目的:探讨益气养阴活血法对糖尿病大鼠自主神经功能的影响。方法:糖尿病大鼠随机分为:正常对照组、空白对照组、糖脉康治疗组、糖心舒高低剂量组、糖脉康加弥可保治疗组。治疗2月,对大鼠进行持续心电观察。结果:造模后各组心率变异HRV指标明显低于正常对照组,说明糖尿病大鼠心率变异性降低,提示合并有自主神经功能损伤。糖心舒高、低剂量组治疗前后相比,HRV各参数均较对照组有明显提高;高、低剂量组间比较,HRV升高率随药物浓度增加而增加。结论:具有益气养阴活血作用的糖心舒能够明显改善糖尿病大鼠的自主神经功能。

目的:探讨冠心病心绞痛中医辨证分型与自主神经功能及心肌缺血的相关性.方法:采用动态心电图监测技术,对气滞血瘀型117例、气虚血瘀型104例心绞痛患者进行心率变异性和缺血负荷指数同步分析.结果:气滞血瘀型以交感与迷走神经平衡失调为主,一过性缺血型ST段下移的时间分布、频度增多,缺血负荷指数较气虚血瘀型组增高30%.气虚血瘀型主要为迷走神经张力明显降低,缺血型ST段下移持续时间达24 h.结论:气滞血瘀证与气虚血瘀证心绞痛患者均有不同程度的自主神经功能紊乱,两证患者心肌缺血程度与自主神经功能高度相关.

目的:探讨冠心病心绞痛患者自主神经功能紊乱与中医辨证分型的相关性.方法:采用动态心电图技术,对117例气滞血瘀型、104例气虚血瘀型心绞痛患者及50例健康人进行心率变异性分析,对比观察迷走神经张力(SDNN、RMSSD、PNN50、HF)、交感神经活性(VLF、LF)、交感与迷走神经平衡关系(LF/HF).结果:心绞痛病组SDNN、RMSSD、PNN50、HF明显低于健康对照组,而VLF、LF、LF/HF显著增高(P＜0.05);两证型间比较,气虚血瘀型组SDNN、RMSSD、PNN50及HF明显降低,气滞血瘀型组LF及LF/HF相对增高(P＜0.05);PNN50及VLF差异无显著性.结论:冠心病心绞痛患者存在不同程度的自主神经功能紊乱;气滞血瘀型以交感与迷走神经平衡失调为主,气虚血瘀型主要为迷走神经张力明显降低.

Objective: To observe the therapeutic effect of Tangxinshu Mixture (TXS) in treating diabetic cardiovascular autonomic neuropathy (DCAN). Methods: Based on Diamicron treatment, 30 patients in the treated group were treated with TXS and the other 30 in the control group were treated with western medicine (vitamin and Methycobal), the therapeutic course for both groups was 12 weeks. The changes of blood glucose, blood lipid, heart rate variability (HRV) were observed before and after treatment. Results: The total effective rate in the treated group was 90.0%, while that in the control group was 66.7 %, comparison between them showed significant difference (P0.05). The effect of treatment in the treated group in terms of lowering blood glucose (either fasting or 2 hrs after meal), serum total cholesterol, triglyceride, low density lipoprotein, and increasing high density lipoprotein content and HRV were all better than those in the control group (P0.05). Conclusion: TXS could effectively control the blood glucose level, improve the microcirculatory disturbance, and definite therapeutic effect in treating DCAN was shown..

自主神经系统与室性心律失常尤其恶性心律失常发生之间有密切相关性.心率变异性(Heart Rate Variability,HRV)是一种无创,定量评估交感神经和迷走神经活动的方法[1].本研究应用具有滋阴养血,泻火安神作用的中药复方心疾宁胶囊治疗室性早搏,观察用药前后HRV能量谱变化,现总结如下.

综述了近10年来气虚血瘀型冠心病病理生理研究热点及疗效机制研究、治则治法的研究概况.参考文献29篇.

为观察心疾宁胶囊对室性心律失常患者心率变异性(HRV)和QT离散度(QTd)的影响,将45例室性心律失常患者随机分为心疾宁治疗组(25例)和心得安对照组(20例),治疗1个月后观察疗效.结果:治疗前后治疗组24小时时域各指标均有显著性改变(P＜0.01);夜间各指标治疗组显著改变(P＜0.05),优于对照组;两组白天SDNN和Tri-Ind均显著改变(P＜0.05);治疗组LF、HF、LF/HF显著改变(P＜0.01),对照组LF、HF、LF/HF显著改变(P＜0.05);治疗组QTd、QTcd显著改变(P＜0.01),对照组QTd显著改变(P＜0.01),QTcd显著改变(P＜0.05).提示心疾宁胶囊能提高心率变异性,降低QT离散度.

对80例室性心律失常患者进行随机分组对照研究,48例用中药心疾宁胶囊,32例用西药心得安治疗.结果表明,用药4周后对室性早搏总疗效,心疾宁组总有效率为91.7%,心得安组为81.3%;心疾宁组与心得安组均能显著提高心率变异性(P＜0.05),两组比较差异无显著性(P＞0.05),提示心疾宁胶囊具有降低交感神经兴奋性和提高迷走神经张力作用.