Coronary Heart Disease Syndromes Of Autonomic Nervous System Function And The Nonlinear Characteristics

OBJECTIVE:Nonlinear phenomenon is commonly existed in natural world. Nonlinear phenomenon is a transitive state from regular movement to irregular movement. Chaos is a special movement form of nonlinear phenomenon. Nonlinear phenomenon is existed in human body. Heart rate variability (HRV) indicates the little difference between the intervals of sinus heart beats, it is able to reflect autonomic nerve function. Recently, people recognized that the syndromes of traditional Chinese medicine (TCM) have nonlinear phenomenon, these TCM syndromes can be researched by nonlinear analytic methods. This study observed the difference of the nonlinear and linear indexes between the syndrome of excess and deficiency simultaneously, in order to reflect the difference of the autonomic nerve function and nonlinear characters among the TCM syndromes, and provide a new methodology for the research of TCM syndromes.METHODS:We observed the patients who aged from 40 to 75, and were diagnosed as coronary heart disease (CHD) by coronary arteriography (CAG), treadmill, electrocardiogram (ECG), or who had the history of myocardial infarction (MI). We divided these patients to different TCM syndrome groups, including the group of excess syndrome, the group of deficiency syndrome, and the group of the syndrome mingled excess with deficiency. We examined all of the patients with 24-hour Holter, and then inputted the results to the Holter analytic machine. We used the machine to get rid of all of disturbed signal, and then obtained the 24-hour continuous heart electric signal and HRV linear indexes. After that, we inputted the continuous signal to the analytic software of nonlinear parameter indexes, and then we got the nonlinear parameter indexes. Finally, we inputted the patients'profile, the information of the group which they were divided, HRV linear and nonlinear parameter indexes to the data base, and compared the difference of the linear and nonlinear parameter indexes among different syndrome groups.RESULTS:We observed 243 patients. Compared in three syndrome groups, there were no difference in patients'age, sexual distinction and the proportion of the patients who diagnosed diabetes. The linear indexes, either time domain indexes or frequency domain indexes, have significant difference among three syndrome groups. It manifested that the linear indexes mean value of excess syndrome group is larger than the group of mingled syndrome, and the value of the mingled syndrome group is larger than the group of deficiency group. This result is identical to the early reports. Compared with the nonlinear parameter indexes of three syndrome groups, including Complexity (Comp), Approximated Entropy (ApEn), and Correlation Dimension (CD) of total 24 hours, from 6am to 10pm, from 10pm to 6am, and every single hour, it manifested that almost all of the mean value of these indexes in the excess syndrome group is larger than in the group of mingled syndrome, and the mean value of the indexes in the mingled syndrome group is larger than in the deficiency syndrome group. The 24-hour variation charts of nonlinear parameter indexes, including Comp, ApEn and CD, showed that the nonlinear parameter rose at night, and went down in the day time.CONCLUSIONS:HRV linear indexes are able to reflect the injured level of the autonomic nerve. The difference of linear indexes between the CHD syndromes of excess and deficiency showed the injured level between the syndrome of excess and deficiency was different. The difference of nonlinear parameter indexes between the excess and deficiency syndrome showed it was different in the autonomic nerve state and the nonlinear character between the syndrome of excess and deficiency. Because of the healthy atmosphere difference between the syndrome of excess and deficiency, the mechanism resulted to the difference of nonlinear indexes may be related to the difference of the healthy atmosphere. The 24-hour variation trend of nonlinear parameter indexes may be related to the law of autonomic nerve activity and the law of Yin and Yang activity in human body. The results of this study showed nonlinear analytic methods could be used to research TCM syndromes, and also could be a new methodology of TCM syndrome research.