快律宁胶囊抗快速心律失常的离体药效学实验研究
详细信息    本馆镜像全文|  推荐本文 |  |   获取CNKI官网全文
摘要
目的:探讨快律宁(以下简称为KLN)胶囊对大鼠离体心脏心室肌细胞电生理的影响及有无促心律失常的风险,探讨KLN胶囊对外源性自由基所致心律失常的影响并分析其作用机制。
     方法:
     实验一:将SPF级SD大鼠分为对照组、普罗帕酮组和KLN胶囊高、中、低剂量组,将对照组分别与用药组进行组间比较,将普罗帕酮组与KLN三个剂量组进行组内比较。
     1.观察KLN胶囊对大鼠离体心室肌细胞动作电位APD50、APD90、APA、VMAX、EAD等电生理指标,分析其作用机制;
     2.分别将各组用药前后的RR间期、QT间期、QTc进行比较,分析KLN胶囊有无促心律失常的风险。
     实验二:将SPF级SD大鼠分为对照组、维拉帕米组和KLN胶囊高、中、低剂量组,采用Langendoff灌流装置对大鼠离体心脏灌注硫酸亚铁/抗坏血酸的方法,复制外源性自由基所致大鼠心律失常模型,对比研究KLN胶囊与维拉帕米对其的保护作用。
     结果:
     实验一:
     1.与对照组相比,KLN胶囊高、中剂量组的APD50、APD90均有延长(p<0.01),而且具有剂量依赖性。低剂量组则不明显(p>0.05)。组内比较显示,普罗帕酮组的APD50、APD90均长于KLN胶囊三个剂量组(P<0.01)。
     2.与对照组相比,KLN胶囊可以剂量依赖的减小VMAX,其中高、中剂量组减小尤为明显(P<0.01),组内比较显示,KLN胶囊三个剂量组与普罗帕酮的VMAX无显著性差异(P>0.05)。
     3.与对照组相比,KLN胶囊可以剂量依赖的降低APA,组内比较显示普罗帕酮组的APA与KLN胶囊中低剂量相比有显著差异,普罗帕酮组的APA较低(P<0.01),与高剂量组相比则无显著性差异(P>0.05)。
     4.KLN胶囊高中低三个剂量组的R-R间期用药后均有显著延长(P<0.05),而且呈剂量依赖性。
     5.KLN胶囊三个剂量组用药前后的QT间期及QTc无显著性差异(P>0.05)。
     6.普罗帕酮组用药后的RR间期、QT间期和QTc均有显著延长(P<0.05))
     7.KLN胶囊三个剂量组在灌流过程中均未诱发EAD,普罗帕酮组则有4例出现了EAD,经统计EAD发生率有显著性差异(P<0.01)。
     实验二:
     1.与对照组相比,KLN胶囊可以剂量依赖的减少对外源性自由基所诱发VEB、VT的发生次数(P<0.01)。
     2.KLN胶囊三个剂量组及维拉帕米组均未出现VF,而对照组则诱发出VF,但经统计无显著性差异(P>0.05)。
     3.与对照组相比,KLN胶囊高剂量组心律失常的出现时间较晚(P<0.05),而KLN胶囊中低剂量组、维拉帕米组心律失常的出现也有推迟的趋势,但经统计无显著性差异(P>0.05)。
     4.与对照组相比,KLN胶囊三个剂量组的心率明显减慢,而且呈剂量相关性。
     5.与对照组性比,KLN胶囊高、中剂量组的心律失常评分明显降低(P<0.05),而KLN胶囊低剂量组和维拉帕米组则与对照组无显著性差异(P>0.05)。
     结论:
     1.KLN胶囊可以剂量依赖的对正常大鼠离体心脏电生理产生影响,而对QT间期无影响,因此可能具有较低的致心律失常的风险。
     2.KLN胶囊对外源性自由基诱发的心律失常可能具有预防和治疗作用,可以明显减慢心率,并可能对恶性心律失常(VT、VF)的发生具有一定的预防和治疗作用,其疗效优于维拉帕米。
     3.KLN胶囊抗快速型心律失常的机制可能与同时作用于钾通道、钠通道,钙通道有关,同时可能对自由基具有清除作用,抑制钙超负荷,可能具有多靶点治疗作用特点,是一种类似于Ⅲ类和Ic类和IV类复合作用的抗心律失常药物,因此对快速型心律失常可能具有很好的疗效,并可能具有较低的致心律失常的风险,具有很好的研究前景。
Objective: To investigate the KLN (hereinafter referred to as the KLN) capsules onthe isolated rat heart ventricular myocytes electrophysiological and whether to promote therisk of arrhythmia to explore the impact the KLN capsule of exogenous free radicalscaused by arrhythmia analysis of its mechanism of action.
