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背景:慢性冠状动脉缺血患者心电图QT间期离散度(QTcoupledissoci-ation,QTcd)比健康老年人要长,有些中药制剂能对这种异常延长加以纠正。目的:探讨老年慢性冠脉缺血患者心电图QTcd与健康老年人相比有无显著差异及自主研制的复方黄芪袋泡饮能否改善这种差异。设计:以诊断为依据的病例对照研究。地点、对象和方法:在杭州铁路分局离退休老干部健康体检基础上,确定31例老年冠心病患者为缺血组,另有33例健康老年人作为对照组。分别测定两组QTd;之后缺血组给予复方黄芪袋泡饮1袋代茶饮用,2次/d,连续4周干预,测定该组干预前后的QTd和血液流变学变化。主要观察指标:①两组老年人QTcd比较。②复方黄芪袋泡饮对缺血组治疗前后的QTcd比较。结果:缺血组QTcd值犤(46.2±11.1)ms犦显著大于对照组犤(28.1±9.8)ms犦(t=6.91,P<0.01),复方黄芪袋泡饮干预缺血组后,QTcd值有显著缩短(t=5.31,P<0.01)。全血高切黏度、全血低切黏度均有所下降(t=2.72,2.66,P<0.01)。冠状动脉缺血症状改善率达90%(28/31)。结论:老年慢性冠状动脉缺血患者静息心电图QTcd值较健康老年人显著延长,复方黄芪袋泡饮能够改善这种异常延长。
BACKGROUND: QT-discodiation (QTcd) in patients with chronic coronary artery ischemia is longer than that in healthy individuals. Some TCM preparations can correct this abnormality. OBJECTIVE: To investigate whether elderly patients with chronic coronary ischemia have significant differences in electrocardiogram QTcd compared with healthy elderly and whether the self-developed compound Huangqi Pouching Drink can improve this difference. Design: A case-control study based on diagnosis. Location, object and method: Based on the physical examination of retired veteran cadres in Hangzhou Railway Sub-bureau, 31 elderly patients with coronary heart disease were identified as ischemic group, and another 33 healthy elderly people were used as control group. Two groups of QTd were measured, and then the ischemic group was given 1 teabag of compound Astragalus membranaceus drink for 2 times per day for four consecutive weeks. QTd and hemorheological changes were measured before and after intervention in this group. MAIN OUTCOME MEASURES: 1 Comparison of QTcd between two groups of elderly. 2Comparison of QTcd before and after treatment with compound Huangqi bag brewed drink to the ischemic group. RESULTS: The QTcd value in the ischemic group was significantly higher than that in the control group (26.2±11.1 ms) (26.1±9.8) ms (t=6.91, P<0.01). The QTcd value after the compound Huangqibaofu was intervened in the ischemic group. Significantly shorter (t=5.31, P<0.01). Whole blood hyperviscosity and whole blood low-cut viscosity all decreased (t=2.72, 2.66, P<0.01). The improvement rate of coronary artery ischemic symptoms was 90% (28/31). Conclusion: The QTcd value of resting electrocardiogram in elderly patients with chronic coronary artery ischemia is significantly longer than that of healthy elderly people. Compound Huangqi bag brewed drink can improve this abnormality.