参麦注射液对不同中医证型冠心病患者心电图改变的影响
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R541.4

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浙江省中医药科技计划项目(2014ZB124)


Effect of Shenmai Injection on Electrocardiogram Changes in Patients with Coronary Heart Disease of Different Chinese Medicine Syndrome Types
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    摘要:

    目的:探究参麦注射液对不同中医证型冠心病患者心电图改变的影响情况。方法:将采用参麦注射液治疗的 271 例冠心病患者,按中医辨证理论,分为 4 个中医组:72 例心肾阴虚组,69 例痰浊痹阻组,56 例心血痹阻组,74 例气阴两虚组;随机选取同时期单纯采用西医治疗的 67 例冠心病患者作为对照组。对比 5 组治疗前后心电图校正最小 QT 间期(QTcmin)、校正最大 QT 间期 (QTcmax) 和校正 QT 间期离散度 (QTcd);校正最小 JT 间期 (JTcmin)、校正最大 JT 间期 (JTcmax) 和校正 JT间期离散度 (JTcd);房室传导阻滞例数;缺血型 T 波例数;ST 段异常例数;测量 V1 导联 P 波的负向波振幅及宽度的乘积(PTF-V1)≤-0.04 mm · s 的例数。结果:5 组治疗后,QTcmin、QTcmax 及 QTcd 指标比较,差异有统计学意义(P<0.05);气阴两虚组相比对照组、心肾阴虚组、心血痹阻组和痰浊痹阻组降低;4 个中医组 QTcd 低于对照组,差异有统计学意义 (P< 0.05)。5 组治疗后,JTcmin、JTcmax 及 JTcd 指标相互比较,差异有统计学意义 (P<0.05);气阴两虚组相比对组、心肾阴虚组、心血痹阻组和痰浊痹阻组降低;4 个中医组 JTcd 明显低于对照组,差异有统计学意义(P<0.05)。5 组治疗后,房室传导阻滞、PTF-V1≤-0.04 mm · s 发生率比较,差异有统计学意义 (P<0.05);气阴两虚组低于对照组、心肾阴虚组,差异有统计学意义 (P<0.05)。结论:参麦注射液可以有效降低不同中医证型冠心病心电图 QTcmin、QTcmax、QTcd、JTcmin、JTcmax 和 JTcd指标,降低房室传导阻滞和 PTF-V1≤-0.04 mm·s 的发生例数,对气阴两虚型改善效果尤为显著。

    Abstract:

    Abstract:Objective:To discuss the effect of Shenmai injection on electrocardiogram changes in patients with coronary heart disease of different Chinese medicine syndrome types. Methods: According to the theory of Chinese medicine syndrome differentiation, a total of 271 cases of patients with coronary heart disease who were treated with Shenmai injection were divided into four groups of Chinese medicine:the group of heart-kidney yin deficiency(72 cases),the group of phlegm- turbidity obstruction(69 cases),the group of heart blood obstruction(56 cases),and the group of qi-yin deficiency (74 cases). A total of 67 cases of patients with coronary heart disease who were given simple western medicine at the same period were randomly selected as the control group. Before and after treatment,minimum corrected QT interval(QTcmin), maximum corrected QT interval(QTcmax),and corrected QT interval dispersion(QTcd) of electrocardiogram were compared in the five groups; minimum corrected JT interval(JTcmin), maximum corrected JT interval(JTcmax), and corrected JT interval dispersion(JTcd) were compared in the five groups;the number of cases of atrioventricular block,ischemic T wave, and abnormal ST segment was compared in the five groups. PTF-V1 was defined as the product of the duration and amplitude of the P-wave during the negative phase shown in lead V1. The number of cases of PTF-V1≤-0.04 mm·s was measured. Results: After treatment, there was significant difference being found in the comparison of indexes including QTcmin, QTcmax, and QTcd among the five groups(P<0.05). After treatment, the QTcmin, QTcmax, and QTcd in the qi- yin deficiency group were decreased when compared with those in the control group as well as the groups of heart-kidney yin deficiency,heart blood obstruction,and phlegm- turbidity obstruction;the QTcd in the four groups of Chinese medicine were lower than that in the control group,the difference being significant(P<0.05). After treatment,there was significant difference being found in the inter-comparison of indexes including JTcmin,JTcmax,and JTcd among the five groups(P< 0.05). After treatment,JTcmin,JTcmax,and JTcd in the qi- yin deficiency group were decreased when compared with those in the control group as well as the groups of heart- kidney yin deficiency, heart blood obstruction, and phlegmturbidity obstruction;JTcd in the four groups of Chinese medicine were significantly lower than that in the control group,the difference being significant(P<0.05). After treatment,there was significant difference being found in the comparison of the incidence of PTF- V1≤-0.04 mm·s and atrioventricular block among the five groups(P<0.05);the above incidence in the group of qi- yin deficiency was lower than those in the control group and the group of heart- kidney yin deficiency, the difference being significant(P<0.05). Conclusion:For coronary heart disease of different Chinese medicine syndrome types, Shenmai injection can effectively decrease indexes of electrocardiogram, namely, QTcmin, QTcmax, QTcd, JTcmin, JTcmax and JTcd,and reduce the number of cases of atrioventricular block and PTF-V1≤-0.04 mm·s,which has significant improvement on qi-yin deficiency type.

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赵凤娟,黄伟刚,俞梅,何伟明.参麦注射液对不同中医证型冠心病患者心电图改变的影响[J].新中医,2020,52(22):63-66

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  • 在线发布日期: 2020-11-27
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