     Methods:
     Experiment1: SPF SD rats were divided into control group, propafenone group andKLN capsule high, medium, low-dose group, the control group and treatment groupbetween the two groups, compared the propafenone group with KLN three dose groups.
     1.Observation the KLN capsule action potential of isolated rat ventricular myocytesthe APD50, APD90, APA, VMAX, EAD and other electrophysiological parameters, analysisof its mechanism of action.
     2.Respectively in each group before and after treatment, RR interval, QT interval,QTc, which were compared and analyzed the risk of KLN capsules without promotingarrhythmias.
     Experiment2: SPF SD rats were divided into control group and the verapamil groupand the KLN capsule high, medium, low-dose group, Langedoff perfusion apparatus forisolated rat heart perfusion ferrous sulfate/ascorbic acid method, copy the exogenous freeradicals induced arrhythmia model, compared to its protective effect of the KLN capsule ofverapamil.
     Results:
     Experiment1:
     1.Compared with the control group, the KLN capsule high, medium-dose group of theAPD50, APD90of both prolonged (p <0.01), and these dose were dependent. Low-dose group was not significant (p>0.05). Comparison group, the propafenone group the APD50,APD90were longer than the KLN capsules three dose groups (P <0.01).
     2.Compared with the control group, the KLN capsule dose-dependent decreases VMAX,which high-dose group decreases, especially (P <0.01). From group showed, the KLNcapsules three dose groups with propafenone VMAXhad no significant differences (P>0.05).
     3.Compared with the control group, the lower the APA the KLN capsules can be adose-dependent group comparison shows that in the propafenone group APA KLN capsulelow dose compared to significant differences in the propafenone group APA lower (P<0.01) compared with the high dose group had no significant difference (P>0.05).
     4.The KLN capsule high medium and low-dose group RR interval after treatmentwere significantly prolonged (P <0.05) and dose-dependent manner.
     5.The KLN capsules before and after administration of three dose groups of QT andQTc were no significant difference (P>0.05).
     6.After administration of propafenone group, RR interval, the QT interval and QTcwere significantly prolonged (P>0.05).
     7.Perfusion process, the KLN capsules three dose groups were not induced by theEAD, the propafenone group had four cases of EAD, which statistics EAD had incidencesignificant difference (P <0.01).
     Experiment2:
     1.Compared with the control group, the KLN capsule dose-dependent reduction ofexogenous free radicals induced of VEB, VT occurrence (P <0.01).
     2.The KLN capsule three dose group and verapamil group were not VF control groupinduced the VF, but no significant statistical difference (P>0.05).
     3.Compared with the control group, the KLN high dose group arrhythmia appear later(P <0.05). The KLN capsule medium and low-dose group, verapamil group of arrhythmiasalso postponed, but statistics had no significant difference (P>0.05).
     4.Compared with the control group the KLN capsule three dose groups heart rateslowed down, and was dose-related.
     5.And control groups KLN capsule high and medium-dose group arrhythmia scorewas significantly lower (P <0.05), while the KLN capsule low dose group, verapamil groupand the control group, had no significant difference (P>0.05).
     Conclusion:
     1.The KLN capsule dose-dependent impact on the normal rat in vitro cardiacelectrophysiology had no effect on the interval QT. Therefore it may have a lowerarrhythmogenic risk.
     2.The KLN capsule exogenous free radical-induced arrhythmias may have preventiveand therapeutic effect. It can significantly slow down the heart rate, and may have somepreventive effect to the occurrence of malignant ventricular arrhythmias (VT, VF). Itsefficacy is superior Verapamil.
     3.KLN Capsule of Tachyarrhythmia mechanism may be simultaneously related topotassium channels, sodium channels, calcium channels. It may be both free radicalsscavenging effect, inhibition of calcium overload. It may have a role of the characteristicsof multi-target therapy, which is a similar to the composite role of class III, class Icandclass IV anti-arrhythmic drugs. Tachyarrhythmia may have a good effect, which may havea lower arrhythmogenic risk with good prospects.
