比索洛尔联合活血安神解郁方对冠状动脉左前降支心肌桥合并焦虑和抑郁患者平板运动试验及不良情绪的影响

Effect of bisoprolol combined with Huoxue Anshen Jieyu Decoction on treadmill exercise test and unhealthy emotion in patients with left anterior descending coronary artery myocardial bridge combined with anxiety and depression

目的观察比索洛尔联合活血安神解郁方对冠状动脉左前降支心肌桥合并焦虑和抑郁患者平板运动试验及不良情绪的影响。方法将2018年4月—2020年4月内蒙古自治区人民医院收治的90例冠状动脉左前降支心肌桥合并焦虑和抑郁患者随机分为对照组和观察组各45例。对照组给予低盐低脂饮食、心理疏导、内科常规治疗和比索洛尔治疗,观察组在此基础上加用活血安神解郁方治疗,2组均治疗3个月。观察2组治疗前后中医症状评分、心电图平板运动试验(ST段压低总时间、ST段压低幅度、ST段恢复时间、运动中心律失常发生率)、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分变化,统计2组疗效及不良反应发生情况。结果治疗后,2组患者中医症状积分、ST段压低幅度、运动中心律失常发生率、SAS评分、SDS评分均明显低于治疗前(P均<0.05),且观察组均明显低于对照组(P均<0.05);2组患者ST段压低总时间、ST段恢复时间均明显短于治疗前(P均<0.05),且观察组均明显短于对照组(P均<0.05);治疗后,观察组和对照组的总有效率分别为86.7%(39/45)和60.0%(27/45),观察组明显高于对照组(P<0.05);2组患者均未出现严重不良反应。结论比索洛尔联合活血安神解郁方治疗冠状动脉左前降支心肌桥合并焦虑和抑郁患者能明显减轻症状,改善心电图平板运动试验指标和不良情绪,临床疗效满意,且安全。

Objective It is to observe the effect of bisoprolol combined with Huoxue Anshen Jieyu Decoction on treadmill exercise test and unhealthy emotion of patients with left anterior descending coronary artery myocardial bridge combined with anxiety and depression.Methods Ninety patients with left anterior descending coronary artery myocardial bridge combined with anxiety and depression who were admitted to the People’s Hospital of Inner Mongolia Autonomous Region from April 2018 to April 2020 were randomly divided into control group and observation group,with 45 cases in each group.The control group was given low-salt and low-fat diet,psychological counseling,conventional medical treatment and bisoprolol.The observation group was treated with Huoxue Anshen Jieyu Decoction based on the treatment in the control group.Both groups were treated for 3 months.The changes of scores of TCM symptoms,ECG treadmill exercise test(Total ST-segment depression time,ST-segment depression amplitude,ST-segment recovery time,incidence of exercise arrhythmia),self-rating anxiety scale(SAS)scores,and self-depression SDS scores were observed before and after treatment in the two groups,the curative effects and incidence of adverse reactions in the 2 groups were counted.Results After treatment,the scores of TCM symptoms,ST-segment depression,the incidence of exercise arrhythmia,SAS score,and SDS score of the two groups were significantly lower than those before treatment(all P<0.05),and the observation group was significantly lower than the control group(P<0.05);the total time of ST-segment depression and ST-segment recovery time of the two groups were significantly shorter than those before treatment(P<0.05),and the observation group was significantly shorter than the control group(P<0.05);the total effective rates of the observation group and the control group were 86.7%(39/45)and 60.0%(27/45),respectively,the observation group was significantly higher than the control group(P<0.05);there was no serious adverse effect in the two groups.Conclusion The combination of bisoprolol and Huoxue Anshen Jieyu Decoction can significantly reduce symptoms,improve ECG treadmill exercise test indicators and bad emotion in the treatment of left anterior descending coronary artery myocardial bridge with anxiety and depression,its clinical efficacy is satisfied with good safety.