Changes in Heart Rate Variability in Patients with Spleen-Qi Deficiency Syndrome

Many functional diseases are related to dysautonomia, and heart rate variability has been used to assess dysautonomia. However, heart rate variability has not been studied in Spleen-Qi deficiency syndrome (SQDS). Healthy volunteers (n = 37) and patients with SQDS (n = 67), recruited from the Clinic of the State University of Ecatepec Valley were included in the study. Outcome measures were average heart rate, standard deviation of the normal-to-normal heartbeat intervals, low frequency (LF), high frequency (HF) power, and the LF/HF ratio. Also, intestinal peristalsis, gastrointestinal symptoms (GSs), fatigue, and level of attention were measured. Standard deviation of the normal-to-normal heartbeat intervals (17 ± 2.3%) and HF (14 ± 3.1%) were lower in SQDS patients (17 ± 1.3%) than in healthy volunteers. SQDS patients had higher heart rate, LF power, LF/HF ratio, and fatigue scores (9.6 ± 1.12%, 16 ± 2.1%, 22 ± 3.8%, and 21 ± 4.1%). The fatigue correlated positively with the LF/HF ratio and negatively with HF power. The SQDS group had lower concentration performance (16.2 ± 1.9%) in the d2 test. The intestinal peristalsis showed a reduction (15 ± 1.3%) as compared with control. GS score and peristalsis correlated negatively with HF. Our results suggest that the pathology of SDQS could be associated with a low vagal tone which causes a decrease in peristalsis, increased fatigue, reduced attention, and appearance of GSs.     

Gastric Dysrhythmias and Transient Sleep Impairment in Healthy Subjects

Studies have shown that impaired sleep quality is associated with exacerbation of gastrointestinal problems. The aim of this study was to measure gastric myoelectrical activity and visceral perception to fullness before and after a water load in healthy volunteers with or without transient sleep impairment. Twenty-eight male subjects (mean age, 39.3 years; range, 14-58 years) were studied. The subjective sleep quality was measured by visual analogue scale (bad [0] to very good [100]. Gastric myoelectrical activity was recorded and analyzed before and after the subjects ingested water until full. Subjects were stratified into two groups, i.e., with impaired sleep quality (Group A [Gr-A]; n = 15; mean age, 35.1 years) and with fine sleep quality (Group B [Gr-B]; n = 13; mean age, 40.7 years). Gr-A subjects ingested less water (514 +/- 21 ml) compared to the Gr-B subjects (621 +/- 50 ml: P < 0.05). After ingestion of the water load, Gr-A had significantly less 2.5- to 3.75-cpm activity (28.0 +/- 4%) by 21-30 min and more tachygastric activity (28 +/- 2 and 30 +/- 4%) by 11-30 min compared with Gr-B (43 +/- 5, 20 +/- 2, and 18 +/- 2%, respectively; P < 0.05). There was a significant positive correlation between sleep quality and the percentage of power in the normal range by 21-30 min after the water load (r = 0.5, P < 0.01). In contrast, a negative correlation was observed between sleep quality and tachygastric activity by 11-20 min (r = -0.4, P < 0.05) and 21-30 min (r = -0.4, P < 0.05) after ingestion of water. Transient sleep impairment is associated with increases in gastric dysrhythmia and altered perception to gastric distension in response to the water load. The study provides a potential clue that transient sleep impairment might influence gastric myoelectrical functioning in healthy individuals.     

儿童青少年1型糖尿病患者胃动力调查结果分析

目的探讨不同病程1型糖尿病患儿胃动力变化及血糖对胃动力的影响。方法正常对照组（A组）24例。1型糖尿病组49例,其中B组为新诊断者28例,平均病程1.5个月;C组为病程3年以上者21例,平均病程6.3年。对上述对象做胃电图检查。糖尿病组进行钡条胃排空试验,同时测定空腹和餐后2h血糖。问卷调查消化道症状。结果问卷调查显示,B组仅1例有消化道症状（占3.6%）,C组有消化道症状10例（占47.6%）,两组差异有统计学意义（P=0.001）。B组有4例出现胃排空延迟,C组有1例,两组差异无统计学意义（P=0.54）。两组胃电图与正常对照组相比,餐前、餐后,胃窦、胃体振幅差异无统计学意义;B组胃体餐后频率低于A组（P〈0.01）;C组胃窦、胃体餐后频率均低于A组（P〈0.05）;B组胃窦餐前振幅低于C组（P〈0.05）。未发现血糖水平、糖化血红蛋白（HbA1c）与胃排空、胃电参数的相关性（P〉0.05）。结论糖尿病组尤其是长病程组消化道症状发生率显著高于正常对照组。儿童青少年1型糖尿病患者病程早期可见胃排空延迟,糖尿病患儿餐后胃电频率下降,提示儿童青少年1型糖尿病患者早期即可出现胃动力异常。     

Electrical activity from colon overlaps with normal gastric electrical activity in cutaneous recordings

The stability of EGG recordings is affected by a variety of artifacts. The aim of this study was to investigate possible overlapping of dominant frequencies in recorded cutaneous electrical activity arising simultaneously from the stomach and/or colon. Ten normal volunteers, eight posttotal colectomy patients, and four patients posttotal gastrectomy were studied. Fasting cutaneous recordings were obtained using four pediatric ECG electrodes attached to the abdominal surface. Electrical activity was recorded and digitally analyzed using custom-designed software. Spectral analysis after gastrectomy and colectomy showed persistence of power peaks in the gastric electrical activity range of frequency (2.5–3.75 cpm). In conclusion, noninvasively obtained colonic frequencies overlap EGG. This hypothesis is supported by the persistence of power peaks in the EGG range of frequency after gastrectomy and colectomy. Therefore, we conclude that contribution of electrical activity arising from the colon could substantially affect EGG recordings.     