引文
[1] Douglas P,Zipes A,John C,et a1.ACCIAHA/ESC2006guidelines formanagement of patients with ventricular aR-Rhythmias and the prevention of suddencardiac death-executive summary.a report of the American College ofCardiology/American Heart Association Task Fore and the European Society ofCardiology Committee for practice guidelines(Wriling Committee to developguidelines for management of patients with ventricular aR-Rhythmias and theprevention of sudden cardiac death)developed in collaboration with the EuropeanHeart Rhythm Association and the Heart Rhythm Society[J].JACC,2006;48(5):247-346
    [2] KUBAC G,KLINKE WP,GRACE M.Randomized double blindlrial comparingsotalol and propranolol in chronic ventricular aR-Rhythmia[J].Can J Cardiol,1988;4(7):355-359.
    [3] The Task Force ofthe Working Group on AR-Rhythmias ofthe European Society ofCardiology.A new approach to classification of antiaR-Rhythmic drugs based Ontheir actions on aR-Rhytlunogeulc mechanisms[J].Eur Heart J,1991;12(10):111-113
    [4]蒋树中,张毅刚,付强,苦参抗心律失常作用电生理机制研究[J].现代中西医结合杂志,2004,13(21):2812-2813
    [5]李燕,何立人.苦参碱类生物碱的心血管系统药理研究[J].中草药,2001,31(3):227
    [6]郭治彬,付金国,赵勇.等.氧化苦参碱对冠心病患者心律失常及心率变异性的影响[J].中国中西医结合杂志,2006,26(4):311-315.
    [7]陈彩霞.张宏艳.人参皂甙Re对异丙肾上腺素致家兔室性心律失常的保护作用[J].中国当代儿科杂志.2009,11(5):384-388.
    [8]高宝英.李学军,刘磊.等.三七中人参三醇甙对动物缺血性心律失常的影响[J].药学学报.1992.27(9):641-643
    [9]汪大金,毛焕元,雷明.等.新的植物性钙拮抗剂颅通定治疗心房颤动的临床研究[J].中国中西医结合杂志.1993,12(8):455.
    [10]马传庚,项思远.甘松乙醇提取液的抗心律失常的实验研究[J].安医学报.1980,15(4):9-12.
    [11]唐其柱,黄睁嵘,史锡腾.等.甘松提取物对家兔心室肌细胞钠钙通道的影响[J].中华心血管病杂志.2004,32(2):267-270.
    [12]葛郁芝,吴志婷,胡朗吉.等.中药甘松挥发油对HEK细胞NaVl.5电流一电压、电导一电压的影响[J].岭南心血管病杂志,2009(增刊):212-213.
    [13]欧阳昌汉,吴基良,陈金和.黄芩甙抗实验性心律失常的作用[J].成宁医学院学报.2002,16(1):7-l0.
    [14]佟继铭,刘玉玲,周崇坦,.等.黄芩茎叶总黄酮抗心律失常作用研究[J].中草药,2002,33(8):731
    [15]朱伯卿,戴瑞鸿,徐稚民.附子治疗房室传导阻滞疑难病例的临床观察[J].中医杂志.1984(4):12-13
    [16]张梅,张艺,陈海红.等.附子抗心律失常有效组分研究[J].时珍国医国药.2000,11(3):193-194.
    [17]沈丽霞,金乐群,张丹参.等.蛇床子素的抗实验性心律失常作用[J].张家口医学院学报.2001.18(1):9-10.
    [18]连其深,张志祖,上官珠.花椒毒酚抗实验性心律失常作用的研究[J].中草药,1996,27(6):347
    [19]郭治彬,曹宏宁,徐智.等.用犬心程控刺激电药理学模型评价甲基莲心碱的抗心律失常作用[J].中国药学.2002,11(2):35-42.
    [20]王嘉,农艺,姚伟星,.等.莲心碱对豚鼠心室肌细胞动作电位及钠与钙电流的影响[J].中草药,2000,32(3):193
    [21]王辉,罗顺德,蔡鸿生.二乙酰基莲心碱抗实验性心律失常的作用[J].中国医院药学杂志,2001,21(6):328-331.
    [22]张俊红,肖军花,徐凯.等.莲心总碱抗心律失常的实验研究[J].医药导报.2005,24(9);759-751.
