| Objective:1. Through observing the relationship between the changes of HRV and Traditional Chinese Medicine (TCM) types of syndrome to research specific indexes of TCM syndrome differentiation and make it objectivity and standardization to contribute dependable standards for clinical treatment.2.To investigate the changes of HRV after treatment in controlled group and traditional Chinese drug treatment(TCDT)group, and the differences between them.Methods:1. With the standard of 60 patients with chronic heart failure were randomly divided into traditional Chinese and western medicine group (treatment group)30 and Western medicine treatment group (control group) 30. The control group(30 cases) were given the traditional treatment against heart failure (CHF). TCM treatment group distracted by deficiency of qi and yin with blood stasis,qi deficiency and blood-water stasis,yang deficiency of heart and kidney with blood stasis. We has used Diuretic Decoction to strengthen Yang of the Spleen and Kidney and Tetrandra and Astragalus Decoction,Pulse-Generating Powder and Six-Ingredient Pill with Rehmannia,Five-Herb Powder with Poria and BaoYuanTang with the basis of western medicine treatment of 2 weeks.2.The degrees of cardiac function, TCM types of syndrome, Therapeutic efficacy and the HRV of all case(SDNN (standard deviation of all means R R intervals all over 24 hours),SDANN (standard deviation of all means of 5 minutes R R intervals all over 24 hours),RMSSD (root mean square of successive R R differences),PNN50 (percentage of adjacent differences more than apart 50)) with CHF were recorded after and before treatment, SPSS 13.0 was used to analysis the correlation. Reference range of bilateral using Mean±standard deviation (X±S); Among groups of the comparative using ANOVA;the relationship between two variables using t test; Count data using Chi-square test, P value<0.05 indicated the statistically significant, P value<0.01 shown to have statistically significant.Results:1. The indexes(SDNN, SDANN)of the HRV in patients with different zheng differentiation-classifications show gradually falling trend as following:qi and yin with blood stasis group> qi deficiency and blood-water stasis group> yang deficiency of heart and kidney with blood stasis group, There were remarkable differences among them as a whole (P<0.01).2. After treatment SDNN,SDANN,RMSSD in TCDT group were obviously higher than those before treatment (all P<0.01), PNN50 were obviously low er (P<0.01).3.After treatment SDNN. SDANN,RMSSD of the patients of the contrast group were obviously higher than those before treatment (all P<0.05) and PNN50 was obviously lower (P<0.05), and the differences were remarkable.4.SDNN,SDANN,RMSSD in two groups were remarkably higher after treatment than those before treatment (P<0.01), but PNN50 was remarkably lower(P<0.01). There were remarkable differences among them as a whole (P<0.01).5. The treatment group and the control group could decrease the heart after treatment with very significant difference (P<0.01), but the two groups showed no significant difference over the same period.Conclusions:1. HRV significantly decreased in patients with CHF.2.The changes of these indexes(SDNN, SDANN)contribute to districting different zheng differentiation-classifications.3. The conventional treatment with cardiotonic, diuretic and vascular dilator can improve the heart function and the variability of heart rate in patients with CHF.4. The effect of TCDT added to regular western medicine can improve the heart function and the HRV, the equilibration of the autonom ic nerve, and the prognosis simultaneously in patients with CHF. |
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