心律大師®腕式生理監視器可同時量測心跳,血壓,自律神經, 及心律不整,而且儀器上可儲存50次以上之測試結果,在臨床及居家應用上都是一個既方便又準確之醫療器材. 使用者在量測時應多重視形成趨勢之資料點,並注意其為改善或惡化方向. 下列臨床及居家應用,僅供心律大師®使用者參考,本公司強烈建議在醫師指示下使用.

心臟病/高血壓 (Cardiovascular Diseases, Hypertension)
通常症狀為HRV偏低及LF% 偏高. 臨床資料顯示,在經歷一次急性心肌梗塞( Acute Myocardial
Infarction)後,若其HRV仍偏低,則其再發或猝死之危險性大大提高. 急性心肌梗塞病人出院後,應定期量測 HRV,確認其逐漸恢復提升(6至12個月). 使用藥物治療心臟病或高血壓的病人應利用心律大師®腕式生理監視器定期監控病情及葯效.

參考文獻:

(1) Wolf MM, Varigos GA, Hunt D, Sloman JG. Sinus arrhythmia in acute myocardial infarction.Med J Aust. 1978;2:52-53.

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(2) Kleiger RE, Miller JP, Bigger JT, Moss AJ, and the Multicenter Post-Infarction Research Group. Decreased heart rate variability and its association with increased mortality afteracute myocardial infarction. Am J Cardiol. 1987;59:256-262

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(3) Restoration of heart rate turbulence by titrated beta-blocker therapy in patients with advanced congestive heart failure: positive correlation withenhanced vagal modulation of heart rate, J Cardiovasc Electrophysiol 2004 Jul;15(7):752-6  (ISSN: 1045-3873),Lin LY; Hwang JJ; Lai LP; Chan HL; Du CC; Tseng YZ; Lin JL,Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and National Taiwan University  Hospital, Taipei, Taiwan

過勞猝死 (Sudden Death)
熬夜,晝夜顛倒,菸酒咖啡過量,或長期處於高壓力狀況下,都有可能發生突如其來的死亡,也就是醫學上的猝死. 猝死之前最常見的症狀是心顫(即心跳急速加快),心律不整,心臟麻痺,心肌衰竭,及腦溢血. 患有心肌梗塞(Congested Heart Disease),心跳過快,或心律不整等疾病的人必須嚴加防患. 不少猝死病患平時並無任何徵候, 即使年輕人也可能發生. 醫學界現在認為,除了藉由過去病例分析外, HRV(即心率變異性 )突然降低是最好的預測指標. 忙碌的上班族應多利用心律大師®腕式生理監視器定期監控HRV. 若發現HRV偏低或逐漸降低,則應立刻休息.

參考文獻: (1) Prevalence and incidence of arrhythmias and sudden death in heart failure.
Heart Fail Rev 2002 Jul;7(3):229-42    (ISSN: 1382-4147)Cleland JG; Chattopadhyay S; Khand A; Houghton T; Kaye GC University of Hull, Castle Hill Hospital, Cottingham, Kingston-upon-Hull, HU16 5JQ

糖尿病 (Diabetes)
糖尿病患初期(甚至血糖仍在正常範圍內,例如飯前110-120 mg/dl)HRV便開始下降. 中期及末期可能併發神經壞死症( Diabetic Neuropathy),此時交感及副交感之細小纖維開始壞死,病人會出現站立眩暈(低血壓),心悸,盜汗,及肚瀉等自律神經失調症狀. 以心律大師®量測自律神經,會發現HRV偏離原有之基準線,治療效果也可依此判斷.

參考文獻:

(1) Ewing DJ, Martin CN, Young RJ, Clarke BF. The value of cardiovascular autonomic function tests: 10 years' experience in diabetes. Diabetes Care. 1985;8:491-498.

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(2) Relations between insulin sensitivity, fitness and autonomic cardiac regulation in healthy, young men.J Hypertens 2004 Oct;22(10): 2007-15    (ISSN: 0263-6352)
Reims HM; Sevre K; Fossum E; Hoieggen A; Mellem H; Kjeldsen SE Department of Cardiology, Ullevaal University Hospital, Oslo, Norway.

