益气活血法对冠心病患者心脏变时性功能不全的影响(1)
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摘 要：目的：观察益气活血法对冠心病患者心脏变时性功能不全的影响及其临床疗效。方法：将63例经临床确诊的冠心病心脏变时功能不全患者作为观察组，以冠心病二级防治标准给予常规治疗。观察组在此基础上加用益气活血方治疗4周，观察治疗前后心脏变时性功能改变情况并与正常对照组(68例)比较。采用分级运动试验法。将运动中最大心率(HRmax)与预测最大心率(190—年龄)的百分比(HRmax/PHRmax)<95%、心脏变时指数(CRI)<0.8、心率储备指数(HRR)<80%为心脏变时功能障碍的诊断指标。结果 观察组HRmax/PHRmax未达到95%者35例(占55.6%)，对照组11例(占16.2%)，两组差别有统计学意义(χ2=22.3，P<0.01); HRR指标未达到80%者,观察组34例(占54%)，对照组(9例，13.2%)，观察组明显高于对照组(χ2=24.6，P<0.01); CRI指标未达到0.8者，观察组31例，占49.2%，对照组19例，占27.9%，观察组明显多于对照组(χ2=6.27，P<0.05)。经过益气活血法治疗 4周后,观察组患者HRmax/PHRmax比值(98.3±4.8%/94.8±4.5%，t =-5.12，P<0.01)、CRI(0.997±0.15/0.805±0.12，t=-54.0，P<0.01)、HRR(90.0±9.6%/78.24±8.2%，t=-75.3，P<0.01)明显高于治疗前。结论：1冠心病存在较明显的心脏变时性功能不全情况，以CI和HRR指标表现明显；2益气活血法治疗能改善冠心病患者的CI，对改善预后和预防心源性猝死(SCD)有一定的作用。
关键词：益气活血法；冠心病；变时性功能不全；心电图分级运动试验
中图分类号：R541.4
文献标识码：A
文章编号：1673-7717(2012)04-0872-03
Effect of Therapy of Reinfoncing Qi and Activating Blood Circulation on
Chronotropic Incompetence in Patients with Coronary Heart Disease
SUN Yingc-hun,ZHENG Yan,YU Xiao-lin,LI Jie
(Qingdao Haiser Hospital，Qingdao 266033，Shandong，China)
Abstract:Objective：To investigate the effect of therapy of reinfoncing Qi and activating blood circulation on chronotropic incompetence of patients with coronary heart disease(CAD). Methods：63 CAD ( observation group) patients were treated with therapy of reinfoncing Qi and activating blood circulation for 4 weeks, and the changes of chronotropic incompetence were examed in comparison with normal control group (68 cases). The diagnosis criteria for chronotropic incompetence as follows: HRmax and PHRmax (190-age) ratio<95%, CRI<0.8, HRR<80%. Results：For 63 patients in the observation group,35 cases(55.6%) failed to come to the HRmax/PHRmax mark 95%, and 11 cases(16.2%) failed to come to the HRmax/PHRmax mark 95% in the normal control group,and there was statistical significance between two groups(χ2=22 ......
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