Analysis of heart rate variability in patients with chest pain accompanied by different traditional Chinese medicine syndromes / 中国中西医结合急救杂志

ABSTRACT

Objective To explore the correlations between different traditional Chinese medicine (TCM) syndromes and the heart rate variability (HRV) accompanying patients with chest pain,and to provide a referen()for clinical syndrome differentiation in such patients.Methods A prospective study was conducted.()hundred and seventeen patients with chest pain admitted into Longhua Hospital Affiliated to Shanghai U()of TCM from January 2015 to October 2016 were assigned in a study object,and according to the diffe()TCM syndromes,they were divided into syndrome of qi deficiency with blood stasis,the blood sta()the deficiency of qi and yin,suppression of the chest yang,phlegm and blood stasis,qi-stagnan ()syndromes.In the same period,123 healthy people having undergone physical examination wer()control group.The time domain indexes of HRV were recorded by dynamic electrocardiogr()normal control group were compared to those of patients with different TCM syndrom()distribution in different TCM syndromes and various HRV time domain indexes we()cycle time domain indexes were as followsthe average standard deviation o()standard deviation of R-R interval (SDNN),24 hours standard deviation of()5 minutes (SDANN),24 hours the mean square root of difference values,()were observed in both groups.Results The chest pain patients a()accounting for the largest proportion (35 cases,29.9％),and ac()smallest proportion (5 cases,4.3％) in the study group;the nu()syndrome (17 cases vs.14 cases),blood stagnation of hea()(6 cases vs.2 cases) and qi-stagnation and blood stasis s()in men;the numbers of patients with deficiency of qi()(4 cases vs.2 cases) in men were more than thos()female patients were lower than those in maj()66.8 (33.4,33.4) vs.103.4 (39.7,135.4),124.7 (88.0,143.4) vs.167.0 (90.5,230.1),84.0 (22.5,132.6) vs.152.4 (31.4,240.0),all P ＜ 0.05].The SDANN in patients with chest discomfort accompanied by any one of the above mentioned types of TCM syndrome was significantly lower than that in the control group,and its degree of descent was more remarkable in the patients with qi deficiency with blood stasis,the blood stagnation of heart and suppression of the chest yang syndromes (ms74.86± 25.69,80.39± 20.53,70.97± 23.53 vs.131.30± 34.70,all P ＜ 0.05);the SDNN of patients with deficiency of qi and yin syndrome was higher than that in the blood stagnation of heart syndrome,phlegm and blood stasis,and qi-stagnation and blood stasis syndrome significantly (ms181.25 ± 65.20 vs.97.88± 23.61,84.28 ± 22.34,89.93 ± 8.43,all P ＜ 0.05);the RMSSD of patients with deficiency of qi and yin syndrome was increased significantly compared with that in the healthy controls and in patients with the blood stagnation of heart syndrome (ms91.94 ± 44.02 vs.28.00± 10.50,32.21 ± 18.25,both P ＜ 0.05).Conclusions Patients with chest pain accompanied by different TCM syndrome types may develop obvious heart rate variability,and the descent of SDANN level was the most significant.The analysis of HRV changes in such patients has positive significance for their diagnosis and treatment.