 

(3) The Association of Heart-Rate Variability With Cardiovascular Risk Factors and Coronary Artery Calcification, Diabetes Care,  June, 2001  by Helen M. Colhoun,  Darrel P. Francis,  Michael B. Rubens,  S. Richard Underwood,  John H. Fuller

 

(4)  “Researchers Find Heart Rate Variability Link to Metabolic Syndrome, a Major Heart Disease Risk “, http://www.emoryhealthcare.org/press_room/ehc_news/2004/Nov/Heart_Rate_Variability.html

憂鬱症 (Depression)



如果你持續兩個星期以上表現出以下五個或以上的症狀，你就需要就醫或拜訪其他心理健康家：
•        持續的悲傷、焦慮、或頭腦空白
•        睡眠過少或過多
•        體重減輕，食慾減退
•        失去活動的快樂和興趣
•        心神不寧或急躁不安
•        持續的對治療無反應的軀體症狀
•        注意力難以集中，記憶力下降，決策困難
•        疲勞或精神不振
•        感到內疚、無望或者自身毫無價值
•        出現自殺或死亡的想法

臨床上所說的憂鬱症不僅僅是“情緒沮喪”,而是一種醫學疾病,每年有上千萬的人患上這種疾病. 婦女患有憂鬱症的可能性是男性的兩倍. 患有其他疾病,比如心臟病、中風、癌症及糖尿病的患者憂鬱症的發病率更高.在HRV量測上,通常症狀為HRV偏低,及 LF%, LF/HF比值偏高. 文獻顯示許多西醫處方藥可以改善憂鬱症狀. 據估計,80％至90％的憂鬱症患者可以經專業治療而痊癒. 專業治療包括藥物療法和心理療法,也可以二者並用,此時可利用心律大師®追蹤療效.

參考文獻:

(1) Agelink MW; Boz C; Ullrich H; Andrich J, Relationship between major depression and heartrate variability. Clinical consequences and implications for

antidepressive treatment. Psychiatry Res 2002 Dec 15;113(1-2):139-49    (ISSN: 0165-1781)

 

(2) Agelink MW; Majewski T; Wurthmann C; Postert T; Linka T; Rotterdam S; Klieser E, Autonomic neurocardiac function in patients with major depression and effects of
antidepressive treatment with nefazodone. J Affect Disord 2001 Feb;62(3):187-98    (ISSN: 0165-0327)

 

(3) Changes in heart rate variability in response to treatment with electroconvulsive therapy J ECT 2004 Jun;20 (2):81-8     (ISSN: 1095-0680), Karpyak VM; Rasmussen KG; Hammill SC; Mrazek DA Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
 

(4) Relationship between major depression and heart rate variability. Clinical consequences and implications for antidepressive treatment. Psychiatry Res 2002 Dec 15;113(1-2):139-49    (ISSN: 0165-1781),Agelink MW; Boz C; Ullrich H; Andrich J
Department of Biological Psychiatry and Neuroscience, Evangl Clinics Gelsenkirchen, Ruhr-University of Bochum, Munckelstr. 27, D-45879, Gelsenkirchen, Germany


過敏性腸道症候群 (Irritable Bowel Syndrome)
什麼是過敏性腸道症候群(腸道激躁症)？其症狀是常常漲氣、噁心，有時腹絞痛,又交替著腹瀉或便秘,又查不出個所以然,它就是是屬於功能性胃腸疾病的一種. 功能性胃腸疾病是指一群會反覆發作,卻無法以解剖、結構病變和生化檢查異常來解釋的胃腸症. 這類疾病病人腸道的構造是正常的,但蠕動功能則失常, 可利用藥物(如Alosetron HCl,商品名Lotronex)來改善狀況.
臨床文獻顯示此類病人之LF% 及LF/HF比值偏高,建議病人利用心律大師®監控病情及追蹤療效.

參考文獻:

(1) http://www2.mmh.org.tw/gi/health/ibs.htm

 

(2) Elsenbruch S; Orr WC, Diarrhea- and constipation-predominant IBS patients differ in postprandial autonomic and cortisol responses. Am J Gastroenterol 2001 Feb;96(2):460-6.

 

(3) Lu CL; Zou X; Orr WC; Chen JD, Postprandial changes of  sympathovagal balance measured by heart rate variability, Dig Dis Sci 1999 Apr;44(4):857-61.

癌症 (Cancer)
癌症治療過程(放射線,西藥,中藥)極可能破壞自律神經組織及免疫力.醫學論文顯示治療乳癌的化療藥物具有破壞自律神經組織及降低HRV現象. 建議利用心律大師定期量測.