    [23]郝丽英,李金呜,常天辉.白花前胡甲素对豚鼠单一心肌细胞钙电流的频率依赖性阻断作用[J].中国药理与毒理学杂志,2000,l0(1):17
    [24]吉检,邱健强,黄艳平,曾银祥,杨智闯.刺五加注射液对冠心病室性心律失常患者QT变异度的影响及临床意义[J]..广西中医药,2002,25(2):12-13
    [25]闫润红,任晋斌,刘必旺.山茱萸抗心律失常作用的实验研究[J].,山西中医,2001,17(5):52.5
    [26]陈兰英,陈奇,刘荣华.炙甘草汤主要有效成分对心肌生理特性的影响[J].中草药,2001,32(2):34
    [27]王普民,李伟,赵金明,张艳玲,胡丽萍,曲良才,李春图,魏晶,下秀英.敛心颗粒剂抗心律失常作用实验研究[J].时珍国医国药.1999,10(12):58-59
    [28]林慧娟.快速型心律失常的辨证治疗[J].山东中医杂志,1991,10(3):16
    [29]刘家骏,金戈,刘小勤.回生饮注射液抗心律失常的研究[J].中国中西医结合急救杂志,2000,7(2):82
    [30]贾钰华,孙学刚,贾满盈.等.定心方治疗快速型心律失常145例观察[J].实用中医药杂志,1999,15(10):3
    [31]贾钰华,孙学刚,贾满盈,.等.清心安神方治疗中老年冠心病室性早搏107例临床观察[J].中医杂志,2000,4(1):27-28
    [32]李树青,牛成早,弁玲.早搏灵治疗过早搏动82例临床及实验研究[J].中医杂志,2000,41(7):410,411
    [33]时飒,徐长庆,王孝铭,娄延平,赵雅君,姜小妹,王康.复方丹参滴丸对外源性自由基所致心律失常的影响[J].哈尔滨医科大学学报,2001,35(5):335-336
    [34]闫润红,任晋斌,刘必旺.山茱萸抗心律失常作用的实验研究[J].山西中医,200l.17(5):52-54
    [35]徐树楠,张再康,李艳新.等,增脉灵抗缓慢型心律失常的实验研究[J].中国药理学通报,2004,20(8):954-951
    [36]蒋文平.心律失常药物治疗的点评专家论坛[J].中国心脏起搏与心电生理杂志,2005;19:342-344
    [37]易京红.中医药治疗快速型心律失常的研究现状[J].北京中医,1999,18(4):55
    [38]黄伟民、徐尚忠,徐有秋.黄连素抗心律失常机理-电压钳制术观察延迟激活钾离子流的变化[J].中华心血管病杂志,1992,5(6):310.
    [39]姜长贵,匡永团.黄连素治疗心律失常32例[J].中西医急救杂志,1998,5(9):402.
    [40]司晓晨.黄连素片对钙离子通道的拮抗作用[J].南京中医药大学学报,1996,12(6):20-22
    [41]沈映君主编.中药药理学.第6版,上海:上海科学技术出版社,1995:51~52.
    [42]石新德.苦参治疗快速型心律失常[J].中医杂志,1995,36(8)
    [43]陈霞,李英骥,张文杰等.氧化苦参碱对豚鼠心室肌细胞钠电流的影响[J].白求恩医科大学学报,2001,21(1):41—42
    [44]李进禧,李留东,邢健东.苦参碱对大鼠心肌细胞钙内流影响的实验研究[J].中成药,2002,24(10):774-776
    [45]何燕.苦参有抗心律失常作用[J].中医杂志,1995,36(8):454
    [46]董昆山.现代临床中药学,北京:中国中医药出版社,1998:60.
    [47]王浴生主编.中药药理应用,北京:人民卫生出版社,1983:400.
    [48]陈丁丁,戴德哉,章涛,等.地黄煎剂抑制异丙肾上腺素诱发的大鼠脑Ca2+-Mg2+-ATP酶活性的升高[J].中药药理与临床,1996,12(5):22-24
    [49]尉中民.当归抗心律失常作用的电生理学研究[J].北京中医学院学报,1985,8(3):40.
    [50]黄从新,丁仲如,李庚山,等.当归提取液对豚鼠新心室肌细胞钠、钙离子通道的影响[J].中国心脏起搏与心电生理杂志,1997,11(2):96-98
    [51]沈映君主编.中药药理学.第6版,上海:上海科学技术出版社,1995:144-145
    [52]邓伟,唐其柱,李欣,等.酸枣仁皂苷A对大鼠心室肌细胞L-型该通道的影响[J].武汉大学学报,2009,30(3):300
    [53]王浴生.中药药理与应用,北京:人民卫生出版社,1983.
