摘要
目的观察桂枝汤加减治疗糖尿病心脏自主神经病变的临床疗效。方法将161例患者随机分为试验组81例和对照组80例,试验组在常规治疗基础上给予桂枝汤加减口服,每日1剂;对照组在常规治疗基础上口服弥可保,每次0.5 mg,每日3次。两组均治疗8周,比较两组治疗前后中医证候积分、心率变异性指标[R-R间期的标准差(SDNN)、全程相邻R-R间期之差的均方根(r MSSD)、全程记录相邻R-R间期差值大于50 ms的个数与总R-R间期个数的百分比(PNN 50)、低频(LF)、高频(HF)、LF/HF]及血清炎症细胞因子[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、转化生长因子β1(TGF-β1)]水平。治疗后评价中医证候疗效。结果试验组中医证候疗效总有效率为100%,对照组为83.75%,试验组优于对照组(P<0.05)。试验组治疗后SDNN、r MSSD、PNN 50、LF、HF、TGF-β1水平明显升高,IL-6、TNF-α、LF/HF及各症状积分和总积分明显降低(P<0.05或P<0.01);对照组治疗后SDNN、r MSSD、LF、HF明显升高,IL-6及心悸、胸闷、疲倦乏力积分和总积分明显降低(P<0.05)。治疗后试验组SDNN、r MSSD、PNN 50、LF、HF、TGF-β1明显高于对照组(P<0.05或P<0.01),IL-6、TNF-α、LF/HF及各症状积分和总积分明显低于对照组(P<0.01)。结论桂枝汤加减能显著改善糖尿病心脏自主神经病变患者的临床症状,改善炎症状态,纠正心脏自主神经失衡。
Objective To observe clinical effects of modified Guizhi Tang （桂枝汤） to treat diabetic cardiac autonomic neuropathy. Methods Totally 161 patients were randomly divided into test group （81 cases） and control group （80 cases）. On the basis of the conventional treatment, the test group was given modified Guizhi Tang, 1 dose daily. On the basis of the conventional treatment, the control group took orally mecobalamin, 0. 5 mg each time, 3 times a day. Both groups were treated for 8 weeks. Compared scores of Chinese medicine syndrome, index of heart rate variability [ standard deviation of R-R interval （ SDNN ）, root-mean-square of difference value between adjacent R-R interval in the whole course （rMSSD）, recording percentage between the numbers that difference value greater than 50ms between adjacent R-R interval and the total numbers of R-R interval in the whole course （ PNN 50）, low frequency （ LF）, high frequency （HF） and LF/HF ] before and after treatment, and levels of serum inflammatory cytokines including interleukin 6 （IL - 6 ）, tumor necrosis factor α （TNF-α） and transforming growth factor β1 （ TGF-β1 ） in the two groups were tested to evaluate the curative effects of Chinese medicine syndrome after treatment. Results In the test group, total effective rate about curative effects for Chinese medical syndromes was 100% but that for the control group was 83.75%. The test group was better than the control group （P 〈 0. 05 ）. After treatment, levels of SDNN, rMSSD, PNN 50, LF, HF and TGF-β1 increased significantly in the treatment group and IL-6, TNF-α, LF/HF, the score of single symptom and the total score decreased significantly （ P 〈 0. 05 or P 〈 0.01 ）. In the control group, SDNN, rMSSD, LF, HF increased obviously after treatment but IL-6, scores of palpitate, choking sensation in chest and fatigue and the total score decreased significantly （P 〈 0. 05 ）. In the test group, SDNN, rMSSD, PNN 50, LF, HF, TGF-β1 were significantly highe
出处
《中医杂志》
CSCD
北大核心
2016年第9期753-757,共5页
Journal of Traditional Chinese Medicine
基金
国家自然科学基金(81072962)
国家中医药管理局中医药重点学科
关键词
糖尿病心脏自主神经病变
桂枝汤
炎症因子
调和营卫
心率变异性
diabetic cardiac autonomic neuropathy
Guizhi and Wei
heart rate variability Tang （桂枝汤）
inflammatory factors
regulating Ying
