摘要
目的:探讨缓慢性心律失常患者左束支区域起搏术后中医证候及心功能的变化。方法:入选64例接受左束支区域起搏的缓慢性心律失常患者,分别于术前及术后6个月进行中医辨证,同时测定患者血B型脑钠肽水平。结果:左束支区域起搏术前缓慢性心律失常患者的中医辨证分型以心气虚证为主,占51.6%,其余为心阳虚证、心血瘀阻证和心阴虚证。术后心气虚证所占比例显著减少(51.6%VS 35.9%),心阴虚证所占比例较前明显增加(17.2%VS 34.3%)。在血B型脑钠肽变化方面,术前辨证属心气虚证患者平均血B型脑钠肽为(157.30±68.72)pg/mL,术后显著下降为(112.19±33.47)pg/mL,手术前后比较,差异有统计学意义(P<0.05);其余3种证型的患者术前术后BNP无显著变化(P>0.05)。结论:左束支区域起搏对缓慢性心律失常患者的中医辨证分型有显著影响,术后心阴虚证患者比例显著增加,对心气虚证患者心功能有较好的改善作用。
Objective:To survey the changes of TCM syndrome and heart function of bradyarrhythmia patients after left bundle branch pacing(LBBP).Methods:A total of 64 bradyarrhythmia patients undergoing LBBP were chosen,and they accepted syndrome differentiation before the operation and six months after the operation,meanwhile,to detect the levels of serum type B-brain natriuretic peptide(BNP)in the patients.Results:Bradyarrhythmia patients before LBBP were differentiated as the syndrome of heart Qi deficiency mainly,accounting for 51.6%,the others as the syndromes of heart Yang deficiency,heart blood stagnation and heart yin deficiency.The proportion of heart Qi deficiency syndrome noticeably reduced after the operation(51.6%VS 35.9%),while the proportion of heart Yin deficiency syndrome increased obviously than before(17.2%VS 34.3%).In terms of BNP,the concentrations of BNP in the patients differentiated as heart Qi deficiency syndrome before the surgery were(157.30±68.72)pg/mL,decreased to(112.19±33.47)pg/mL evidently after the operation,and the difference was statistically significant before and after the operation(P<0.05);and no significant changes have been found in the levels of BNP before and after the operation in the patients of other three syndromes(P>0.05).Conclusion:LBBP has the significant impact on syndrome differentiation and patterns of bradyarrhythmia patients,the proportion of the patients with heart Yin deficiency syndrome increasing evidently after the operation,showing the better improvement effects on heart function of the patients with heart Qi deficiency syndrome.
作者
田伟
张大炜
李腾飞
王靖
TIAN Wei;ZHANG Dawei;LI Tengfei;WANG Jing(Beijing Hospital of TCM Affiliated to Capital Medical University,Beijing 100010,China;Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing 100037,China)
出处
《西部中医药》
2023年第4期89-92,共4页
Western Journal of Traditional Chinese Medicine
