中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
20期
2463-2467
,共5页
冠心病%心电描记术%参麦注射液%辨证分型
冠心病%心電描記術%參麥註射液%辨證分型
관심병%심전묘기술%삼맥주사액%변증분형
Coronary disease%Electrocardiography%Shenmai injection%Syndrome differ classification
目的：探讨参麦注射液对不同中医证型冠心病（ CHD）患者心电图改变的影响，为临床合理用药提供依据。方法选取2011年1月—2015年2月于首都医科大学附属北京地坛医院住院采用参麦注射液治疗的CHD患者402例为中医组，根据中医辨证分型分组，心血痹阻组76例、痰浊痹阻组104例、气阴两虚组112例、心肾阴虚组110例，另选择同期应用单纯西医治疗的CHD患者96例为对照组。对照组给予常规限盐、休息、强心、吸氧、扩血管、利尿等基础治疗，中医组在对照组治疗基础上给予参麦注射液（50 ml，静脉滴注，1次/d）治疗。观察各组患者治疗前后心电图V1导联P波双向的负向波振幅及宽度的乘积（ PTF-V1）≤-0.04 mm·s、ST段异常、缺血型T 波、房室传导阻滞发生率及校正 QT 间期离散度（ QTcd）、校正 JT 间期离散度（ JTcd）情况。结果治疗前，5组患者PTF-V1≤-0.04 mm·s、ST段异常、缺血型T 波、房室传导阻滞发生率、校正最大QT间期（ QTcmax）、校正最小QT间期（ QTcmin）、QTcd、校正最大JT间期（ JTcmax）、校正最小JT间期（ JTcmin）、JTcd比较，差异均无统计学意义（P>0.05）。治疗后，气阴两虚组患者PTF-V1≤-0.04 mm·s、房室传导阻滞发生率低于对照组（P<0.005）；气阴两虚组患者QTcd、JTcd低于对照组、心血痹阻组、痰浊痹阻组、心肾阴虚组（ P<0.05）。结论参麦注射液对CHD患者心电图改善具有积极作用，对气阴两虚型CHD患者心电图改善较为显著。
目的：探討參麥註射液對不同中醫證型冠心病（ CHD）患者心電圖改變的影響，為臨床閤理用藥提供依據。方法選取2011年1月—2015年2月于首都醫科大學附屬北京地罈醫院住院採用參麥註射液治療的CHD患者402例為中醫組，根據中醫辨證分型分組，心血痺阻組76例、痰濁痺阻組104例、氣陰兩虛組112例、心腎陰虛組110例，另選擇同期應用單純西醫治療的CHD患者96例為對照組。對照組給予常規限鹽、休息、彊心、吸氧、擴血管、利尿等基礎治療，中醫組在對照組治療基礎上給予參麥註射液（50 ml，靜脈滴註，1次/d）治療。觀察各組患者治療前後心電圖V1導聯P波雙嚮的負嚮波振幅及寬度的乘積（ PTF-V1）≤-0.04 mm·s、ST段異常、缺血型T 波、房室傳導阻滯髮生率及校正 QT 間期離散度（ QTcd）、校正 JT 間期離散度（ JTcd）情況。結果治療前，5組患者PTF-V1≤-0.04 mm·s、ST段異常、缺血型T 波、房室傳導阻滯髮生率、校正最大QT間期（ QTcmax）、校正最小QT間期（ QTcmin）、QTcd、校正最大JT間期（ JTcmax）、校正最小JT間期（ JTcmin）、JTcd比較，差異均無統計學意義（P>0.05）。治療後，氣陰兩虛組患者PTF-V1≤-0.04 mm·s、房室傳導阻滯髮生率低于對照組（P<0.005）；氣陰兩虛組患者QTcd、JTcd低于對照組、心血痺阻組、痰濁痺阻組、心腎陰虛組（ P<0.05）。結論參麥註射液對CHD患者心電圖改善具有積極作用，對氣陰兩虛型CHD患者心電圖改善較為顯著。
목적：탐토삼맥주사액대불동중의증형관심병（ CHD）환자심전도개변적영향，위림상합리용약제공의거。방법선취2011년1월—2015년2월우수도의과대학부속북경지단의원주원채용삼맥주사액치료적CHD환자402례위중의조，근거중의변증분형분조，심혈비조조76례、담탁비조조104례、기음량허조112례、심신음허조110례，령선택동기응용단순서의치료적CHD환자96례위대조조。대조조급여상규한염、휴식、강심、흡양、확혈관、이뇨등기출치료，중의조재대조조치료기출상급여삼맥주사액（50 ml，정맥적주，1차/d）치료。관찰각조환자치료전후심전도V1도련P파쌍향적부향파진폭급관도적승적（ PTF-V1）≤-0.04 mm·s、ST단이상、결혈형T 파、방실전도조체발생솔급교정 QT 간기리산도（ QTcd）、교정 JT 간기리산도（ JTcd）정황。결과치료전，5조환자PTF-V1≤-0.04 mm·s、ST단이상、결혈형T 파、방실전도조체발생솔、교정최대QT간기（ QTcmax）、교정최소QT간기（ QTcmin）、QTcd、교정최대JT간기（ JTcmax）、교정최소JT간기（ JTcmin）、JTcd비교，차이균무통계학의의（P>0.05）。치료후，기음량허조환자PTF-V1≤-0.04 mm·s、방실전도조체발생솔저우대조조（P<0.005）；기음량허조환자QTcd、JTcd저우대조조、심혈비조조、담탁비조조、심신음허조（ P<0.05）。결론삼맥주사액대CHD환자심전도개선구유적겁작용，대기음량허형CHD환자심전도개선교위현저。
Objective To investigate the influence of Shenmai injection on electrocardiogram ( ECG ) changes in patients with coronary heart disease( CHD)of different TCM syndromes. Methods Enrolled 402 CHD inpatients who received Shenmai injection in Beijing Ditan Hospital Affiliated to Capital Medical University from January 2011 to February 2015 and assigned them into TCM group. According to TCM syndrome differentiation,the TCM group was further divided into blood stasis group(n=76),phlegm stasis group(n=104),Qi and Yin deficiency group(n=112)and heart-kidney Yin deficiency group(n =110). Another 96 CHD patients were enrolled as control group,in which only western medicine treatment was conducted during the same period. Both groups were given basic treatments, including conventional restriction on salt consumption,rest,cardiotonic drug,oxygen uptake,vascular dilation and diuresis. The TCM group was also given Shenmai injection(50 ml,intravenous drip,once per day). ECG index of incidence of PTF-V1≤-0. 04 mm·s,abnormity in ST segment,ischemic T wave,atrioventricular block,QTcd and JTcd were compared among the five groups. Results Before treatment,the five groups were not significantly different(P>0. 05)in incidence of PTF-V1≤-0. 04 mm·s,abnormity in ST segment, ischemic T wave, atrioventricular block, QTcmax, QTcmin, QTcd, JTcmax, JTcmin and JTcd. After treatment,the Qi and Yin deficiency group was lower(P<0. 005)than the control group in PTF-V1≤-0. 04 mm·s and the incidence of atrioventricular block;the Qi and Yin deficiency group was lower ( P<0. 05 )in QTcd and JTcd than the control group,the blood stasis group,the phlegm stasis group and the heart -kidney Yin deficiency group. Conclusion Shenmai injection has a positive effect on the improvement of ECG of CHD patients. The ECG improvement of CHD patients with Qi and Yin deficiency is more significant.
