调心饮对糖尿病心脏自主神经病变心率变异性的影响
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摘要
目的:评价调心饮对糖尿病心脏自主神经病变的临床疗效及对心率变异性的影响。方法:将60例糖尿病心脏自主神经病变患者随机分为试验组和对照组,各30例,试验组在给予达美康、二甲双胍的基础上,给予调心饮治疗,水煎服,日一剂,对照组在给予达美康、二甲双胍治疗基础上,给予弥可保500ug,tid,疗程8周,观察治疗前后两组的临床症状,血糖控制情况,心率变异性指标,血尿常规,肝肾功变化,比较其疗效差异。结果:治疗后,总有效率试验组为90.0%,对照组为53.33%,两组比较差异有显著性(P<0.05);试验组在改善临床症状、降低空腹血糖、餐后2h血糖、改善HRV指标方面均优于对照组(P<0.05)。结论:调心饮治疗糖尿病心脏自主神经病变的疗效显著,可以改善患者心率变异性。
Abstract Objective: To evaluate the influence of Tiao xin yin treatment of diabetic cardiac autonomic neuropathy in patients with heart rate variability.Methods:60 patients of diabetic cardiac antonomic neuropathy were divided into experiment group(n=30) and control group (n=30),the experiment group were treated with Diamicron,Diformin and tiao xin yin ,with a total course of treatment for 8 weeks.Control group were treated with Diamicron, Diformin and Methycobal, observed changes in the blood glucose,clinical symptom,heart rate variability index,blood cenvention, uro-convention, liver function,renal function before and after treatment.Results:After treatment,effective power in experiment Is 90%,and 53.3% in control group.the differences was statically significant(P<0.05).Conc lusion: Tiao xin yin treatment of diabetic cardiac autonomic neuropathy has significant effect and can improve heart variability.
Abstract Objective: To evaluate the influence of Tiao xin yin treatment of diabetic cardiac autonomic neuropathy in patients with heart rate variability.Methods:60 patients of diabetic cardiac antonomic neuropathy were divided into experiment group(n=30) and control group (n=30),the experiment group were treated with Diamicron,Diformin and tiao xin yin ,with a total course of treatment for 8 weeks.Control group were treated with Diamicron, Diformin and Methycobal, observed changes in the blood glucose,clinical symptom,heart rate variability index,blood cenvention, uro-convention, liver function,renal function before and after treatment.Results:After treatment,effective power in experiment Is 90%,and 53.3% in control group.the differences was statically significant(P<0.05).Conc lusion: Tiao xin yin treatment of diabetic cardiac autonomic neuropathy has significant effect and can improve heart variability.
引文
