Research Article Open Access

Heart Rate Variability as a Predictor of the Outcome of Treatment with Kampo Medicines that Include Bupleuri Radix(Saiko)

Abstract

Background: Kampo preparations that include Bupleuri Radix (saiko) are prescribed for neurosis, insomnia, and symptoms that have a strong association with autonomic nervous system disorders, especially for female patients. The aim of this study is to determine if any aspect of heart rate variability (HRV), as a surrogate marker of autonomic nervous system activity, is related to the outcome of treatment with Kampo medicines that include saiko, which would allow the determination of which patients these medicines would be most effective for. Methods: We retrospectively analyzed the data of 54 new female patients (≥20 years) who visited the Kampo Medicine Clinic of Kyushu University Hospital from January 2008 to June 2013 to determine which HRV values can be used to predict the outcome of treatment for patients receiving medicines that include saiko. The patients were divided into an effective group (27 patients) and an ineffective group (27 patients) based on the physician’s decision of effectiveness at two weeks after initiation of the drug. Results: VLF (0.003 Hz to 0.04 Hz)/TF of the effective group was significantly higher than that of the ineffective group (effective group: 0.35 ± 0.05, ineffective group: 0.30 ± 0.08, P=0.009). Conversely, ULF-1(0.0001 Hz to 0.0003 Hz)/TF of the effective group was significantly lower than that of the ineffective group (effective group, 0.21 ± 0.07; ineffective group, 0.27 ± 0.08, P=0.006). The cut-off values from ROC analysis were 0.35 for VLF/TF (sensitivity, 63%; Specificity, 78%; AUC, 0.71) and 0.24 for ULF-1/TF (Sensitivity, 78%; specificity, 56%: AUC. 0.71). Conclusion: Our data suggest that ULF-1/TF and VLF/TF have potential as predictors of the outcome of treatment for patients receiving medicines that include saiko.

Aya Murakami, Toshio Kubota, Daisuke Kobayashi, Yasuhiro Sumoto, Norihiro Furusyo, Shin- Ichi Ando, Mosaburo Kainuma and Takao Shimazoe

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