自拟补气活血通络止痛方治疗心肌梗死后室性早搏的疗效及对心肌酶、心率震荡的影响研究

Curative Effect of Using Self-made Buqi Huoxue Tongluo Zhitong Recipe in the Treatment of Ventricular Premature Beat after Myocardial Infarction and Its Influences on Myocardial Enzymes and Heart Rate Turbulence

目的:观察自拟补气活血通络止痛方治疗心肌梗死(MI)后室性早搏的疗效及对心肌酶、心率震荡的影响。方法:选择2018年9月~2020年9月于我院收治的96例MI后室性早搏患者作为研究对象,采用随机数字表法将其分为观察组和对照组,48例/组。对照组予以胺碘酮治疗,观察组在对照组基础上加用自拟补气活血通络止痛方治疗,均治疗1个月。比较两组治疗后的室性早搏临床疗效,治疗前后的主要症状积分、血清心肌酶指标[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白T(TnT)]水平、心率震荡指标[震荡起始值(TO)、震荡斜率(TS)、正常R-R间期标准差(SDNN)]、心功能指标[左室射血分数(LVEF)、左室短轴缩短率(LVFS)、二尖瓣舒张早/晚期峰值速度比值(E/A)],以及治疗期间的用药安全性。结果:治疗后,观察组患者的治疗总有效率91.67%明显高于对照组的75.00%(P<0.05);同时,观察组心悸不安、胸慌气短、早搏频发、急躁易怒的症状积分,血清CK、CK-MB、TnT水平和TO指标均明显低于对照组(P<0.05),TS、SDNN、LVEF、LVFS和E/A指标均高于对照组(P<0.05);两组治疗期间不良反应发生情况无明显差异(P>0.05)。结论:在西药治疗基础上采用自拟补气活血通络止痛方治疗MI后室性早搏,可明显缓解患者临床症状,改善心率震荡和心肌酶指标水平,提升心功能和临床治疗疗效。

Objective: To explore the curative effect of using Self-made Buqi Huoxue Tongluo Zhitong Recipe in the treatment of ventricular premature beat(VPB) after myocardial infarction(MI) and its influences on myocardial enzymes and heart rate turbulence(HRT). Methods: A total of 96 VPB patients after MI who were admitted to the hospital from September 2018 to September 2020 were enrolled as the research objects. They were divided into an observation group and a controlled group by the random number table method, 48 cases in each group. The controlled group was treated with amiodarone, while the observation group was additionally treated with Self-made Buqi Huoxue Tongluo Zhitong Recipe. Both groups were treated for 1 month. The clinical curative effect on VPB after treatment, scores of main symptoms, levels of serum myocardial enzyme indexes [creatine kinase(CK), creatine kinase MB(CK-MB), troponin T(TnT)], HRT indexes [turbulence onset(TO), turbulence slope(TS), standard deviation of all normal-to-normal intervals(SDNN)] and cardiac function indexes [left ventricular ejection fraction(LVEF), left ventricular fraction shortening(LVFS), ratio of early/late mitral valve diastolic peak systolic velocity(E/A)] before and after treatment, and medication safety during treatment were compared between the two groups. Results: After treatment, the total response rate of treatment in the observation group was significantly higher than that in the controlled group(91.67% vs 75.00%)(P < 0.05). The scores of symptoms(palpitation, shortness of breath, frequent premature beat, irritability), levels of serum CK, CK-MB and TnT, and TO in the observation group were significantly lower than those in the controlled group(P < 0.05), while TS, SDNN, LVEF, LVFS and E/A were higher than those in the controlled group(P < 0.05). There was no significant difference in the occurrence of adverse reactions during treatment between the two groups(P > 0.05). Conclusion: On the basis of western medicine treatment, the application of Self-made Buqi Huoxue Tongluo Zhitong Recipe in the treatment of VPB after MI can significantly alleviate clinical symptoms of patients, improve HRT and levels of myocardial enzyme indexes, and improve cardiac function and clinical curative effect.