[1] Spallone V. Menzinger G. Autonomic Neuropathy: clinical and instrumental findings. Clin Neurosci,1997,4(6):346-358
[2] Foss CH,VestboE,Froland A,etal.Autonomic neuropathy in non-diabetic offspring of type 2diabetic subjects is associated with urinary albumin excretion rate and 4-h ambulatory blood pressure,the Fredericia Study.diabetes,2001,50:630=-636
[3] Aaronl.vinik,MD.Diabetic Autonomic Neuropathy Diabetes Care, 2003,2- 6(6):1553-1579
[4] Ewing DJ,Martyn CN,Young RJ,etal,The value of cardiovascular autonomic function tests:10 years experience in diabetes.Diabetes Care,1985,8:491-498
[5]廖二元,超楚生.糖尿病[M].内分泌学.北京:人民卫生出版社,2006
[6]周建华,袁战军,马芸,等。心率变异性分析对糖尿病合并自主神经病变的诊断价值.中国糖尿病杂志,1998,6:22
[7]中华心血管病杂志编委会心率变异性对策专题组.心率变异性检测临床应用的建议[J].中华心血管杂志,1998,26(4):252-255
[8] Task Force of The European Society of Cardiogy and the north American Society of pacing and electrophysiology.Heart rate variability standards Of measurement,physiogical interpretation and clinical use. Circulation,1996,939(5) :1043-1065
[9]戴嘉,吴寒,庄亚纯等.心率变异性在糖尿病心脏自主神经病变的临床意义.中国心血管杂志,1999,4(3):162-163
[10]许樟荣.糖尿病心血管自主神经病变[J].国外医学:内分泌分册,2004,24(2):84-86
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[12]杨香婷,潘守政,丁贯一,何伟玺,崔志红,郭树霞,Ⅱ型糖尿病患者心率变异性分析,临床医学,2001,21(2):2-4
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[18]毛福荣,何冬娟,自主神经功能检测对糖尿病早期自主神经病变的诊断价值[J],临床医学.2008,28(8):73-74
[19]曾欣,王欣,王伟,运动疗法改善2型糖尿病无症状性心肌缺血的研究[J].中国现代医生,2009,47(21):16-17
[20]凌丹芸,汤正义,王卫庆,抗氧化剂a-硫辛酸在糖尿病神经病变治疗中的作用[J].世界临床药物,2007,26(12):726-729
[21]张秀华,大剂量甲钴胺对糖尿病自主神经病变患者心率变异性的影响[J].实用医技杂志,2009,16(6):460-461
[22]刘伟芳,施丽芳,凯时联合弥可保治疗对糖尿病心脏自主神经病变患者心率变异性的影响,药物与临床,2010,7(24):51
[23]李伟红,胡春荣,李艳美,比索洛尔对糖尿病自主神经病变患者心率变异性的影响,心血管康复杂志,200817(4):396-397
[24]林令华,于军会,李志改,许金华,依帕司他治疗糖尿病自主神经病变疗效分析,医学信息,2006,19(4):634-635
[25]孙世萍,殷晓轩,宋丽绚,庄皎,崔文,糖心平合剂对糖尿病心脏自主神经病变心率变异指标的影响,中医学报,2010,25(147):294-296
[26]李智滨,宋炜,糖欣胶囊治疗2型糖尿病心脏自主神经病变临床观察(J),医学理论与实践。2005,19(10):1160
[27]翟玉民,中医治未病理论与糖尿病心脏病防治探讨,光明中医,2009,24(9):1636-1637
[28]韩文生,谭子新,阎英杰,刘福来,王淑珍,魏红,伊朝晖,中药益心胶囊治疗糖尿病心脏自主神经病变患者52例临床观察,中国实用医药,2010,5(13):164
[29]杨晓晖,糖尿病心脏病的中医分期辨治探讨,北京中医,2006,25(7):403-404
[30]丁书文,李晓,李运伦,陈守强,心系疾病中的热毒学说,中国医药学报,2004,19(10):592-593
[31]刘长山.黄芩苷对糖尿病患者红细胞醛糖还原酶活性及周围神经传导速度的影响[J].中国神经科学杂志,2002,18(2):555
[1]沈稚舟,吴松华,邵福源,等,糖尿病慢性并发症,上海医科大学出版社,1998;107
[2] Spallone V. Menzinger G. Autonomic Neuropathy: clinical and instrumental findings. Clin Neurosci,1997,4(6):346-358.