參考文獻:

(1)Impairment of heart rate variability during paclitaxel therapy. Cancer 2000 May 1;88(9):2149-53    (ISSN: 0008-543X),Ekholm EM; Salminen EK; Huikuri HV; Jalonen J; Antila KJ; Salmi TA; Rantanen VT, Department of Obstetrics and Gynecology, University of Turku, Finland.

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(2) Immediate effects of docetaxel alone or in combination with epirubicin on cardiac function in advanced breast cancer. Anticancer Res 2003 Mar-Apr;23(2C):1869-73    (ISSN: 0250-7005), Syvanen K; Ekholm E; Anttila K; Salminen E,Department of Oncology, Turku University Hospital, Finland, Kiinamyllynkatu 4-8, Fin-00520 Turku,Finland.

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(4) Vagal changes following cancer chemotherapy: implications for the development of nausea.Psychophysiology 2000 May;37(3):378-84    (ISSN: 0048-5772), Morrow GR; Andrews PL; Hickok JT;Stern R, Behavioral Medicine Unit, University of Rochester School of Medicine and Dentistry, New York,
USA.

減肥 (Diet)
減肥藥之副作用可能造成自律神經組織破壞. 有些雖然毒性較低,但可能造成交感神經及新陳代謝過盛. 另外,若節食過度造成營養不良,極可能發生心律不整甚至猝死. 值得慶賀的是若依靠運動及適度飲食控制來降低體重,則自律神經與心血管系統功能均會加強,而HRV也會升高. 本網站提供免費身材纖細指數測試.進行減肥時應特別注意HRV, LF%,及LF/HF比值是否偏離自己原有之基準線.

參考文獻:

(1) Neuropeptide Y in obese women during treatment with adrenergic modulation drugs. Med Sci Monit 2001 May-Jun;7(3):403-8    (ISSN: 1234-1010)Zahorska-Markiewicz B; Obuchowicz E; Waluga M; Tkacz E; Herman ZSDepartment of Pathophysiology, Silesian Medical University, ul. Medykow 18, 40-752 Katowice, Poland.

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(2)Changes of autonomic cardiac profile after a 3-week integrated body weight reduction program in severely  obese patients. J Endocrinol Invest 2003 Feb;26(2):138-42    (ISSN: 0391-4097), Facchini M; Malfatto G;Sala L; Silvestri G; Fontana P; Lafortuna C; Sartorio A,Division of Cardiology, Italian Institute for Auxology,IRCCS, Milan, Italy.

 

(3) Efficacy and safety of ephedra and ephedrine for weight loss and athletic
performance: a meta-analysis. JAMA 2003 Mar 26;289(12):1537-45    (ISSN: 0098-7484)
Shekelle PG; Hardy ML; Morton SC; Maglione M; Mojica WA; Suttorp MJ; Rhodes SL; Jungvig L; Gagne J, Southern California Evidence-based Practice Center-RAND, Santa Monica, Calif 90407-2138, USA

 

(4)Pharmacologic agents for weight reduction.J Gend Specif Med 2002 Sep-Oct;5(5):16-21    (ISSN: 1523-7036), Haller C; Schwartz JB  Division of Clinical Pharmacology, University of California, San Francisco, USA.


失眠 (Insomnia)
腦力使用過當,煩惱多,壓力大,都可能造成交感神經過盛及併發失眠症. 許多失眠藥若長期使用會造成自律神經失調. 最有效的方法是降低壓力(事情永遠是做不完的啦!)及減少煩惱(天塌下來了還有高個子的人頂!).  不管是否服藥,監控時應特別注意HRV是否太低及LF%及LF/HF比值是否偏高.

參考文獻:

(1) Situational insomnia: consistency, predictors, and outcomes.
Sleep 2003 Dec 15;26(8):1029-36    (ISSN: 0161-8105), Bonnet MH; Arand DL Dayton Department of Veterans Affairs Medical Center, Wright State University, OH 45428, USA.

 

(2)Hilton MF; Bates RA; Godfrey KR; Chappell MJ; Cayton RM, Evaluation of frequency and time-frequency spectral analysis of heart rate variability as a diagnostic marker of the sleep apnoea syndrome, Med Biol EngComput 1999 Nov;37(6):760-9

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(3) A review of the evidence for the efficacy and safety of trazodone in
insomnia. J Clin Psychiatry 2005 Apr;66(4):469-76    (ISSN: 0160-6689), Mendelson WB, University of Chicago, Chicago, IL, USA. (4) Heart rate variability during sleep and the early development of posttraumatic stress disorder, Biol Psychiatry 2004 May 1;55(9):953-6   (ISSN: 0006-3223), Mellman TA; Knorr BR; Pigeon WR; Leiter JC; Akay M, Department of Psychiatry, Dartmouth Medical School, Lebanon, New Hampshire, USA.