    [54]董昆山.现代临床中药学,北京:中国医药出版社,1998:226.
    [55] Michael R.Franz,CuR-Rent status of monophasic action potential ecording:theories,measurements and interpretations[J].Cardiovascular Res,1999,41:25-40.
    [56] Franz MR,Burkhoff D,Spurgeon H,et al.In vitro validation of a new cardiaccathetertechnique for recording monophasic action potential[J].Eur Heart J,1986,7:34-41.
    [57] Ino T.Karagueuzian HS,Hong K,et al.Relation of monophasic actionpotentialrecorded with contact electrode to underlying transmemberance actionpotentialproperties in isolated cardiac tissures:a systematic microelectrode validationstudy[J].Cardiovas Res,1988,22:255-264.
    [58] Franz MR.Bridging the gap between basic and clinical electrophysiology: whatcanbe learned from monophasic action potential recording [J].J CardiovascElectrophysiol,1994,5:699-710.
    [59] Roden DM.Drug-induced prolongation of the QT interval[J].N Engl J Med。2004,350(10):1013.1022.
    [60] Khalifa M,Drolet B,Daleau P,Lefez C,Gilbert M, Plante S,et al.Block ofpotassium cuR-Rents in guinepig ventricular myocytes and tensthenins of cardiacrepolarigation in man by the histamine H1receptor antagonist diphenhydramine[J].J Pharmacol Exp Ther,1999,288(2):858-865.
    [61] BUDILLON A,BRUZZESE F,GENNARO D E,et a1.Mulfipletarget drugs:inhibitors of heat shock protein90and of histone deacetylase[J].Curt Drug Targets,2005;6(3):337-351.
    [62]杨宝峰.药理学(第6版)[M].北京:人民卫生出版社,2003
    [63] Joshua I.Goldhaber Sen Ji.Scott T Lamp,et a1.Effects of exogenous free radlcalOn electromechcal funetion and metabolism in isolated rabbit and guinea pigventric]e [J].J Clinlnvest.1989,83:1800.
    [64] EIisabetta Cerbai, Giuseppe Ambrosio, Francesco Porciatti, et al.CeIIuIareIectrophydioIogicaI basis for oxygen radical-induced aR-Rhythmias.Apatch-clamp study in guinea pig ventricuIar myocytes[J].CircuIation,1991,84(4):1773-1782.
    [65]刘家兰,刘红,李德清等.山莨菪碱对外源性自由基发生系统加重离体大鼠心脏缺血再灌注损伤的保护作用[J].中国药理学通报,1993;9(3);190-193
    [66] Baysal E.Sallivan SG.Stern.A.Prouxidant and antioxidant effects of ascorbate onBuooh-induced erythrocyte membrane damage [J].int J Biochem.1989,21(10):1109
    [67] Bermer M,Hearse DJ,Manning As,Reperlusion-induced aR-Rhythmias andoxygenferived free radicals.Studies“with antifress radical”intreventions and a freeradical-generating system in the isolated perused rat heart[J].Cire REs,1986,58(3);331.
    [68] Pallandi RT,PeR-Ry MA,Campbell TJ.Proarhythmic effects of an oxygen-derivedfree radical generating system on action potentialsrecorded from guinea pigventricular[J]. Cue Res,1987,61(1);50
    [69] Ravingerov T.Tribulov N.Slez Jetal.Free oxygen radicals contribute to high incidenceof reperfusion-induced acthythmias in isolated rat heart.Life Sci.1999.65:1927-1930.
    [70] Tanguy S.Boucher F.Besse Setal.Trace elements and cardio protection: increasingendogenous glutathione peroxidase activity by oral selenium supplementation in ratslimits reperfusion-induced aR-Rhythmus.J Trace Elern Med Biol.1998Mar.12,J.28-38.
    [71]王新一,徐宏远等.不同浓度的外源性自由基生成系统致心律失常作用的比较[J].哈尔滨医科大学学报.1999,8(4)251-253.
    [72] Walker MJ,Curtis MJ,Hearse DJ,et al.The Lambeth conventions:guidelines forthe study of aR-Rhythmias in ischemia,infarction and reperfusion[J].CardiovascRes,1988;22:447 55.