[3] Koistinen MJ.Prevalence of asymptomatic myocardial ischaemia in diabetic subjects[J].BMJ,1990,301(6743):92-95
[4] VeglioM,SivieriR,ChinagliaA,etal.QT interval prolongation and mortality in type 1 diabetic patients:a 5-year cohort prospective study.Neuropathy study group of the Italian society of the study of diabetes,Piemonte Affiliate[J].Diabetes Care,2000,23(9):1381-1383
[5]林少达,李碧慧,糖尿病心血管自主神经病变的诊治现状,中华临床医师杂志[J],2010,4(9):1473-1476
[6] Vinik AI,Maser RE,Mincheld BD,etal.Diabetic autonomic neuropathy.Diabetes Care,2003,26:1553-1579
[7]凌丹芸,汤正义,张炜,等,导致2型糖尿病心血管自主神经病变的主要危险因素及其对病情评估的价值[J].中华内科杂志,2006,45(10):815-819
[8]叶山东,糖尿病心血管自主神经病变的研究进展,新医学,2004,35(1):10-12
[9]王杨天,糖尿病性心脏自主神经病变的新进展,医学研究生学报,2006,19(9):845-847
[10] Pittenger GL,Malik RA,Burcus N,etal.Specific fiber deficits in sensorimotor diabetic polyneuropathy correspond to cytoxicity against neuroblastoma cells of sera from patients with diabetes[J].Diabetes Care,2001,24(8):1468-1475
[11]费立鹏.中国的精神卫生问题-21世纪的挑战和选择[J].中国神经精神疾病杂志,2004,30(1):1-10,;
[12]石其昌,章健民,徐方忠,等.浙江省15岁及以上人群精神疾病流行病学调查[J].中华预防医学杂志,2005,39(4):229-236
[13] Parker G,G ladstone G,Chee KT.Depression in the planet’s largestethnic group:the Chinese[J].Am JPsychiatry,2001,158:857-864.
[14]刘静芹,尹贺欣,刘凯,何晓蕊,糖尿病患者心脏自主神经病变相关因素研究,中国慢性病预防与控制[J],2008,16(4):371-373
[15]许樟荣,糖尿病心血管自主神经病变,国外医学内分泌学分册[J].国外医学内分泌学分册,2004,24(2):84-86
[16] Neil HAW:Epidemiology of diabetic autonomic neuropathy.In Autonomic Failure.Bannister R,Mathias CJ,Dds.Oxford Medical.1992;p683-697
[17]刘晓芳,叶志前.心率变异性的分析方法和应用.国外医学生物医学工程分册,2001,24(1):42-46
[18] Bemardi L,Ferrari MR,etal.Application of chaos theoy(approximate entropy) to detect cardiac autonomic dysfunction in diabetes(abstract).Diabetetologia.1995;38 (suppll):A241
[19] Schnell O, Hammer K, Muhr2Becker D, et al. Cardiac sympathetic dysinnervation in type 2 diabetes mellitus with and without ECG-based cardiac autonomic neuropathy[J]. J Diabetes Complications, 2002, 16:220-227.
[20] Veglio M,Giunti S,Stevens LK,etal.Prevalence of QT interval dispersion in type 1 diabetes and its relation with cardiac ischaemia:the EURODIAB IDDM complications study group[J].Diabetes Care,2002,25(4):702-707
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[23] Vinik AI,Maser RE,Mitchel BD,etal.Diabeticautonomic neuropathy[J].Diabetes Care,2003,26(6):1553-1579
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[25]闫秋艳,吴洪波,关志宝.弥可保降阶梯治疗糖尿病自主神经病变的临床观察[J].中国误诊学杂志,2007,7(21):5010-5011
