血府逐瘀汤联合双联抗血小板药物对冠心病心绞痛患者QT间期离散度、左室舒张功能的影响

Effect of Xuefu Zhuyu decoction combined with dual antiplatelet on QT interval dispersion and left ventricular diastolic function in patients with coronary heart disease and angina pectoris

目的分析血府逐瘀汤联合双联抗血小板药物对冠心病心绞痛患者QT间期离散度(QTd)、左室舒张功能的影响。方法选取该院2020年4月至2022年4月收治的136例冠心病心绞痛患者为研究对象,使用随机数字表法将其分为观察组与对照组,每组各68例。对照组给予氯吡格雷及阿司匹林双联抗血小板药物治疗,观察组在对照组基础上给予血府逐瘀汤。比较两组疗效,记录比较两组治疗前后中医症状积分,比较两组治疗前后QTd,并计算校正QTd(QTcd),比较两组治疗前后左室舒张功能[舒张早期二尖瓣血流峰值(E)、舒张晚期二尖瓣血流峰值(A)、E/A、E峰减速度时间(DT)、等容舒张时间(IVRT)],比较两组不良反应发生率。结果观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组胸痛、胸闷、心悸、面色青白、唇舌紫暗积分均较治疗前明显下降,且观察组各项症状积分明显低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组QTd、QTcd水平均较治疗前明显下降,且观察组QTd、QTcd水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组与对照组E、E/A较治疗前均有明显上升,A、DT、IVRT均较治疗前明显下降,且观察组E、E/A明显高于对照组,A、DT、IVRT明显低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论血府逐瘀汤联合双联抗血小板药物对冠心病心绞痛有较好疗效,能够有效缓解患者临床症状,调节QTd并改善左室舒张功能,且安全性较高,具有临床应用价值。

Objective To analyze the effects of Xuefu Zhuyu Decoction combined with dual antiplatelet drug on QT interval dispersion(QTd)and left ventricular diastolic function in patients with coronary heart disease and angina pectoris.Methods A total of 136 patients with coronary heart disease and angina pectoris admitted to Sun Simiao Hospital,Beijing University of Traditional Chinese Medicine from April 2020 to April 2022 were selected as research objects,and were divided into observation group and control group by random number table method,with 68 cases in each group.Patients in control group were given clopidogrel and aspirin combined antiplatelet therapy,and patients in observation group were given Xuefu Zhuyu decoction on the basis of the control group.Compared the efficacy of the two groups,recorded and compared the TCM symptom scores of the two groups before and after treatment,compared the QTd of the two groups before and after treatment,and calculate the correction QTd(QTcd).Left ventricular diastolic function[peak mitral valve blood flow in early diastolic period(E),peak mitral valve blood flow in late diastolic period(A),E/A,peak deceleration time of E(DT),isovolumic diastolic time(IVRT)]were compared between the two groups before and after treatment,and the incidence rates of adverse reactions were compared between the two groups.Results The total effective rate of observation group was higher than that of control group,the difference was statistically significant(P<0.05).After treatment,scores of chest pain,chest tightness,palpitation,pale complexion and purple lip and tongue in both groups decreased significantly compared with those before treatment,and scores of various symptoms in observation group were significantly lower than those in control group,the differences were statistically significant(P<0.05).After treatment,the levels of QTd and QTcd in the two groups decreased significantly compared with before treatment,and the levels of QTd and QTcd in observation group were significantly lower than those in control group,the differences were statistically significant(P<0.05).After treatment,the levels of E and E/A in observation group and control group increased significantly compared with before treatment,while the levels of A,DT and IVRT decreased significantly compared with before treatment,and the levels of E and E/A in observation group were significantly higher than those in control group,while the levels of A,DT and IVRT in observation group were significantly lower than those in control group,with statistical significance(P<0.05).There was no significant difference on the incidence rates of adverse reactions between the two groups(P>0.05).Conclusion Xuefu Zhuyu Decoction combined with dual antiplatelet drug has a good effect on angina pectoris of coronary heart disease,which can effectively relieve clinical symptoms,regulate QTd and improve left ventricular diastolic function and has high safety and clinical application value.