脑心通胶囊辅助治疗不稳定型心绞痛的疗效及对心率变异性和QT离散度的影响

Curative Effect of Adjuvant Treatment of Naoxin Tong Capsule on Unstable Angina Pectoris and Influence to Heart Rate Variability and QT Interval Dispersion

目的:探讨脑心通胶囊对不稳定型心绞痛(UAP)患者的疗效及作用机制。方法:将80例UAP患者随机按数字法分为对照组和观察组各40例。两组均参照"不稳定性心绞痛和非ST段抬高心肌梗死诊断与治疗指南"进行常规治疗,对照组采用倍他乐克,47.5 mg/次,1次/d,晨服。观察组在对照组治疗的基础上加用脑心通胶囊,4粒/次,3次/d。两组疗程均为12周。记录观察期内心绞痛症状、性质、持续时间、发作次数、诱发原因及硝酸甘油片的用量;分别于治疗前后采用24 h动态心电图进行心率变异性(HRV)检测;采用普通心电图仪检测QT间期离散度(QTd)和校正的QT离散度(QTcd)。结果:经Ridit分析,治疗后观察组心电图疗效优于对照组(P<0.05);治疗后观察组每周心绞痛发作次数及硝酸甘油片用量少于对照组(P<0.01);治疗后两组HRV各参数24 h正常R-R间期标准差(SDNN),24 h每5 min平均正常的R-R间期的标准差(SDANN)、相邻正常R-R间期差值的均方根(RMSSD)及相邻正常R-R间期差值≥50 ms的心搏数占总R-R间期数的百分数(PNN50)及均较治疗前上升(P<0.01),观察组HRV各参数提高程度优于对照组(P<0.01);治疗后两组QTd和QTcd均比治疗前缩短(P<0.01),观察组QTd和QTcd较对照组缩短更显著(P<0.01)。结论:在西医常规治疗的基础上,脑心通胶囊辅助治疗不稳定型心绞痛疗效显著,并能改善患者HRV和QTd,这对预防恶性心律失常及心源性猝死具有积极的临床意义。

Objective： Discuss the influence of Naoxin Tong capsule to heart rate variability （HRV） and QT interval dispersion on,patients with unstable angina pectoris （UAP）. Method： Eighty cases with UAP were randomly divided into control group （40 cases） and observation group （40 cases） by random number table. Both groups ＇ patients received conventional treatment refer to＇ diagnosis and treatment guidelines of （UAP） and Non ST segment elevation myocardial infarction＇, patients in the control group took betaloc, 47.5 mg/time, 1 time/day, taken orally in the morning. Based on the control group, patients in the observation group took Naoxin Tong capsules, 47.5 mg/time, 3 times/day. Course of treatment in two groups were both 12 weeksJ During the observation period, recording symptoms, quale, duration time, outbreak time, causes and volume of nitroglycerin of angina. Before and after treatment, HRV was detected by 24 hours dynamic electrocardiogram. QTd and corrected QT dispersion （QTcd） were detected by common electrocardiograph. Result： Analyzed by Ridit, after treatment, curative effect of electrocardiogram in the observation group was superior to the control group （P 〈 0. 05 ）. Every week after treatment, outbreak time of angina and volume of nitroglycerin in the observation group were less than the control group （P 〈 0.01 ）. Compared with the time before treatment, HRV parameters such as standard diviation of normal R-R interval standard deviations＇ （SDNN） , average normal R-R interval standard deviation （ SDANN）, root mean square difference of adjacent normal R-R interval （RMSSD） and percentage of R-R interval number （PNNS0） in treatment groups all increased （P 〈 0.01 ）, and increasing degree of HRV parameters in the observation group were superior to the control group （P 〈 0.01 ）. After treatment, QTd and QTcd in both groups were shorter than those before treatment （P 〈 0.01 ）, and it was more obviously in the observation group than in the control group （P 〈 0.01 ）. Conclusion： Based on the western medicine treatment, Naoxin Tong capsule had significant curative effect when it as adjuvant treatment was used to unstable angina pectoris, it can ameliorate HRV and QTd of patients, and there is a positive clinical significance to prevent malignant an＇hythmia and sudden cardiac death.