参松养心胶囊联合琥珀酸美托洛尔对冠心病心律失常患者血流动力学及心率变异的影响
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摘要
目的:探讨参松养心胶囊联合琥珀酸美托洛尔对冠心病(CHD)心律失常患者血流动力学及心率变异(HRV)的影响。方法:选取本院收治的CHD心律失常患者90例为研究对象,随机分为观察组和对照组,2组患者均给予常规强心、降脂、硝酸酯类、利尿剂、血管紧张素转换酶抑制剂、营养心肌、正性肌力等药物治疗,对照组口服琥珀酸美托洛尔缓释片,观察组在对照组基础上口服参松养心胶囊,2组患者均持续治疗4周后进行评价。2组患者治疗前后采集晨起空腹静脉血,采用无创血流动力学检测仪测定血细胞沉降率(ESR)、血细胞比容(HCT)、血浆比黏度(np)、高切变率下全血黏度(nbh)、低切变率下全血黏度(nbl);离心提取血清,采用ELISA法检测血管内皮生长因子(VEGF),散射比浊法测定C反应蛋白(CRP)、脑钠肽(BNP)。治疗前后行24h心电监测,测定早搏数及心率变异(HRV)指标,包括窦性心搏R-R间期标准差(SDNN)、每隔5min窦性心搏R-R间期平均值标准差(SDANN)、相邻窦性心搏R-R间期差值均方根(RMSSD)、每隔5min窦性心搏R-R间期标准差平均值(SDNNI)、相邻窦性心搏R-R间期差值4h大于50ms所占百分比(PNN50)。结果:观察组治疗后ESR、HCT、np、nbh、nbl低于对照组(P<0.05);观察组治疗后CRP、VEGF、BNP低于对照组(P<0.05);观察组治疗后SDNN、SDANN、PNN50高于对照组(P<0.05)。结论:参松养心胶囊联合琥珀酸美托洛尔可有效改善CHD心律失常患者血流动力学,减轻机体炎症反应,改善HRV,提高治疗效果。
Objective:To explore the effect of Shensong Yangxin capsule in combined with metroprolol succinate on the hemodynamics and heart rate variability(HRV)in patients with arrhythmia of coronary heart disease(CHD).Methods:A total of 90 patients with arrhythmia of CHD who were admitted in our hospital from October,2016 to September,2017 were included in the study and randomized into the observation group and the control group.The patients in the two groups were given routine heart strengthening,lipid lowering,nitrates,diuretics,ACEI,myocardial nourishing,and positive inotropic action.The patients in the control group were orally administrated with metroprolol succinate released tablets.On the above basis,the patients in the observation group were given Shensong Yangxin capsule.After a continuous 4-week treatment,the efficacy was evaluated.The morning fasting venous blood before and after treatment was collected and centrifuged for the serum.The noninvasive hemodynamics detector was used to detect ESR,HCT,np,nbh,and nbl.ELISA was used to detect VEGF.The scattering turbidimetry was used to detect CRP and BNP,and 24 h-ECG monitoring was performed before and after treatment.Premature beat number and HRV indicators,including SDNN,SDANN,RMSSD,SDNNI,and PNN50 were detected.Results:ESR,HCT,np,nbh,and nbl after treatment in the observation group were significantly lower than those in the control group(P<0.05).CRP,VEGF,and BNP after treatment in the observation group were significantly lower than those in the control group(P<0.05).SDNN,SDANN,and PNN50 after treatment in the observation group were significantly higher than those in the control group(P<0.05).Conclusions:Shensong Yangxin capsule in combined with metroprolol succinate can effectively improve the hemodynamcis in patients with arrhythmia of CHD,alleviate the inflammatory reaction,improve HRV,and enhance the therapeutic effect.