脑卒中急性期空腹胃电图动态变化分析

目的观察脑卒中患者急性期空腹胃电图参数的动态变化,并探讨其相关发生机制。方法应用体表胃电图检测127例急性脑卒中患者入院24 h及入院1周时空腹胃电参数变化,并与34名健康对照组相对比。结果与正常组相比,脑卒中患者入院24 h胃窦及胃体部胃电振幅明显降低,入院1周时两部位胃电振幅则升高接近正常水平。胃窦及胃体部两不同时间的胃电频率与正常组相比无统计学意义。同时,脑出血患者入院24 h胃窦及胃体部的胃电振幅与正常组相比均明显降低（P〈0.05）,入院1周时已升高至正常水平。而脑梗死患者胃窦及胃体部两不同时间胃电振幅与正常组相比均无统计学意义。结论脑卒中患者急性期胃窦、胃体部的蠕动频率未见明显改变,而胃窦、胃体部的蠕动强度受到抑制,且不同性质的脑卒中类型对胃动力的影响亦不相同,其中脑出血患者胃窦、胃体部的蠕动强度降低尤为明显。     

穴位埋线结合免煎中草药颗粒治疗功能性消化不良临床观察

目的观察穴位埋线结合免煎中草药颗粒治疗功能性消化不良(FD)的效果。方法治疗组40例给予穴位埋线结合免煎中草药颗粒治疗;对照组40例给予奥美拉唑结合莫沙必利治疗,疗程均为8周。观察2组临床疗效及治疗前后胃电图变化。结果治疗后2组症状均较治疗前明显好转,治疗组治愈17例,显效13例,有效7例,无效3例,总有效率92%;对照组治愈7例,显效9例,有效12例,无效12例,总有效率70%,2组总有效率比较有显著性差异(P<0.05)。餐后正常慢波百分比治疗组治疗前为(42.87±21.32)%,治疗后为(54.46±19.38)%,治疗前后比较有显著性差异(P<0.05);对照组治疗前后无明显变化(P>0.05)。结论穴位埋线结合免煎中草药颗粒治疗FD患者有明显效果。     

Effects of Electroacupuncture at Different Points on Colorectal Distention-induced Changes in Blood Pressure, Electrogastrogram, Gastric Tension and Gastric Blood Flow

Objective: To investigate the specificity of the effects of electroacupuncture (EA) at different acupoints on gastric functional activity and gastric blood flow after colorectal distension (CRD) in the rat. Methods: Fifty Wistar rats were randomly divided into 5 groups: a control group, a Zusanli group, a non-point group, a Taichong group and a Neiguan group. Rats were anesthetized after 18 h of fasting, and a rat model of nociceptive blood pressure elevation and abnormal electrogastrogram (EGG) and gastric tension (GT) was prepared by gasbag-induced CRD. EA was given bilaterally, and its effects on gastric blood flow (GBF) of the arcus vasculosi of the greater omentum, blood pressure, EGG fast wave properties, and gastric smooth muscle tension (GT) were quantified. Results: CRD induced an increase in blood pressure that was significantly inhibited by EA at all points (all P<0.05), and the inhibitory effects were greater in the Zusanli and Neiguan groups compared to the non-point group (both P<0.05). CRD also caused reductions in GT and GBF, and in the amplitude, frequency and duration of EGG waves (all P<0.05). These effects were also reversed by EA. The effects of EA on EGG wave amplitude, GT, and GBF were superior in the Zusanli group compared to the Taichong group, Neiguan group, and the non-point group. Conclusion: EA significantly counteracted CRD-induced changes in blood pressure, GBF, EGG, and GT. The effects of stimulation at Zusanli (ST 36) were significantly greater compared to other points, indicating relative specificity of this acupoint.     

胰十二指肠切除术病人胃电图变化

通过对胰十二指肠切除术病人手术前后体表胃电图的研究，探讨手术对病人胃电及排空功能的影响。结果表明：保留幽门的胰十二指肠切除术病人术前６０％存在胃律紊乱及胃排空障碍，８０％此类病人术后出现胃电及胃排空异常。上述结果提示：对拟行保留幽门的胰十二指肠切除术病人术前胃电图检查表现胃节律紊乱及胃排空障碍者，术中应考虑胃及空肠造瘘。     

糖尿病胃肠植物神经病变的胃电图变化观察

用胃电图对糖尿病患者和正常人进行胃肠道植物神经功能检测对比，发现糖尿病组胃电图平均振幅（ＡＰ）和峰值频率（ＦＰ）均比正常组低，除胃窦ＡＰ外，均有显著性或非常显著性差异（Ｐ〈０．０５或Ｐ〈０．０１）；糖尿病有胃肠道症状组与无症状组比较，除胃体ＦＰ有显著差异外，均未显示出显著差异，并发现肢体神经肌电图与胃电图异常有其密切相关性。