通心络胶囊治疗冠心病无症状性心肌缺血患者对动态心电图及血流动力学的影响

Effect of Tongxinluo capsule on dynamic electrocardiogram and hemodynamics in patients with silent myocardial ischemia of coronary heart disease

目的研究通心络胶囊治疗冠心病(CHD)无症状性心肌缺血(SMI)患者对动态心电图、血流动力学指标的影响。方法120例冠心病SMI患者,按随机数字表法分为对照组和观察组,每组60例。对照组给予阿司匹林常规治疗,观察组在对照组基础上联合通心络胶囊治疗。比较两组患者治疗前后24 h心电图指标(ST段压低总持续时间、ST段压低次数、心肌缺血总负荷)、各种早搏次数[房性早搏(APBs)、室性早搏(VPBs)、交界性早搏(JPBs)次数]、血流动力学指标[全血低切粘度(WBLSV)、全血高切粘度(WBHSV)、血浆粘度(PV)]及不良反应发生情况。结果治疗后,两组患者ST段压低总持续时间短于本组治疗前,ST段压低次数、心肌缺血总负荷低于本组治疗前,且观察组患者ST段压低总持续时间(16.02±4.68)min短于对照组的(24.83±5.49)min,ST段压低次数(3.18±0.61)次/24 h、心肌缺血总负荷(23.46±5.21)mm·min低于对照组的(4.12±1.03)次/24 h、(43.13±5.81)mm·min,差异具有统计学意义(P<0.05)。治疗后,两组患者APBs、VPBs、JPBs次数均少于本组治疗前,且观察组患者APBs次数(104.23±36.72)次/24 h、VPBs次数(68.11±20.45)次/24 h、JPBs次数(68.19±20.43)次/24 h少于对照组的(296.75±48.78)、(262.03±65.79)、(153.26±39.72)次/24 h,差异具有统计学意义(P<0.05)。治疗后,两组患者WBLSV、WBHSV、PV均低于本组治疗前,且观察组患者WBLSV(9.01±0.86)mPa·s、WBHSV(4.02±0.44)mPa·s、PV(1.10±0.28)mPa·s低于对照组的(9.51±0.93)、(4.68±0.47)、(1.46±0.33)mPa·s,差异具有统计学意义(P<0.05)。观察组患者用药期间不良反应发生率为3.33%,低于对照组的18.33%,差异具有统计学意义(P<0.05)。结论与单用阿司匹林相比,冠心病SMI患者联用通心络胶囊治疗的效果更理想,可有效改善心电图状态,预防各种早搏的发生,改善血流动力学指标,减少不良反应,安全可靠。

Objective To study the effect of Tongxinluo capsule on dynamic electrocardiogram and hemodynamics in patients with silent myocardial ischemia(SMI)of coronary heart disease(CHD).Methods A total of 120 patients with SMI of coronary heart disease were divided into control group and observation group according to the random numerical table,with 60 cases in each group.The control group was treated with aspirin conventionally,and the observation group was treated with Tongxinluo capsule on the basis of the control group.Both groups were compared in terms of 24-h electrocardiogram indexes(total duration of ST-segment depression,number of ST-segment depression,total ischemia burden),the number of premature beats[atrial premature beats(APBs),ventricular premature beats(VPBs),junctional premature beats(JPBs)],hemodynamic indexes[whole blood low-shear viscosity(WBLSV),whole blood high-shear viscosity(WBHSV),plasma viscosity(PV)],and the occurrence of adverse reactions.Results After treatment,the total duration of ST-segment depression in both groups was shorter than that before treatment in this group,and the number of ST-segment depressions and total ischemic burden were lower than those before treatment in this group;the total duration of ST-segment depression(16.02±4.68)min in the observation group was shorter than(24.83±5.49)min in the control group;the number of ST-segment depressions(3.18±0.61)times/24 h and the total ischemic burden(23.46±5.21)mm·min in the observation group were lower than(4.12±1.03)times/24 h,(43.13±5.81)mm·min in the control group;the differences were statistically significant(P<0.05).After treatment,the number of APBs,VPBs and JPBs in both groups was less than those before treatment in this group;the number of APBs(104.23±36.72)times/24 h,number of VPBs(68.11±20.45)times/24 h and number of JPBs(68.19±20.43)times/24 h in the observation group was less than(296.75±48.78),(262.03±65.79),(153.26±39.72)times/24 in the control group;the differences were statistically significant(P<0.05).After treatment,the WBLSV,WBHSV and PV in both groups were lower than those before treatment in this group;the WBLSV(9.01±0.86)mPa·s,WBHSV(4.02±0.44)mPa·s,and PV(1.10±0.28)mPa·s in the observation group were lower than(9.51±0.93),(4.68±0.47),and(1.46±0.33)mPa·s in the control group;the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 3.33%,which was lower than 18.33%in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with aspirin alone,Tongxinluo capsule is more effective in treating patients with SMI of coronary heart disease.It can effectively improve the electrocardiogram status,prevent the occurrence of premature beats,improve hemodynamic indicators,reduce adverse reactions,and is safe and reliable.