[26]张琳珠,刘静芹,鲁建幸,等,弥可保对糖尿病自主神经病变心率变异的影响[J].承德医学院学报,2007,24(2):139-142
[27]刘伟芳,施丽芳,凯时联合弥可保治疗对糖尿病心脏自主神经病变患者心率变异性的影响,药物与临床,2010,7(24):50-51
[28]林令华,于军会,李志改,许金华,依帕司他治疗糖尿病自主神经病变疗效分析,医学信息,2006,19(4):634-635
[29] Ebbehoj E,Poulsen PL,Hansen KW,etal.Effects on heart rate variability of metoprolol supplementary to on going ACE-inhibitor treatment in type 1diabetic patients with abnormal albuminuria [J].Diabetologia,2002,45(7):965-975
[30] Bechir M,Enseleit F,Chenevard R,etal.Effect of losartan on muscle sympathetic activity and baroreceptor function in systemic hypertension.Am J Cardiol,2005, 95(1):129-131
[2] Foss CH,VestboE,Froland A,etal.Autonomic neuropathy in non-diabetic offspring of type 2diabetic subjects is associated with urinary albumin excretion rate and 4-h ambulatory blood pressure,the Fredericia Study.diabetes,2001,50:630=-636
[3] Aaronl.vinik,MD.Diabetic Autonomic Neuropathy Diabetes Care, 2003,2- 6(6):1553-1579
[4] Ewing DJ,Martyn CN,Young RJ,etal,The value of cardiovascular autonomic function tests:10 years experience in diabetes.Diabetes Care,1985,8:491-498
[5]廖二元,超楚生.糖尿病[M].内分泌学.北京:人民卫生出版社,2006
[6]周建华,袁战军,马芸,等。心率变异性分析对糖尿病合并自主神经病变的诊断价值.中国糖尿病杂志,1998,6:22
[7]中华心血管病杂志编委会心率变异性对策专题组.心率变异性检测临床应用的建议[J].中华心血管杂志,1998,26(4):252-255
[8] Task Force of The European Society of Cardiogy and the north American Society of pacing and electrophysiology.Heart rate variability standards Of measurement,physiogical interpretation and clinical use. Circulation,1996,939(5) :1043-1065
[9]戴嘉,吴寒,庄亚纯等.心率变异性在糖尿病心脏自主神经病变的临床意义.中国心血管杂志,1999,4(3):162-163
[10]许樟荣.糖尿病心血管自主神经病变[J].国外医学:内分泌分册,2004,24(2):84-86
[11]戴嘉,吴寒,沈华,等,老年糖尿病心率变异性测定.实用老年医学,2000,14(1):29-30
[12]杨香婷,潘守政,丁贯一,何伟玺,崔志红,郭树霞,Ⅱ型糖尿病患者心率变异性分析,临床医学,2001,21(2):2-4
[13]张复生,闫晓霞.心率变异性研究发展概况[J].心脏杂志,2000,12(2):122
[14] Kienzl MF,Ferguson DW,Briqette CL.Clinical hemodynamic and sympathetic neural correlate of heart rate variability in congestive heart failure(J).Am J Cardiol,1992,69:761
[15] Bemardi L,Ferrari MR,etal.Application of chaos theoy (approximate entropy) to detect cardiac qutonomic dysfunction in diabetes (abstact).Diabetologia.1995; 38(suppl):A241
[16]陈林,陈孟杨,邓玉莲,等,心率功率谱检测糖尿病患者心脏植物神经活性,附件医科大学学报,1995,29(2):129-130
[17]李永勤,耿琪,高方,邓亲恺,糖尿病自主神经病变的心率变异性分析,中国医学物理学杂志[J],2003,20(1):49-52
[18]毛福荣,何冬娟,自主神经功能检测对糖尿病早期自主神经病变的诊断价值[J],临床医学.2008,28(8):73-74
[19]曾欣,王欣,王伟,运动疗法改善2型糖尿病无症状性心肌缺血的研究[J].中国现代医生,2009,47(21):16-17
[20]凌丹芸,汤正义,王卫庆,抗氧化剂a-硫辛酸在糖尿病神经病变治疗中的作用[J].世界临床药物,2007,26(12):726-729