Objective:To explore the effect of Shensong Yangxin capsule in combined with metroprolol succinate on the hemodynamics and heart rate variability(HRV)in patients with arrhythmia of coronary heart disease(CHD).Methods:A total of 90 patients with arrhythmia of CHD who were admitted in our hospital from October,2016 to September,2017 were included in the study and randomized into the observation group and the control group.The patients in the two groups were given routine heart strengthening,lipid lowering,nitrates,diuretics,ACEI,myocardial nourishing,and positive inotropic action.The patients in the control group were orally administrated with metroprolol succinate released tablets.On the above basis,the patients in the observation group were given Shensong Yangxin capsule.After a continuous 4-week treatment,the efficacy was evaluated.The morning fasting venous blood before and after treatment was collected and centrifuged for the serum.The noninvasive hemodynamics detector was used to detect ESR,HCT,np,nbh,and nbl.ELISA was used to detect VEGF.The scattering turbidimetry was used to detect CRP and BNP,and 24 h-ECG monitoring was performed before and after treatment.Premature beat number and HRV indicators,including SDNN,SDANN,RMSSD,SDNNI,and PNN50 were detected.Results:ESR,HCT,np,nbh,and nbl after treatment in the observation group were significantly lower than those in the control group(P<0.05).CRP,VEGF,and BNP after treatment in the observation group were significantly lower than those in the control group(P<0.05).SDNN,SDANN,and PNN50 after treatment in the observation group were significantly higher than those in the control group(P<0.05).Conclusions:Shensong Yangxin capsule in combined with metroprolol succinate can effectively improve the hemodynamcis in patients with arrhythmia of CHD,alleviate the inflammatory reaction,improve HRV,and enhance the therapeutic effect.
引文
1王廷会,张少峰,马剑华,等.老年冠心病患者心血管病危害因素与冠状动脉病变程度的相关性分析[J].中西医结合心血管病电子杂志,2015,3(35):100-101.
2 吕冬,曾维富.通心络胶囊联合美托洛尔治疗冠心病室性心律失常的临床疗效观察[J].实用心脑肺血管病杂志,2016,24(11):79-82.
3 何欣.冠心病心律失常通过稳心颗粒联合美托洛尔治疗的效果分析[J].中国医药指南,2016,14(31):204-205.
4 黄越升.稳心颗粒与美托洛尔联用对冠心病并发室性心律失常的影响[J].牡丹江医学院学报,2017,38(4):72-73.
5 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.慢性稳定性心绞痛诊断与治疗指南[J].中华心血管病杂志,2007,35(3):195-206.
6 方利华.瑞舒伐他汀对冠心病合并高脂血症老年患者血脂水平和炎症因子影响的临床研究[J].中国现代医学杂志,2015,24(36):43-46.
7 李园园.两种心电图监测冠心病心肌缺血与心律失常的效果比较[J].河北医学,2016,22(12):1956-1961.
8 姜贤雄,贾连旺.稳心颗粒对冠心病室性心律失常患者心肌缺血与心功能的影响[J].浙江中医杂志,2014,49(3):229-231.
9 王贵奇.琥珀酸美托洛尔缓释片联合稳心颗粒治疗冠心病心律失常的临床效果观察[J].临床医学研究与实践,2017,2(4):41-42.
10 盖郁博,李春媛.琥珀酸美托洛尔缓释片联合稳心颗粒治疗冠心病心律失常的疗效和用药的安全性[J].中国医药科学,2016,6(8):47-50.
11 林青,张晓丹,李治民,等.参松养心胶囊对老年冠心病无症状性心肌缺血患者血管内皮细胞功能、心率震荡及心率变异性的影响[J].现代中西医结合杂志,2016,25(27):2988-2991.
12 马春,李淑玲,杨丽华.益肾通络法治疗冠心病心律失常的临床研究[J].中国中医药现代远程教育,2017,15(14):44-45.
13 丁海涛.参松养心胶囊联合美托洛尔片治疗冠心病心律失常的疗效分析[J].当代医药论丛,2017,15(5):70-71.
14 吴作跃,瘳佳丹,姚宇玫.参松养心胶囊联合美托洛尔缓释片对老年冠心病心律失常患者的疗效及BNP、HR水平的影响[J].中国生化药物杂志,2017,37(8):45-46.
15 王丹,来利红,刘威.琥珀酸美托洛尔缓释片在心律失常中的作用和对炎症因子的影响[J].河南科技大学学报(医学版),2016,16(4):262-264.