    [73]陈国桢,王鲤珍,吴美玲.心房扩大与房性快速心律失常关系分析[J].临床心电学杂志,2000,9(3):143-145
    [74] Barckhardt D.Diltiazem in ischemid-ischemia-induced and reperfusionaR-Rhythmias[J].J Cardiovase Pharmocol,1990,16(supp16):26
    [75]王芳,李东.当归的化学及药理研究进展[J].中国药房,2003,14(10):630-631
    [76]杨澄,仇熙等.黄连炮制品清除氧自由基和抗指质过氧化作用[J].南京大学学报2001,37(5)32-33
    [77]马琦,袁其朋,丁柯,崔志云等.酸枣仁抗氧化成分提取及其活性[J].过程工程学报.2010,10(4)757-758
    [78]钮伟真.介绍一套小动物离体灌流心脏心电信号研究装置.[J].中国心脏起搏与心电生理杂志,2000,14(2):124-126.
    [79] Bazett HC.An analysis of the time.relations of electrocardiograms[J].Heart,1920,7:353-370.
    [80]黄彩云,谢世荣,杨静娴,黄胜英,高广猷.甘草水提液抗实验性心律失常的作用[J].大连医科大学学报,2003,25(1):24-25
    [81]脉象与脉图变化在心血管疾病临床诊断中的意义.岳沛平.[J].中华实用中西医杂
    志,2005,18:1256-1258
    [1]贾钰华,孙学刚,贾满盈.等.定心方治疗快速型心律失常145例观察[J].实用中医药杂志,1999,15(10):3
    [2]陈文垲.芪芍金藤汤辨治冠心病快速心律失常38例[J].中国中医急症,1996,5(5):201
    [3]戚宏,华明珍,赵旭涛.等.定心片治疗冠心病快速型心律失常的临床研究[J].山东中医杂志,1999,18(10):438
    [4]宋中午,邓艳繁,牛慧玲,.等.定律汤治疗心律失常68例[J].四川中医,1998,16(11):24
    [5]杨发荣.中药转律汤治疗快速房颤32例[J].辽宁中医杂志,1997,24(2):68
    [6]何永田,袁福茹,边可陶,.等.延胡索加味治疗快速型心律失常7l例临床观察[J].吉林中医药,1996,(1):14
    [7]段学忠,李猷河,孙锡印.宁心复脉饮治疗阴虚火旺兼痰瘀型快速型心律失常120例临床观察[J].中国中医药科技,1998,5(2):110
    [8]莫测,李健强.心律失常的中医药辨证治疗[J].安徽中医临床杂志,2002,14(6):514
    [9]王振涛,韩丽华.中医辨治快速型心律失常的思路与方法[J].中医杂志,2005,46(10):783.
    [10]魏执真.调脉汤治疗快速型心律失常的研究[J].中国医药学报,1992,7(3):14
    [11]李跃冲,魏明刚.心宁胶囊治疗快速心律失常304例临床观察[J].中医杂,2000,41(10):25
    [12]金曙光.百合生脉汤治疗老年人快速心律失常的临床观察[J].中华现代中西医杂志,2003,1(4):335.
    [13]陈伯钧,张文清,张敏州.冠心病中医分型与心律失常及心功能关系分析[J].现代中西医结合杂志,2000,9(19):1857-1858
    [14]林慧娟.快速型心律失常的辨证治疗[J].山东中医杂志,1991,10(3):16
    [15]张桂芬.中医药治疗快速心律失常的研究进展[J].现代中医,2000,47(2):48-49
    [16]毕云,魏丹霞.辨证治疗冠心病心律失常98例临床观察[J].新中医,2000,32(1,139
    [17]王中原,刘红.中医药治疗早搏研究概况[J].河南中医,2000,20(6):71
    [18]刘宗莲,徐淑文.陈鼎祺辨治心律失常经验[J].中国中医基础医学杂志,2007,13(6):467-468.
    [19]王本祥.现代中药药理学[M].天津:天津科学技术出版社,1997:148-149,880-884,927,l105.
    [20]石德新.苦参治疗快速型心律失常[J].中医杂志,1995,36(8):453
    [21]王海荣.单味大剂量黄连治疗室性早搏167例[J].实用中西医结合杂志,1993(1):25
    [22]孙冉.炙甘草汤治疗冠心病心律失常42疗效观察[J].中国现代药物应用,2010,4(5):166.
