Sun T B, Yang C C H, Kuo T B J
Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
Diabet Med. 2006 Apr;23(4):360-6. doi: 10.1111/j.1464-5491.2006.01798.x.
There are relatively few effective methods to treat autonomic neuropathy in patients with diabetes mellitus. Our aim was to test the hypothesis that hyperbaric oxygen therapy may restore cardiac neural regulation dysfunction in diabetic individuals with foot complications.
We conducted a prospective randomized controlled study in patients with diabetic foot problems. Daily heart-rate variability analysis from 5-min electrocardiography was used to evaluate the temporal change of cardiac neural regulation. The experimental group consisted of 23 subjects exposed to hyperbaric oxygen therapy of 202.65 kPa for 90 min every Monday to Friday for 4 weeks (20 treatments). The control group consisted of 15 age-, sex- and disease-matched subjects who were not exposed to hyperbaric therapy. Patients with medical complications and failure of wound healing were excluded to eliminate possible confounding effects.
There was no significant difference in baseline R-R interval (RR), variance, high-frequency power (HF), low-frequency power (LF), and LF/HF ratio between the two groups. In the hyperbaric oxygen group there were significant increases in changes of RR (82.7 +/- 16.02 ms); variance 0.88 +/- 0.12 ln(ms2); HF 1.06 +/- 0.18 ln(ms2); and LF 0.87 +/- 0.15 ln(ms2) after the treatment. Measurements of tissue oxygen demonstrated significant increases in local tissue oxygenation in the hyperbaric oxygen group (53.0 +/- 2.6 mmHg) compared with the control group (27.5 +/- 3.1 mmHg), P < 0.05.
Hyperbaric oxygen therapy has a significant vagotonic effect, which is beneficial in improving cardiac neural regulation in patients with diabetic autonomic dysfunction.
治疗糖尿病患者自主神经病变的有效方法相对较少。我们的目的是验证高压氧疗法可恢复患有足部并发症的糖尿病个体心脏神经调节功能障碍这一假说。
我们对患有糖尿病足问题的患者进行了一项前瞻性随机对照研究。通过对5分钟心电图进行每日心率变异性分析，以评估心脏神经调节的时间变化。实验组由23名受试者组成，他们每周一至周五接受202.65 kPa的高压氧治疗，每次90分钟，共4周（20次治疗）。对照组由15名年龄、性别和疾病匹配但未接受高压氧治疗的受试者组成。排除有医学并发症和伤口愈合失败的患者，以消除可能的混杂效应。
两组之间的基线R-R间期（RR）、方差、高频功率（HF）、低频功率（LF）和LF/HF比值无显著差异。在高压氧组中，治疗后RR变化（82.7±16.02毫秒）、方差0.88±0.12 ln（毫秒²）、HF 1.06±0.18 ln（毫秒²）和LF 0.87±0.15 ln（毫秒²）均有显著增加。组织氧测量显示，与对照组（27.5±3.1 mmHg）相比，高压氧组局部组织氧合显著增加（53.0±2.6 mmHg），P<0.05。
高压氧疗法具有显著的迷走神经兴奋作用，有利于改善糖尿病自主神经功能障碍患者的心脏神经调节。