16 杨法,苏明兰,李小珠,等.T波电交替#心率变异联合检测对急性心肌梗死患者恶性心律失常预测评估的作用[J].白求恩医学杂志,2016,14(3):272-274.
17 李昕阳.老年冠心病室性心律失常与心率变异临床探析[J].当代医学,2015,5(376):60-61.
18 周琴英,夏碧华.西药联合参松养心胶囊对老年冠心病合并心律失常患者血流动力学的影响及疗效[J].中国老年学杂志,2014,34(5):1165-1167.
19 李红旗,胡立群,徐艳龙,等.老年高血压患者同型半胱氨酸水平与心率变异的相关性[J].中国临床保健杂志,2017,20(4):379-382.
2 吕冬,曾维富.通心络胶囊联合美托洛尔治疗冠心病室性心律失常的临床疗效观察[J].实用心脑肺血管病杂志,2016,24(11):79-82.
3 何欣.冠心病心律失常通过稳心颗粒联合美托洛尔治疗的效果分析[J].中国医药指南,2016,14(31):204-205.
4 黄越升.稳心颗粒与美托洛尔联用对冠心病并发室性心律失常的影响[J].牡丹江医学院学报,2017,38(4):72-73.
5 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.慢性稳定性心绞痛诊断与治疗指南[J].中华心血管病杂志,2007,35(3):195-206.
6 方利华.瑞舒伐他汀对冠心病合并高脂血症老年患者血脂水平和炎症因子影响的临床研究[J].中国现代医学杂志,2015,24(36):43-46.
7 李园园.两种心电图监测冠心病心肌缺血与心律失常的效果比较[J].河北医学,2016,22(12):1956-1961.
8 姜贤雄,贾连旺.稳心颗粒对冠心病室性心律失常患者心肌缺血与心功能的影响[J].浙江中医杂志,2014,49(3):229-231.
9 王贵奇.琥珀酸美托洛尔缓释片联合稳心颗粒治疗冠心病心律失常的临床效果观察[J].临床医学研究与实践,2017,2(4):41-42.
10 盖郁博,李春媛.琥珀酸美托洛尔缓释片联合稳心颗粒治疗冠心病心律失常的疗效和用药的安全性[J].中国医药科学,2016,6(8):47-50.
11 林青,张晓丹,李治民,等.参松养心胶囊对老年冠心病无症状性心肌缺血患者血管内皮细胞功能、心率震荡及心率变异性的影响[J].现代中西医结合杂志,2016,25(27):2988-2991.
12 马春,李淑玲,杨丽华.益肾通络法治疗冠心病心律失常的临床研究[J].中国中医药现代远程教育,2017,15(14):44-45.
13 丁海涛.参松养心胶囊联合美托洛尔片治疗冠心病心律失常的疗效分析[J].当代医药论丛,2017,15(5):70-71.
14 吴作跃,瘳佳丹,姚宇玫.参松养心胶囊联合美托洛尔缓释片对老年冠心病心律失常患者的疗效及BNP、HR水平的影响[J].中国生化药物杂志,2017,37(8):45-46.
15 王丹,来利红,刘威.琥珀酸美托洛尔缓释片在心律失常中的作用和对炎症因子的影响[J].河南科技大学学报(医学版),2016,16(4):262-264.
16 杨法,苏明兰,李小珠,等.T波电交替#心率变异联合检测对急性心肌梗死患者恶性心律失常预测评估的作用[J].白求恩医学杂志,2016,14(3):272-274.
17 李昕阳.老年冠心病室性心律失常与心率变异临床探析[J].当代医学,2015,5(376):60-61.
18 周琴英,夏碧华.西药联合参松养心胶囊对老年冠心病合并心律失常患者血流动力学的影响及疗效[J].中国老年学杂志,2014,34(5):1165-1167.
19 李红旗,胡立群,徐艳龙,等.老年高血压患者同型半胱氨酸水平与心率变异的相关性[J].中国临床保健杂志,2017,20(4):379-382.