Study On Relationship Between TCM Syndrome Of Unstable Angina And Heart Rate Variability And Levels Of Inflammatory Factors

Objective: To investigate the relationship between the Traditional Chinese Medicine(TCM) syndrome-types of unstable angina(UA) and heart rate variability(HRV) and serum levels of inflammatory factors in UA patients.Methods: Selecting patients with UA according to criterion of diagnose and TCM syndromes differentiation-classification from “The principle in clinic study of TCP(tryline)”, and choose 21 UA patients with phlegm-heat-blood stasis syndrome(PHBS), and 19 UA patients with deficiency of both qi and yin(DBQY) syndrome. Besides, 20 healthy people were included into the control group. HRV of subjects were assessed by 24 h Holter ECG monitoring. Serum levels of hypersensitive C reaction protein(hs-CRP) and interleukin-6(IL-6) were measured in all UA patients. Correlation analyses were conducted on the natural logarithms of hs-CRP and IL-6 to evaluate their association with SDNN and RMSSD.Results: UA patients with PHBS syndrome and DBQY syndrome had lower HRV compared with the healthy people. RMSSD and HF which reflect the vagal nerve tone in patients with DBQY syndrome were lower than patients with PHBS syndrome, whereas patients with PHBS syndrome had higher LF/HF than patients with DBQY syndrome. Comparisons of hs-CRP and IL-6 levels between the two different symdromes showed no statistically significant difference. Additionally, UA patients with the highest level of hs-CRP(>3mg/L) had the lowest SDNN, RMSSD and HF. SDNN negatively correlated with Ln hs-CRP(Beta=-0.408, P=0.009) and Ln IL-6(Beta=-0.670, P<0.001).Conclusion: Different degree of injury in sympathetic nerve and vagal nerve system is associated with syndrome differentiation of TCM in the development of UA. Patients with PHBS syndrome present the excitatory trend of sympathetic nerve, while patients with DBQY syndrome have more severe impaired cardiac autonomic innervations than the patients with PHBS syndrome, especially the vagal nerve. Reduction of HRV parameters are correlated with increased levels of inflammatory factors in patients with UA, and the autonomic nervous system dysfunction, especially the overexcited sympathetic nervous system is associated with inflammation in the pathological process of UA. It indicates that restore the autonomic nerve system balance with TCM may help alleviating the inflammatory reaction in the process of coronary heart disease.