    [23]王建平.中西医结合治疗心房颤动32例[J].实用中医内科杂志.2003,17(3):181.
    [24]王健.中西医结合治疗频发性室性早搏45例观察[J].实用中医药杂志,2008,24(12);780.
    [25]李健,叶烨,吴晓新.等.炙甘草汤联合丹参滴丸治疗冠心病室性早搏临床观察[J].新中医.2009,41(7):43-44.
    [26]宋俊生,吴喜庆,陆小左.等.炙甘草汤及其加减方治疗“脉结代、心动悸”临床对照实验的系统评价[J].天津中医药大学学报,2008.27(4):246-249.
    [27]牛爱玲.章德峰.瓜萎薤白半夏汤治疗室性早搏82例[J].河南医药信息.1994,2(3):29.
    [28]吴劲松.中西医结合治疗顽固性频发室性早搏52例临床观察[J].中医药导报.2008.14(7):18-19.
    [29]梁碧伟,周颖玲,冯颖青.中西医结合治疗心律失常临床观察[J].首都医药.2000,7(6):40.
    [30]余信之.加味黄连阿胶汤治疗快室率心房纤颤疗效观察[J].中国中医急症,2008.17(3):285-286.
    [31]李琳.中西医结合治疗冠心病频发室性早搏35例总结[J].湖南中医杂志.2006,22(4):9.
    [32]金卓祥.黄连温胆汤治疗复杂性缓慢型心律失常26例[J].现代中西医结合杂志,2009.18(3):269.
    [33]刘华荣,刘少波.中西医结合治疗冠状动脉粥样硬化性心脏病频发室性期前收缩42例[J].中国中西医结合急救杂志,1999,6(8):377.
    [34]卢良成.快速型心律失常治法探究[J].浙江中医学院学报,1992,16(5):l
    [35]杜宗礼,翟艳清,李正兰,等.中西医结合治疗冠心病心律失常临床观察[J].实用中医药杂志.2008,24(10):651.
    [36]胡润兰.养心汤佐治心律失常38例临床观察[J].湖北中医杂志,2009,30(11):29-30.
    [37]何永田,袁福茹,边可陶,.等.延胡索加味治疗快速型心律失常7l例临床观察[J].吉林中医药,1996,(1):14
    [38]谢东霞.当归生姜羊肉汤加味治疗频发室性早搏88例[J].山西中医,2002,18(5):17
    [39]毕云,魏丹霞.辨证治疗冠心病心律失常98例临床观察[J].新中医,2000,32(1,139
    [40]汪晓芳,张京春,陈可远.心安胶囊治疗室性心律失常30例临床研究[J].中医杂志,2000,4l(1):666
    [41]李秀芝,史建平,刘红英.国老调律丸治疗快速心律失常152例临床观察[J].中西医结合心脑血管病杂志,2003,l(4):210-211.
    [42]贾钰华,余林中,陈育尧,.等.定心方对家兔心肌缺血及再灌注损伤的保护作用和抗心律失常作用的研究[J].中国中西医结合杂志,2000,19(11):678
    [43]黄忠钧,薛丽平.调脉饮治疗冠心病快速型心律失常30例[J].辽宁中医杂志,1998,25(6):265.
    [44]王金荣,王知佳,唐桂荣.黄连生脉饮治疗过早搏动357例临床观察[J].中医杂志,2001,42(6):355
    [45]夏善玲.天王定心汤治疗反复发作性快速心房纤颤32例[J].实用中西医结合杂志,1997,10(1):35-36.
    [46]王静,吴松村,杨光.自制参芪汤治疗心梗后室性早搏40例[J].时珍国医国药,2001,12(1):72
    [47]任毅.定心汤加味治疗心律失常44例[J].中国民间疗法,2001,9(7):47.
    [48]李树青,牛成早,弁玲.早搏灵治疗过早搏动82例临床及实验研究[J].中医杂志,2000,41(7):410,411
    [49]舒力强,赵晓华.加味定悸方治疗快速型心律失常临床观察[J].吉林中医药,2007,27(4):l9-20.
    [50]刘爱华,马驰骋,刘爱军.心脑l号治疗心功能不全和心律失常作用的研究[J].中国中西医结合急救杂志,2001,8(1):27
    [51]侯哲国.步长稳心颗粒与倍他乐克联合治疗室上性心律失常[J].医药论坛杂志.2007,9(28):68-70.
