰湿质、湿热质患者(P＜0.05),而LF/HF低于气虚质、阴虚质、痰湿质、湿热质患者(P＜0.05);不同中医体质患者FBG、HbA1c比较差异无统计学意义(P＞0.05)。结论糖尿病患者偏颇体质较平和质患者心率变异性降低,表现为交感神经张力增大,迷走神经张力降低,其平衡协调破坏。

Objective To explore the relationship between heart rate variability and autonomic nervous function in elderly diabetic patients with different constitutions of traditional Chinese medicine. Methods 250 elderly patients with diabetes mellitus in our hospital from March 2016 to April 2017 were selected; the SDANN, SDNNI, RMSSD, PN50%, LF, HF, LF/HF, fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) were measured. Results In patients with general biased constitution, SDANN, SDNNI, RMSSD, PN50%, LF and HF were (88.37±10.02) ms, (78.82±9.44) ms, (41.14±11.43) ms, (22.28±6.53) ms, (10.03 ±4.33) ms, (203.38±78.23) ms² and (122.21±80.03) ms², which were lower than those in patients with plain constitution (P＜0.05), while LF/HF was (1.68±0.43), which was higher than that in patients with plain constitution (P＜0.05); in patients with blood stasis, SDANN, SDNNI, RMSSD and PN50 were lower than those with Qi deficiency, Yin deficiency, phlegm-dampness, damp-heat and other types (P＜0.05); LF and HF in Yin deficiency type patients were lower than those in Qi deficiency type, blood stasis type, phlegm-dampness type, damp-heat type and other types (P＜0.05); LF/HF in Yin deficiency patients was lower than that in Qi deficiency patients, blood stasis patients, phlegm-dampness patients and damp-heat patients (P＜0.05); SDANN, SDNNI, RMSSD, PN50, LF and HF in other types of patients were higher than Qi deficiency, Yin deficiency, phlegm-dampness and damp-heat (P＜0.05), while LF/HF was lower than those with Qi deficiency, Yin deficiency, phlegm-dampness and damp-heat (P＜0.05); there was no significant difference in FBG and HbA1c in patients with different constitutions of TCM (P>0.05). Conclusion The heart rate variability of biased constitution patients with diabetes mellitus was lower than that of patients with mild constitution, manifested by increased sympathetic nerve tension, decreased vagal nerve tension and destroyed balance and coordination.

1、任诗佳, 林肖峰, 刘文华. 贝前列素钠改善老年2型糖尿病患者的心脏自主神经功能和心率变异性的评估研究[J]. 中国医师杂志, 2016, 18(6):927-929.

2、胡永奎, 凌刘. 老年2型糖尿病合并冠心病患者的心率变异性研究[J]. 河北医学, 2016, 22(2):236-238.

3、宋雯婧, 邵加庆. 糖尿病心血管自主神经病变检测的研究进展[J]. 国际内分泌代谢杂志, 2018, 38(5):321.

4、岑永庄, 刘新霞, 黄国贤. 65岁以上老人中医体质与体质量指数和2型糖尿病关系的探讨[J]. 广州中医药大学学报, 2016, 33(6):790-794.

5、傅涛, 陈宏, 闫国强,等. 厄贝沙坦对缺血性心肌病合并2型糖尿病患者心率变异性、室性心律失常及左心功能的影响[J]. 北京医学, 2016, 38(7):723-725.

6、 SOUZA N M, GIACON T R, PACAGNELLI F L, et al. Dynamics of heart rate variability analysed through nonlinear and linear dynamics is already impaired in young type 1 diabetic subjects[J]. Cardiol Young, 2016, 26(7):1383-1390.

7、梅超红, 王德惠. 基于中医体质辨识的生活方式干预对糖尿病前期患者的影响[J]. 吉林中医药, 2017, 37(5):440-442.

8、孙芳毅, 施靖, 王红芳,等. 表阿霉素对合并糖尿病的早期乳腺癌患者心率变异性影响[J]. 肿瘤学杂志, 2017, 23(11):992-995.

9、靳晶, 黄丽红. 2型糖尿病患者的心率变异性、心率减速力及连续心率减速力分析[J]. 医学与哲学, 2016, 37(16):36-37.

10、王旭玲, 吴立. 急性冠状动脉综合征合并2型糖尿病患者糖化血红蛋白与心率变异性的相关性研究[J]. 山西医药杂志, 2016, 45(12):1448-1449.

11、柳璇. 《中医体质分类与判定》标准研究现状[C]. 中医体质学术年会, 2012.

12、 MEYER M L, GOTMAN N M, SOLIMAN E Z, et al. Association of glucose homeostasis measures with heart rate variability among Hispanic/Latino adults without diabetes: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)[J]. Cardiovasc Diabetol, 2016, 15(1):1-10.

13、李桂平, 邓华钊, 邱爱婷,等. 贝前列素钠治疗糖尿病心脏自主神经病变疗效评价[J]. 现代医院, 2012, 12(1):10-13.

14、陈莉. 中医体质辨识在军休所干部体检中的应用[J]. 现代医院, 2016, 16(9):1396-1398.

15、赵蒙, 高云. 中医体质辨识在2型糖尿病患者健康管理中应用效果研究[J]. 中国中医药信息杂志, 2016, 23(6):31-34.