Stress (스트레스연구)

The Korean Society of Stress Medicine (대한스트레스학회)
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Role of the Baseline Heart Rate Variability to the Effect of the Huanglian-Jie-Du Granule in Hwa-Byung Patients: Supplementary Analysis from the Randomized Trial Comparing Huanglian-Jie-Du Granule and Placebo for Hwa-Byung

화병 환자의 심박변이도 차이에 따른 황련해독탕의 효과: 화병에 대한 무작위 대조 비교임상시험 결과의 추가 분석

  • Choi, Yu-Jin (Department of Neuropsychiatry, Kyung Hee University Korean Medicine Hospital) ;
  • Cho, Seung-Hun (Department of Neuropsychiatry, Kyung Hee University Korean Medicine Hospital)
  • 최유진 (경희대학교 한방병원 신경정신과) ;
  • 조성훈 (경희대학교 한방병원 신경정신과)
  • Received : 2018.11.08
  • Accepted : 2018.12.04
  • Published : 2018.12.31
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Abstract

Background: The purpose of the study was to explore whether the effect of Huanglian-jie-du granule depends on the baseline heart rate variability in patients with Hwa-byung. Methods: We used the supplementary data from a randomized, double-blind, placebo-controlled trial of Huanglian-jie-du granule for Hwa-byung patients. Study drugs were taken orally three times per day for one week. Heart rate variability was measured three times; before the treatment, after the treatment, and month follow-up period. Spearman's rho test was done to explore the role of the baseline heart rate variability to the effect of Huanglian-jie-du granule. Results: Baseline low frequency power of heart rate variability was negatively correlated with the reduction of the insomnia severity index in experimental group (r=-0.493 p=0.02). Also, Huanglian-jie-de granule significantly decreased the low frequency power of heart rate variability in patients with Hwa-byung compared to placebo (mean difference 266 [95% CI: 29~503], p=0.028). In Hwa-byung symptoms, stuffy, pushing up in the chest, and flush of anger were correlated with low frequency power of heart rate variability (p=0.010, p=0.000, and p=0.016, respectively). Conclusions: The effect of the Huanglian-jie-de granule for insomnia seems to be lower when the baseline low frequency power of heart rate variability is higher in Hwa-byung patients. Also, Huanglian-jie-de granule is likely to decrease the sympathetic activity in patients with Hwa-byung. Measurement of heart rate variability may be the useful to understand the state of Hwa-byung patients.

화병은 뚜렷한 스트레스 사건과 관련되어 가슴의 답답함, 열감, 치밀어 오름, 억울하고 분한 감정 등이 나타나는 증후군이다. 본 논문에서는 화병에 대한 황련해독탕의 임상시험 결과를 교감신경의 활성도를 반영한다고 알려져 있는 심박변이도의 저주파(0.04~0.15 Hz) 영역 값을 중심으로 분석하여 다음과 같은 결과를 얻었다. 첫째, 황련해독탕 시험군에서 초기 심박변이도 저주파 값이 클수록 불면 증상의 개선 정도가 작게 나타났다. 둘째, 위약과 비교했을 때, 황련해독탕은 복용 7일 후 심박변이도 저주파 값을 유의하게 감소시켰다. 셋째, 화병 증상 중 가슴이 답답함, 치밀어 오름, 분노가 심박변이도 저주파 값과 유의미한 상관성이 있었다. 이를 바탕으로 심박변이도는 화병 환자를 평가할 때 유용할 것이라고 기대된다.

Keywords

Acknowledgement

Supported by : Korea Health Industry Development Institute (KHIDI)

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