    [52]张颖杰.稳心颗粒治疗快速心律失常临床观察[J].中国现代实用医学杂志,2004,3(8):75.
    [53]胡晓风,张晓星,徐伟建.黄芪、生脉注射液治疗心律失常的临床疗效观察[J].当代医学,2009,15(7):47-48.
    [54]杨杰孚.刘德平.佟佳宾.步长稳心颗粒治疗室性早搏的疗效及安全性[J].中华心血管病杂志,2004,32(2):265-266.
    [55]宋晓东,刘磊.步长稳心颗粒治疗小儿病毒性心肌炎窦性心动过缓伴室性期前收缩[J].中国民康医学.2008.20(8):750-751.
    [56]刘宇翔,李轩.稳心颗粒治疗老年快速心律失常临床观察[J].中西医结合心脑血管病杂志,2009.7(8):898-899.
    [57]谷春华,吴以岭.田书彦,.等.参松养心胶囊对冠心病室性早搏疗效及心脏自主神经功能的影响[J].中国中西医结合杂志,2005,25(9):783-786
    [58]孟立军,王文英,郑德胜.参松养心胶囊治疗窦性心动过缓的临床观察[N].络病学基础与临床研究(四)-第四届国际络病学大会论文集,2008:328-329.
    [59]王滨,陈亮,吴迪.参松养心胶囊治疗快速性房颤70例临床研究[J].中医药信息,2009,26(4):58-59.
    [60]郭瑞兰,陈学敏,刘炜.中药参松养心胶囊治疗室性心律失常疗效观察[J].中国实验方剂学杂志.2009,15(9):110.
    [61]沈安明,吕军,谢轶群.健心胶囊治疗室性心律失常临床研究[J].贵阳中医学院学报,2007,29(2):36-37.
    [62]杲碧青,刘丽莹.养心通脉胶囊治疗室性早搏48例[J].新中医,2008,40(5):77-78.
    [63]徐桂芬,王文华,姚风祯.穴位注射生脉注射液抗家兔快速型心律失常的实验研究[J].中国急救医学.2006,26(10):683-684.
    [64]古天明,肖业伟,王西霞.等.生脉注射液抗家兔缺血性心律失常的作用[J].华西药学杂志,2009,24(1):42-44.
    [65]刘美清.参麦注射液为主治疗中老年冠心病室性早搏56例临床观察[J].湖南中医药导报.2002.8(11):652.
    [66]叶小斌.稳心颗粒联合心律平治疗室性期前收缩临床观察[J].中国综合临床,2007.23(13):42-43.
    [67]韩杰,郭丽青,孙露宁.中西医结合治疗冠心病过早搏动48例[J].山东中医杂志,1999,18(1I):507-508
    [68]李廉,程震峰.美托洛尔联合参松养心胶囊治疗器质性室性早搏的近期疗效观察[J].中国医师杂志,2009,1l(1):131
    [69]陈平娥.中西医结合治疗冠状动脉粥样硬化性心脏病心房颤116例临床观察[J].中国中西医结合急救杂志,1999,6(3):124-125
    [70]朱明军,张群生,王永霞.传统方辨治心律失常概况[J].中国实验方剂学杂志,2007,13(7):70-72,封3.
    [71]马玉琛.针刺迎香治疗快速型心律失常68例疗效观察[J].中国针灸,1996,16(5):21
    [72]段俊峰,陈丽贤,范秀华,.等.推拿结合水针治疗脊性心律失常的疗效观察[J].颈腰痛杂志,2003,24(5):293-294.
    [73]顾国龙.针刺内关终止阵发性室上性心动过速的体会[J].南京中医药大学学报,1996,12(1):29
    [74]王鹏辉,陈丽宏.室性早搏采用针药结合治疗的临床观察[J].中华中西医学杂志,2009,7(1):26-27.
    [75]罗利.针刺配合导管起搏抢救急性心肌梗塞合并严重心律失常的临床观察[J].中国针灸,1996,16(7):l
    [76]孙立虹.针药并用治疗室性早搏25例[J].针灸临床杂志,1993,9(6):10
    [77]卢爱军,庞爱军.用穴位给药法治疗心律失常的研究现状与展望[J].时珍国医国药,2008,19(5):1278-1280.

© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号

地址:北京市海淀区学院路29号 邮编:100083

电话:办公室:(+86 10)66554848;文献借阅、咨询服务、科技查新:66554700