参麦注射液对慢性充血性心力衰竭患者心率变异性的影响

Study on the influences of Shenmai injection(参麦注射液) on the variability of heart rate in patients with congestive heart failure

目的 :探讨参麦注射液对慢性充血性心力衰竭 (CHF)患者心率变异性 (HRV )的影响。方法 :将 42 4例 CHF患者随机分为 2组 :参麦注射液加常规抗心力衰竭 (心衰 )治疗组 (参麦组 ) 316例 ,常规抗心衰治疗对照组 10 8例。治疗前进行 HRV测定 ,2组间比较各指标均无显著性差异 (P均 >0 .0 5 ) ,治疗 1个疗程 (15日 )后再次进行 HRV测定。结果 :1参麦组治疗后 2 4小时 5分钟平均正常 R R间期标准差 (SDANN)、2 4小时相邻R R间期差值的均方根 (RMSSD)、2 4小时正常相邻 R R间期之差大于 5 0 ms的心搏数所占百分比(PNN5 0 )、低频成分 (L F)、中频成分 (MF)、高频成分 (HF)、总功率谱 (TP)较治疗前均显著升高 (P均 <0 .0 1) ,L F/HF显著降低 (P<0 .0 1)。 2对照组治疗后 SDANN、RMSSD、PNN5 0 、L F、MF、HF、TP较治疗前均显著升高 (P均 <0 .0 5 ) ,L F/HF显著降低 (P<0 .0 5 )。 3治疗后参麦组与对照组比较 SDANN、RMSSD、PNN5 0 、L F、MF、HF、TP均显著升高 (P均 <0 .0 5 ) ,L F/HF显著降低 (P<0 .0 5 )。结论 :1常规强心、利尿、扩血管治疗可改善心功能 ,提高 CHF患者的 HRV;2参麦加常规抗心衰治疗在改善 CHF患者心功能的同时 ,改善 HRV更显著 ,且能改善自主神经平衡性 。

Objective:To investigate the influence of Shenmai injection(参麦注射液) on the variability of heart rate in patients with chronic congestive heart failure(CHF).Methods:Four hundred and twentyfour patients with CHF were randomly divided into two groups.Three hundred and sixteen cases(Shenmai group) were treated with Shenmai injection and conventional western medicine,meanwhile 108 cases (control group) treated with western medicine alone.The heart rate variability (HRV) were measured before treatment.There were not marked differences in the indexes in two groups ( P >0 05).The HRV would be taken again after a therapeutic course (15 days).Results:①After treatment standard deviation of all means of 5minutes RR intervals all over 24 hours (SDANN),root mean square of successive RR differences(RMSSD),percentage of adjacent differences more than apart (PNN 50 ),low frequency(LF),middle frequency(MF),high frequency(HF),total power(TP) in Shenmai group were obviously higher than those before treatment (all P <0 01),and LF/HF were obviously lower ( P <0 01).②After treatment SDANN,RMSSD,PNN 50 ,LF,MF,HF,TP of the patients of the contrast group were obviously higher than those before treatment (all P <0 05) and LF/HF was obviously lower ( P <0 05).③SDANN,RMSSN,PNN 50 ,LF,MF,HF,TP in two groups were remarkably higher after treatment than those before treatment ( P <0 05),but LF/HF was remarkably lower ( P <0 05 ).Conclusions:①The conventional treatment with cardiotonic,diuretic and vascular dilator can improve the heart function and the variability of heart rate in patients with CHF.② The treatment with Shenmai injection and conventional therapy for heart failure can improve the heart function and the HRV,the equilibration of the autonomic nerve,and the prognosis simultaneously in patients with CHF.