通心络胶囊防治抗精神病药物对心脏影响的疗效观察

Tongxinluo Capsule on the impact of antipsychotic drugs on the efficacy of the heart

目的：了解通心络对抗精神病药物所致心脏不良反应的疗效。方法：对93例住院患者按入院顺序随机分为通心络胶囊组（A组）和对照组（B组）。通心络胶囊组在应用抗精神病药治疗的同时合用通心络胶囊口服，每次3粒，每日3次；对照组仅用抗精神病药物治疗。两组疗程均为4个月，治疗期间每月复查1次心电图。对心电图的变化进行分析。结果：（1）两组均出现心电图异常，A组9例，占20．93％；B组19例，占38％，P〈0．05，两组比较差异有显著性意义（均P〈0．05）。两组中以氯丙嗪和甲硫达嗪引起的心电图异常率高。（2）两组均以用药1～2个月心电图异常率为最高，以后逐渐减少。用药1—2个月心电图异常率两组比较差异有显著性意义（U=2．041，P〈0．05）。（3）两组心电图异常变化的情况：A组出现T波或Q—T延长者4例；B组出现T波或Q—T延长者16例，差异有非常显著性意义（U=2．615，P〈0．01）。两组出现窦性心动过速、窦性心动过缓、传导阻滞、期外收缩几率接近。（4）两组抗精神病药剂量与心电图异常的关系：以氯丙嗪效价折算。两组相比，抗精神病药物的剂量≤600mg／天时，差异无显著性意义（P〈0．05）；剂量〉600mg／天时，A组心电图异常发生率低于B组（P〈0．05）。结论：服用抗精神病药物引起心电图异常的比例较高，通心络胶囊可减少抗精神病药物对心脏的影响和毒性，而且在改善抗精神病药物引起T波或Q—T延长中有非常明显的作用，从而使临床医师便于大剂量使用抗精神病药物。

Objective：To understand the Tongxinluo on antipsychotics due to the efficacy of cardiac toxicity. Methods：93 cases of hospitalized patients by randomly divided into groups of Tongxinluo capsule （A group） and control group （B group）. Tongxinluo capsule group, while in the application of antipsyehotic treatment combination Tongxinluo capsules orally, 3 capsules per day, three times ; the control group only antipsychotic drug treatment. Group 2 course of treatment is 4 months, a monthly review of one times during treatment ECG. The changes on the ECG analysis. Results ： （ 1 ） The two groups were ECG abnormalities, A group of 9 cases, accounting for 20.93% ; B group of 19 cases, accounting for 38% , P 〈 0.05,2 group difference was significant （ all P 〈 0.05 ）. Two groups with chlorpromazine and thioridazine caused by the high rate of abnormal ECG. （2） 2 groups are drugs from January to February ECG rate is the highest, and then gradually decrease. ECG abnormal rate of drugs from January to February compared two groups was significant difference （U = 2.041, P〈0.05）. （3） 2 groups of ECG abnormalities： A group of T-wave, or QT appears to extend the 4 cases; B group appears T - wave, or QT prolongation of 16 cases, the difference was statistically significant （ U = 2. 615, P 〈 0.01 ） . Group 2 appears sinus tachycardia, sinus bradycardia, conduction Yin stagnation, extrasystoles probability close. （4） The two groups antipsychotic dose and the relationship between ECG abnormalities： the potency of chlorpromazine conversion. Group 2 compared with the dose of antipsyehotics ≤ 600 mg / day the difference was not statistically significant （ P 〈 0.05 ） ; dose of 〉 600 mg / day, A group of ECG abnormalities occurred was lower than B group （P 〈 0.05 ）. Conclusions： ECG abnormalities caused by taking antipsychotics higher proportion of Tongxinluo capsule can reduce the effects of antipsychotic drugs on the heart and toxicity, but also in improving the antipsychotics cause QT extension of the T wave or a very significant role, and thus enables clinicians to facilitate the use of high - dose antipsychotics.