益心舒胶囊对心衰合并焦虑患者左心室功能和心率变异性的影响

The Effect of Yixinshu Capsule on Left Ventricular Function and Heart Rate Variability in Patients with Heart Failure Complicated with Anxiety

目的探究分析益心舒胶囊对心力衰竭合并焦虑患者左心室功能和心率变异性的影响。方法选取2018年8月—2022年1月宁夏回族自治区人民医院收治的心力衰竭合并焦虑患者88例作为研究对象,根据随机数表法把88例患者分为中医组与传统组,每组44例。传统组予以常规治疗药物,中医组在其基础上加用益心舒胶囊治疗,所纳入患者治疗观察时长均为8周,测定与记录患者的左心室功能、心率变异性、焦虑情绪变化情况,同时随访患者的主要心血管不良事件发生情况。结果治疗8周后,两组焦虑自评量表(SAS)评分明显低于治疗前,中医组SAS评分也明显低于传统组,差异有统计学意义(P<0.05)。治疗8周后,两组左室射血分数明显高于治疗前,左心室舒张末期内径明显低于治疗前,中医组左室射血分数明显高于传统组,左心室舒张末期内径明显低于传统组,差异有统计学意义(P<0.05)。治疗8周后,两组相邻NN之差大于50 ms的个数占整个窦性心搏个数的比值(PNN50)、RR间期的平均值标准差(SDANN)均高于治疗前,中医组PNN50、SDANN与传统组相比也显著提高,差异有统计学意义(P<0.05)。所有患者随访1年,中医组的再发心力衰竭、心肌梗死、靶血管血运重建、心源性死亡等主要心血管不良事件发生率明显低于传统组,差异有统计学意义(P<0.05)。结论益心舒胶囊在心力衰竭合并焦虑患者的应用能改善患者的左心室功能,缓解患者的焦虑症状,也可改善患者的心率变异性状况,降低患者的随访主要心血管不良事件发生率。

Objective To investigate and analysis the effects of Yixinshu capsules on left ventricular function and heart rate variability in patients with heart failure combined with anxiety.Methods 88 patients with heart failure combined with anxiety admitted to People's Hospital of Ningxia from August 2018 to January 2022 were selected as the research subjects.Accorded to the randomized numerical table method,the patients were divided into the traditional Chinese medicine group of 44 cases and the traditional Chinese medicine group of 44 cases.The traditional group were treated with conventional treatment drugs,while the traditional Chinese medicine group were treated with Yixinshu capsules on top of it,and the duration of treatment and observation for all included patients was 8 weeks.Measured and recorded the left ventricular function,heart rate variability,and changes in anxiety of patients,and follow up on the occurrence of major cardiovascular adverse events.Results The anxiety SAS scores of the Chinese medicine group and the traditional group after 8 weeks of treatment were significantly lower than those before treatment(P<0.05),and the anxiety SAS scores of the Chinese medicine group after 8 weeks of treatment were also significantly lower than those of the traditional group(P<0.05).After 8 weeks of treatment,the left ventricular ejection fraction of the traditional Chinese medicine group were significantly higher than that before treatment(P<0.05),and the left ventricular end diastolic diameter were significantly lower than that before treatment(P<0.05).There were also significant difference compared between the traditional Chinese medicine group and the traditional group(P<0.05).After 8 weeks of treatment,the PNN50 and SDANN of the traditional Chinese medicine group and the traditional group were both higher than before treatment(P<0.05).After 8 weeks of treatment,the PNN50 and SDANN of the traditional Chinese medicine group were also significantly increased compared to the traditional group(P<0.05).All patients were followed up for 1 year.The incidence of major cardiovascular adverse events such as recurrent heart failure,myocardial infarction,target vessel revascularization,and cardiac death in the traditional Chinese medicine group were significantly lower than that in the traditional Chinese medicine group(P<0.05).Conclusion Yixinshu capsule can improve left ventricular function,alleviate anxiety symptoms,and improve heart rate variability in patients with heart failure and anxiety,reducing the incidence of major cardiovascular adverse events during follow-up.