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目的探讨心脏起搏器植入术对不同中医证型病态窦房结综合征患者的影响。方法选取2012年2月—2014年2月哈尔滨医科大学附属第四医院收治的病态窦房结综合征患者82例。经中医辨证,分为心气虚证58例,心阳虚证24例。比较并分析手术前后患者的中医症状分级量化评分和血流动力学指标。结果术前心气虚证和心阳虚证患者的中医症状分级量化评分比较,差异无统计学意义(P>0.05);术后心气虚证患者中医症状分级量化评分低于心阳虚证患者(P<0.05);不同证型患者的术后中医症状分级量化评分均低于术前(P<0.05)。术后患者心室射血分数(LVEF)、每搏输出量(SV)与术前比较,差异无统计学意义(P>0.05);而心排血量(CO)、心排血指数(CI)高于术前(P<0.05)。术后心气虚证和心阳虚证患者的LVEF、SV比较,差异无统计学意义(P>0.05);心气虚证患者CO、CI高于心阳虚证患者(P<0.05)。结论心脏起搏器植入术对不同中医证型病态窦房结综合征患者均有一定的临床疗效,心气虚患者优于心阳虚患者,其机制可能是提高CO和CI水平。
Objective To investigate the effect of pacemaker implantation on patients with sick sinus syndrome with different TCM syndromes. Methods Totally 82 patients with sick sinus syndrome were enrolled in the Fourth Affiliated Hospital of Harbin Medical University from February 2012 to February 2014. The traditional Chinese medicine syndrome differentiation, divided into 58 cases of card Qi deficiency, heart Yang deficiency syndrome in 24 cases. The scores of TCM symptoms and hemodynamics were compared and analyzed before and after operation. Results There was no significant difference in quantification of TCM symptom scores between patients with heart-qi deficiency syndrome and patients with heart-yang deficiency syndrome before operation (P> 0.05) .Quality scores of symptom? P <0.05). Quantified scores of TCM symptom score in patients with different syndromes were lower than those before operation (P <0.05). The ventricular ejection fraction (LVEF) and stroke volume (SV) in postoperative patients were not significantly different from those before operation (P> 0.05). The cardiac output (CO), cardiac output index Higher than preoperative (P <0.05). There was no significant difference in LVEF and SV between patients with and without heart-Qi deficiency after cardiopulmonary bypass (P> 0.05). Patients with heart-Qi deficiency had higher CO and CI than those with card-yang deficiency (P <0.05). Conclusion Pacemaker implants have clinical effects on patients with different syndromes of Sinusoidal Syndrome. The patients with heart-qi deficiency are superior to those with heart-yang deficiency, the mechanism may be to improve the level of CO and CI.