女性更年期荷爾蒙治療 (Hormone Replacement Therapy)
美國國家衛生部(NIH)最近完成之大型荷爾蒙藥物人體試驗(H.E.R.S.)證實服用雙重女性荷爾蒙
(estrogen/progesterone combined)過久,會提高罹患心臟病及癌症之危險性. 於此同時HRV臨床研究也證實不少服用女性荷爾蒙病人其HRV有下降趨勢,然而只服用Estrogen的病人則沒有此趨勢. 建議正服用荷爾蒙之女性應定期使用心律大師量測自律神經活性,並特別注意HRV及HF%是否偏低, LF%是否偏高.

參考文獻:

(1) Writing Group for the Women's Health Initiative Investigators: Risks and benefits of estrogen plus progestin in healthy postmenopausal women. principal results from the Women's Health Initiative randomized controlled trial. JAMA 2002; 28:321-333

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(2) Christ M; Seyffart K; Tillmann HC; Wehling M,Hormone replacement in postmenopausal women: impact of progestogens on autonomic tone and blood pressure regulation. Menopause 2002 Mar-Apr;9(2):127-36

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(3) Christ M; Seyffart K; Wehling M,Attenuation of heart-rate variability in postmenopausal women on progestin-containing hormone replacement
therapy. Lancet 1999 Jun 5;353(9168):1939-40

(4) Yildirir A; Kabakci G; Yarali H; Aybar F; Akgul E; Bukulmez O; Tokgozoglu L; Gurgan T; Oto A,
Effects of hormone replacement therapy on heart rate variability in postmenopausal women, AnnNoninvasive Electrocardiol 2001 Oct;6(4):280-4.

運動治療 (Exercise Therapy)
醫學文獻證實長期性有規律的運動,可以升高HRV,降低心率,及改善自律神經失調. 對於大多數交感神經過盛(HRV偏低; LF/HF偏高)的文明人,此消息實為一大福因. 只要立下運動計畫,並確實執行,其實身心健康不一定要靠藥物; 對於少數副交感神經過盛(LF/HF及HF%偏低)或心臟打血功能不佳(即心輸出太低;通常其HRV偏低但LF/HF正常;中醫師稱此為陰陽俱虛)的人,應選擇能讓心跳加速的運動(最好超過每分鐘120次),長期下來便可將自律神經平衡回來(LF/HF在1.0 -1.5之理想狀態).  記得用心律大師®來監控身心恢復的進度.

參考文獻:

(1) Levy WC; Cerqueira MD; Harp GD; Johannessen KA; Abrass IB; Schwartz RS; Stratton JR,
Effect of endurance exercise training on heart rate variability at rest in healthy young and older men, Am JCardiol 1998 Nov 15;82(10):1236-41.

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(2) Davy KP; De Souza CA; Jones PP; Seals DR, Elevated heart rate variability in physically active young and older adult women. Clin Sci (Lond) 1998 Jun;94(6):579-84  

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(3)Eight weeks of moderate-intensity exercise training increases heart rate variability in sedentary postmenopausal women. Am Heart J 2004 May;147(5):e21    (ISSN: 1097-6744), Jurca R; Church TS;Morss GM; Jordan AN; Earnest CP, The Cooper Institute, Dallas, Tex 75230, USA

 

(4) Effects of exercise
on heart rate variability: inferences from meta-analysis.Med Sci Sports Exerc 2005 Mar;37(3):433-9    (ISSN: 0195-9131), Sandercock GR; Bromley PD; Brodie
DA, Research Centre for Health Studies, Buckinghamshire Chilterns University College, Buckinghamshire,UNITED KINGDOM


中藥治療 (Herbal Medicine)
許多良好的中藥配方,對於西醫診斷不出之自律神經失調症候群特別具有療效. 中醫師診斷上所依據的虛、實、陰、陽等徵候與自律神經系統之交感與副交感有高度關聯性. 自然療法,另類療法,與整合醫學常用到的能量療法,可以說是一語道破了自律神經活性之重要性. 有了心律大師®,便可科學客觀地監控療效. 監控的重點是心律大師所量测的八個生理參數是否逐漸歸向正常.

