Maintenance Hemodialysis Patients With Short-range Heart Rate Variability Change The Relationship Between Tcm Syndrome

ObjectiveThe aim of the study was to observe short-term heart rate variability and TCM syndromes on maintenance hemodialysis patients.Explore the relationship between short-term heart rate variability and TCM syndromes.Methods100maintenance hemodialysis patients were incorporated into effective cases which maintain the original subjects for the scheme treatment.Refer to the chronic renal failure syndrome diagnostic standard and symptoms grading quantitative table of the chinese herbal medicine clinical research guiding principle promulgated by the state drug administration in2002,set quantitative syndromes questionnaire.The patient’s generally information was needed too,such as gender,age,original disease,maintain hemodialysis time,frequency and so on. Collecting the patient’s5min short-term HRV indexes. Frequency domain and time domain information were directly gained by holter analysis software. The collected data was established to database by the SPSS19.0statistical software for analysis.Results1.In cases with deficiency syndrome undertaking maintenance hemodialysis,dim complexion, dry mouth and throat.weakness.coldness of limbs were the most common deficiency syndromes. In cases with excess syndrome undertaking maintenance hemodialysis, squamous and dry skin.dry stool,numbness of the limbs,greasy mouth were the most common excess syndromes. The analysis showed that94%of the patients had the syndrome of deficiency.Qi deficiency of the spleen and kidney syndrome was the majority type in the deficiency syndrome,followed by Yang deficiency of the spleen and kidney syndrome. The cases with pathogenic factors prevailing took91%of all the patients.In excess syndrome, blood-statis syndrome was the majority type,followed by damp-heat syndrome and damp-muddy syndrome. The research point out the deficiency of spleen and kidney and the complexity of deficiency and excess are the main mechanisms in hemodialysis patients.2.We compared the maintenance hemodialysis patient’s short-range HRV frequency domain index with the normal range.The results showed that the frequency domain index including TP.LF.HF had statistically significant difference between the patients and the normal range(P<0.01). The level of TP.LF.HF was significantly higher in hemodialysis patients with Qi deficiency of the spleen and kidney syndrome type compared with the patients with other TCM symptom type groups(P<0.05). The level of TP was significantly lower in hemodialysis patients with deficiency of Yin and Yang syndrome type compared with the other groupsOP<0.01). There is no statistically significant difference in the level of TPXF.HF among the rest TCM syndrome type groups.3.The level of TI,TRLF,VLF,HF,SDNN,LF/HF was significantly lower in32hemodialysis patients with diabetes complications compared with the rest68cases with diabetes.4.The patients with Yang deficiency of the spleen and kidney syndrome had lower LF/HF than the normal range(P<0.05). The patients with the deficiency of both Qi and Yin and the Yin deficiency of liver and kidney syndrome were merged into Yin deficiency syndrome. The level of LF/HF was significantly higher in patients with Yin deficiency syndrome type compared with the normal range (P<0.05). There is statistically significant difference in the level of LF/HF between the Yin deficiency syndrome and the Yang deficiency syndrome.Conclusion1.There was serious damage on autonomic nervous function in the maintenance hemodialysis patient’s, including the sympathetic nerve and parasympathetic nerve. It’s lower in the patients with diabetes complications.2.The autonomic nervous function of the patients in Qi deficiency of the spleen and kidney syndrome type was better than the other groups,while the patients in deficiency of Yin and Yang syndrome type had the poorest autonomic nervous function.3.The level of LF/HF was closely related to patient’s Yin and Yang syndrome. Yang deficiency group was lower than the normal range, while Yin deficiency group was higher. Yang deficiency patients had advantage on parasympathetic nerve,while the Yin deficiency patients had advantage on sympathetic nerve.