通痹舒心颗粒对ACS伴焦虑抑郁病人hs-CRP、NT-proBNP及心率变异性的影响
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摘要
目的观察通痹舒心颗粒对急性冠脉综合征(ACS)伴焦虑抑郁病人高敏C反应蛋白(hs-CRP)、N末端B型脑钠肽原(NT-proBNP)及心率变异性(HRV)的影响。方法将符合纳入标准的90例病人按随机数字表法分为试验组和对照组,各45例。两组均遵照指南予以基础治疗并进行情志干预,治疗组在此基础上加服通痹舒心颗粒,每次1包,每日2次,分早晚2次冲服。两组病人均连续干预治疗12周。分别在入院时、第4周、第12周按照汉密顿焦虑量表(HAMA)及汉密顿抑郁量表(HAMD)进行评分,在入院及第12周时分别进行hs-CRP、NT-proBNP及心率变异性测定,观察其变化情况。结果治疗后4周时,两组HAMD、HAMA评分与入院时比较有明显降低,差异有统计学意义(P<0.05),试验组与对照组治疗后HAMD、HAMA评分比较有明显降低,差异有统计学意义(P<0.05);治疗后12周时,两组hs-CRP、NT-proBNP较治疗前明显下降,差异有统计学意义(P<0.05);治疗后两组间hs-CRP、NT-proBNP比较差异有统计学意义(P<0.05);与治疗前比较,两组干预治疗后全程相邻窦性心搏间期之差的均方根值(RMSSD)、全部相邻的窦性心搏间期之差大于50 ms的心搏数占总的窦性心搏间期个数百分比(PNN50%)及高频功率(HF)增高,低频功率(LF)、低频高频谱功率比值(LF/HF)下降,差异均有统计学意义(P<0.05),且治疗后试验组HRV指标均明显优于对照组(P<0.05)。结论通痹舒心颗粒能降低急性冠脉综合征伴焦虑抑郁病人HAMD、HAMA评分和hs-CRP、NT-proBNP测定值,改善心率变异性。
Objective To observe the effects of Tongbi Shuxin granule( TSG) on high-sensitivity C-reactive protein( hs-CRP),N-terminal pro B-type natriuretic peptide( NT-proBNP),heart rate variability( HRV) in patients with acute coronary syndrome( ACS) accompanied by anxiety and depression. Methods Ninety patients with ACS accompanied by anxiety and depression were randomly divided into two groups according to the random number table method: The control group(n = 45) treated with routine treatment plus emotional intervention,and the treatment group(n = 45) treated with routine treatment,emotional intervention plus TSG for 12 weeks. The scores of Hamilton Anxiety Scale( HAMA) and the Hamilton Depression Scale( HAMD) were evaluated at admission,4th week,12 th week. The levels of hs-CRP,NT-proBNP and HRV were measured at admission and 12 th week. Results After treatment,the scores of HAMA and HAMD were decreased,which were lower than that in control group(P < 0. 05). The scores of HAMA and HAMD were decreased,which were lower than that in control group(P <0. 05). The levels of hs-CRP and NT-proBNP were decreased at 12 th week,which were lower than that in control group(P < 0. 05). After treatment,RMSSD,PNN 50% and HF increased while LF and LF / HF decreased,which were better than that in control group(P < 0. 05).Conclusion TSG can reduce the scores of HAMA and HAMD and the levels of hs-CRP and NT-proBNP,improve HRV in patients with ACS accompanied by anxiety and depression.
Objective To observe the effects of Tongbi Shuxin granule( TSG) on high-sensitivity C-reactive protein( hs-CRP),N-terminal pro B-type natriuretic peptide( NT-proBNP),heart rate variability( HRV) in patients with acute coronary syndrome( ACS) accompanied by anxiety and depression. Methods Ninety patients with ACS accompanied by anxiety and depression were randomly divided into two groups according to the random number table method: The control group(n = 45) treated with routine treatment plus emotional intervention,and the treatment group(n = 45) treated with routine treatment,emotional intervention plus TSG for 12 weeks. The scores of Hamilton Anxiety Scale( HAMA) and the Hamilton Depression Scale( HAMD) were evaluated at admission,4th week,12 th week. The levels of hs-CRP,NT-proBNP and HRV were measured at admission and 12 th week. Results After treatment,the scores of HAMA and HAMD were decreased,which were lower than that in control group(P < 0. 05). The scores of HAMA and HAMD were decreased,which were lower than that in control group(P <0. 05). The levels of hs-CRP and NT-proBNP were decreased at 12 th week,which were lower than that in control group(P < 0. 05). After treatment,RMSSD,PNN 50% and HF increased while LF and LF / HF decreased,which were better than that in control group(P < 0. 05).Conclusion TSG can reduce the scores of HAMA and HAMD and the levels of hs-CRP and NT-proBNP,improve HRV in patients with ACS accompanied by anxiety and depression.
引文
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[8]王兆宏,陈还珍,闫建玲,伴有抑郁症状急性冠脉综合征早期应用氟哌噻吨美利曲辛疗效观察[J].中华老年多器官疾病杂志,2011,10(3):252-255.
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[10]朱梅生,张爱伦.冠心病伴抑郁或焦虑障碍对心率变异的影响[J].新疆医科大学学报,2011,34(8):868-875.
[2]胡大一,郭艺芳.急性冠脉综合征的诊治进展[J].中国实用内科杂志,2008,28(1):1-2.
[3]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.非ST段抬高急性冠脉综合症诊断和治疗指南[J].中华心血管病杂志,2012,40(5):353-367.
[4]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:68-76.
[5]王昀,王琪,张令越,等.急性冠状动脉综合征中医证候分布规律研究[J].浙江中医药大学学报,2011,35(2):139-141.
[6]方药中.实用中医内科学[M].上海:上海科技出版社,1985:432-439.
[7]张艳芳,赵美丽.血浆NT-pro BNP和hs-CRP水平与急性冠脉综合征关系研究进展[J].中国现代医药杂志,2014,16(6):99-103.
[8]王兆宏,陈还珍,闫建玲,伴有抑郁症状急性冠脉综合征早期应用氟哌噻吨美利曲辛疗效观察[J].中华老年多器官疾病杂志,2011,10(3):252-255.
[9]Haaf P,Balmelli C,Reichlin T,et al.N-terminal pro-B-type natriuretic peptide in the early evalation of suspected acute myocardial infarction[J].Am J Med,2011,124(8):731-739.
[10]朱梅生,张爱伦.冠心病伴抑郁或焦虑障碍对心率变异的影响[J].新疆医科大学学报,2011,34(8):868-875.