參考文獻:

(1) 利用心率變異數評估中醫陰陽體質之研究, Journal of Medical and Biological Engineering,
22(S): s91— s98, 陳敬修,邱創乾,宋慶龍,張永賢,中國醫藥學院中國醫學研究所, 逢甲大學 自動控制工程研究所,統計暨精算研究所

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(2) Effects of Korean traditional herbal remedy on heart rate variability: linear
and nonlinear analysis. Int J Neurosci 2005 Mar;115(3):393-403    (ISSN: 0020-7454), Lee MS; Shin BC;Rim YH; Woo WHProfessional Graduate School of Oriental Medicine, Wonkwang University, Iksan, Republic of Korea.

 

(3)Evaluation of modulations in heart rate variability caused by a composition of herbal extracts.Arzneimittelforschung 2000 May;50(5):420-4    (ISSN: 0004-4172), Cysarz D; Schurholz T; Bettermann H;Kummell HC, Department of Clinical Research, Community Hospital Herdecke, Germany.


氣功/太極拳/針灸治療 (Chi, Tai-Chi, Acupuncture)
東西方文獻都顯示常練氣功或太極拳的人,可以提高HRV及 HF%( 並降低LF%),針灸治療也有類似效
果,對於提升副交感神經功能助益頗大. 不管是初習者或師傅指導學員,都可利用心律大師®來觀察效果.

參考文獻:

(1)心律變異度研討會論文摘要集, 台北榮總教學研究部主辦, 2003年四月二十六日

 

(2)The effect of wai tan kung on autonomic nervous modulation in the elderly, J Biomed Sci 2003 Nov-Dec;10(6 Pt2):697-705    (ISSN: 1021-7770), Lu WA; Kuo CD;Institute of Traditional Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.

 

(3) 以心率變異性分析探討針刺非穴位與自律神經的關係,
J Chin Med 13(1): 1-9, 2002, 劉定明,張永賢,林昭庚,邱創乾,紀美智,李燊銘, 中國醫藥學院中國醫學研究所, 逢甲大學 自動控制工程研究所, 統計暨精算研究所

 

(4) Effect of magnitopuncture on sympathetic and parasympathetic nerve activities in healthy drivers--assessment by power spectrum analysis of heart rate variability. Eur J Appl Physiol 2003 Jan;88(4-5):404-10 Li Z; Jiao K; Chen M; Wang C Shanghai Jiaotong
University, Shanghai 200030, China.

 

(5) Effect of sensory stimulation (acupuncture) on sympathetic and
parasympathetic activities in healthy subjects. J Auton Nerv Syst 2000 Feb 14;79(1):52-9   (ISSN: 0165-1838), Haker E; Egekvist H; Bjerring P, Department of Physical Therapy, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.

按摩治療 (Massage Therapy)
緊張疲憊的身軀,經由全身按摩,可幫助睡眠,恢復體力. 按摩後再用心律大師®確認,一定可以避免因長期緊張及壓力所引發之身心疾病.觀察重點是HRV是否恢復升高, 過高的LF/HF比值是否逐步下降.

參考文獻:

(1)The short-term effects of myofascial trigger point massage therapy on cardiac autonomic tonein healthy subjects. J Adv Nurs 2002 Feb;37(4):364-71    (ISSN: 0309-2402), Delaney JP; Leong KS;Watkins A; Brodie D, Wirral Metropolitan College, Department of Medicine, Clinical Sciences Centre,University Hospital Aintree, Liverpool, UK.

 

(2) The mechanisms of massage and effects on performance,
muscle recovery and injury prevention. Sports Med 2005;35(3):235-56    (ISSN: 0112-1642), Weerapong P;Hume PA; Kolt GS, New Zealand Institute of Sport and Recreation Research, Division of Sport andRecreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland,New Zealand.

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(3) Energy healing training and heart rate variability; energy healing: an alternative explanation for efficacy attributed to massage therapy; economic evaluation in complementary and alternative medicine; J Altern Complement Med 2005 Jun;11(3):391-6     (ISSN: 1075-5535), Burleson KO; Schwartz GE; Murphy DG; Laidlaw TM; Pirrone-Novel C; Hulme C, University of Arizona, Tucson, AZ.