[21]张秀华,大剂量甲钴胺对糖尿病自主神经病变患者心率变异性的影响[J].实用医技杂志,2009,16(6):460-461
[22]刘伟芳,施丽芳,凯时联合弥可保治疗对糖尿病心脏自主神经病变患者心率变异性的影响,药物与临床,2010,7(24):51
[23]李伟红,胡春荣,李艳美,比索洛尔对糖尿病自主神经病变患者心率变异性的影响,心血管康复杂志,200817(4):396-397
[24]林令华,于军会,李志改,许金华,依帕司他治疗糖尿病自主神经病变疗效分析,医学信息,2006,19(4):634-635
[25]孙世萍,殷晓轩,宋丽绚,庄皎,崔文,糖心平合剂对糖尿病心脏自主神经病变心率变异指标的影响,中医学报,2010,25(147):294-296
[26]李智滨,宋炜,糖欣胶囊治疗2型糖尿病心脏自主神经病变临床观察(J),医学理论与实践。2005,19(10):1160
[27]翟玉民,中医治未病理论与糖尿病心脏病防治探讨,光明中医,2009,24(9):1636-1637
[28]韩文生,谭子新,阎英杰,刘福来,王淑珍,魏红,伊朝晖,中药益心胶囊治疗糖尿病心脏自主神经病变患者52例临床观察,中国实用医药,2010,5(13):164
[29]杨晓晖,糖尿病心脏病的中医分期辨治探讨,北京中医,2006,25(7):403-404
[30]丁书文,李晓,李运伦,陈守强,心系疾病中的热毒学说,中国医药学报,2004,19(10):592-593
[31]刘长山.黄芩苷对糖尿病患者红细胞醛糖还原酶活性及周围神经传导速度的影响[J].中国神经科学杂志,2002,18(2):555
[1]沈稚舟,吴松华,邵福源,等,糖尿病慢性并发症,上海医科大学出版社,1998;107
[2] Spallone V. Menzinger G. Autonomic Neuropathy: clinical and instrumental findings. Clin Neurosci,1997,4(6):346-358.
[3] Koistinen MJ.Prevalence of asymptomatic myocardial ischaemia in diabetic subjects[J].BMJ,1990,301(6743):92-95
[4] VeglioM,SivieriR,ChinagliaA,etal.QT interval prolongation and mortality in type 1 diabetic patients:a 5-year cohort prospective study.Neuropathy study group of the Italian society of the study of diabetes,Piemonte Affiliate[J].Diabetes Care,2000,23(9):1381-1383
[5]林少达,李碧慧,糖尿病心血管自主神经病变的诊治现状,中华临床医师杂志[J],2010,4(9):1473-1476
[6] Vinik AI,Maser RE,Mincheld BD,etal.Diabetic autonomic neuropathy.Diabetes Care,2003,26:1553-1579
[7]凌丹芸,汤正义,张炜,等,导致2型糖尿病心血管自主神经病变的主要危险因素及其对病情评估的价值[J].中华内科杂志,2006,45(10):815-819
[8]叶山东,糖尿病心血管自主神经病变的研究进展,新医学,2004,35(1):10-12
[9]王杨天,糖尿病性心脏自主神经病变的新进展,医学研究生学报,2006,19(9):845-847
[10] Pittenger GL,Malik RA,Burcus N,etal.Specific fiber deficits in sensorimotor diabetic polyneuropathy correspond to cytoxicity against neuroblastoma cells of sera from patients with diabetes[J].Diabetes Care,2001,24(8):1468-1475
[11]费立鹏.中国的精神卫生问题-21世纪的挑战和选择[J].中国神经精神疾病杂志,2004,30(1):1-10,;
[12]石其昌,章健民,徐方忠,等.浙江省15岁及以上人群精神疾病流行病学调查[J].中华预防医学杂志,2005,39(4):229-236
[13] Parker G,G ladstone G,Chee KT.Depression in the planet’s largestethnic group:the Chinese[J].Am JPsychiatry,2001,158:857-864.
[14]刘静芹,尹贺欣,刘凯,何晓蕊,糖尿病患者心脏自主神经病变相关因素研究,中国慢性病预防与控制[J],2008,16(4):371-373
[15]许樟荣,糖尿病心血管自主神经病变,国外医学内分泌学分册[J].国外医学内分泌学分册,2004,24(2):84-86
[16] Neil HAW:Epidemiology of diabetic autonomic neuropathy.In Autonomic Failure.Bannister R,Mathias CJ,Dds.Oxford Medical.1992;p683-697
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