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目的了解帕金森病自主神经系统(PD-ANS)功能障碍中医证型与交感神经皮肤反应(SSR)及心率变异性(HRV)变化的相关性。方法选择104例PD-ANS功能障碍患者为观察组,50例正常体检者为对照组。分别检测SSR及HRV,比较组间的差异性。同时进行证候分布规律调查,分析PD-ANS功能障碍患者中医证型与SSR和HRV水平之间的关系,及其中医单证分布规律。结果观察组上肢潜伏期、下肢潜伏期均较对照组延长,上肢波幅、下肢波幅均较对照组降低,观察组SDNN、SDANN、r MSSD、LF、HF和LF/HF明显低于对照组(P<0.05,P<0.01);与风证、气虚证及瘀证患者相比,痰证、热证及髓海不足证PD-ANS功能障碍患者上肢及下肢潜伏期明显延长,上肢及下肢波幅明显降低;痰证、热证及髓海不足证PD-ANS功能障碍患者SDNN、SDANN、LF和LF/HF明显升高,r MSSD和HF明显降低(P<0.05)。结论患者潜伏期延长,波幅缩短,SDNN、SDANN、r MSSD、LF、HF和LF/HF降低可能是PD-ANS功能障碍发生的危险因素;髓海不足,痰热互结是PD-ANS功能障碍发病的主要病机。
Objective To investigate the relationship between TCM syndromes and sympathetic skin reaction (SSR) and heart rate variability (HRV) in Parkinson’s disease autonomic nervous system (PD-ANS) dysfunction. Methods 104 patients with PD-ANS dysfunction were selected as observation group and 50 normal subjects as control group. SSR and HRV were detected, the differences between groups were compared. At the same time, the distribution of syndromes was investigated, and the relationship between TCM syndromes and SSR and HRV levels in patients with PD-ANS dysfunction and the distribution of TCM documents were analyzed. Results The latency of upper limbs and latency of lower extremities in the observation group were longer than those in the control group, while the amplitude of upper extremities and lower extremity amplitude were lower than those in the control group. The SDNN, SDANN, r MSSD, LF, HF and LF / HF in the observation group were significantly lower than those in the control group , P <0.01). Compared with patients with wind syndrome, qi deficiency syndrome and stasis syndrome, the latency of upper extremity and lower extremity in patients with PD-ANS dysfunction was significantly prolonged and the amplitude of upper extremity and lower extremity was significantly decreased in sputum syndrome, phlegm syndrome, Syndrome, heat syndrome and marrow failure in patients with PD-ANS dysfunction SDNN, SDANN, LF and LF / HF increased significantly, r MSSD and HF decreased significantly (P <0.05). Conclusions Patients with prolonged latency, shortened amplitude, and decreased SDNN, SDANN, rMSSD, LF, HF, and LF / HF may be risk factors for PD-ANS dysfunction; dysplastic marrow and phlegm- The main pathogenesis.