补气活血方治疗气虚血瘀型冠心病PCI术后合并室性早搏的临床观察*

作者：罗静静1，张铁军2，何红涛2，冯庆涛2，董燕平2，李 霞2，张 曼2

单位：1.河北中医药大学，河北 石家庄 050011； 2.河北中医药大学第一附属医院，河北 石家庄 050011

引用：引用：罗静静，张铁军，何红涛，冯庆涛，董燕平，李霞，张曼.补气活血方治疗气虚血瘀型冠心病PCI术后合并室性早搏的临床观察[J].中医药导报,2025,31(11):74-78,84.

DOI：10.13862/j.cn43-1446/r.2025.11.013

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摘要：

目的：探讨补气活血方治疗气虚血瘀型冠心病经皮冠状动脉介入治疗（PCI）术后合并室性早搏的疗效。方法：将80例冠心病PCI术后合并室性早搏患者，随机分为治疗组和对照组，每组各40例。对照组患者服用阿司匹林肠溶片、阿托伐他汀钙片、酒石酸美托洛尔等药物治疗，治疗组在对照组治疗的基础上，予补气活血方口服，共治疗4周。观察治疗前、后两组患者室性早搏次数、动态心电图指标、自主神经功能指标及血清LTBP-2、periostin表达水平变化，并评价中医证候疗效和室性早搏疗效。结果：中医证候疗效与室性早搏疗效总有效率治疗组分别为90.00%（36/40）、87.50%（35/40），高于对照组的70.00%（28/40）、67.50%（27/40），差异有统计学意义（P＜0.05）；治疗后两组患者室性早搏次数均减少（P＜0.05），SDNN、RMSSD、PNN50均升高（P＜0.05），自主神经功能指标均升高（P＜0.05），血清LTBP-2、periostin表达水平均降低（P＜0.05）；且治疗后治疗组患者室性早搏次数明显少于对照组（P＜0.05），SDNN、RMSSD、PNN50高于对照组（P＜0.05），自主神经功能指标高于对照组（P＜0.05），血清LTBP-2、periostin表达水平均低于对照组（P＜0.05）。结论：补气活血方治疗气虚血瘀型冠心病PCI术后合并室性早搏，可减少室性早搏次数，其可能与提高心率变异性及自主神经功能，降低血清LTBP-2、periostin表达水平而改善心肌缺血有关。

关键词：冠心病；PCI术；室性早搏；补气活血方；心率变异性；潜在转化生长因子结合蛋白2；血清骨膜蛋白

Abstract：

Objective: To investigate the efficacy of Buqi Huoxue formula on patients with ventricular premature beats after percutaneous coronary intervention (PCI) for coronary heart disease with Qi deficiency and blood stasis. Methods: A total of 80 patients with ventricular premature beats after PCI for coronary artery disease were randomly divided into treatment group and control group, with 40 in each. Patients received aspirin enteric coated tablet, atorvastatin calcium tablet and metoprolol tartrate in control group. In addition to the standard treatment given to the control group, patients in the treatment group were administered the Buqi Huoxue formula orally. The total treatment duration for both groups was 4 weeks. Parameters observed and recorded before and after treatment included the frequency of ventricular premature beats, ambulatory electrocardiogram (Holter) indices, autonomic nervous function indices, and serum levels of latent transforming growth factor binding protein 2 (LTBP-2) and periostin protein in both groups. Additionally, the therapeutic efficacy based on traditional Chinese medicine (TCM) syndrome and the clinical efficacy for ventricular premature beats were statistically analyzed. Results: The total effective rates for TCM syndrome efficacy and ventricular premature beat efficacy in the treatment group were 90.00% (36/40) and 87.50% (35/40), respectively, which were higher than those in the control group at 70.00% (28/40) and 67.50% (27/40), with statistically significant difference (P<0.05). The frequency of premature ventricular beats was reduced in two groups after treatment (P<0.05), and SDNN, RMSSD and PNN50 were increased (P<0.05). Autonomic function indexes were elevated in two groups after treatment (P<0.05), and the levels of serum LTBP-2 and periostin protein decreased (P<0.05). The treatment group showed less number of premature ventricular beats than control group (P<0.05), while higher SDNN, RMSSD and PNN50 than control group (P<0.05) after treatment. The treatment group showed higher autonomic function indexes than control group (P<0.05), while lower levels of serum LTBP-2 and periostin protein than control group (P<0.05) after treatment. Conclusion: The Buqi Huoxue formula can reduce the frequency of ventricular premature beats in patients with ventricular premature beats after PCI for coronary heart disease with Qi deficiency and blood stasis. This effect is potentially mediated by improving heart rate variability and autonomic nervous function, as well as by reducing serum levels of LTBP-2 and periostin protein, thereby alleviating myocardial ischemia.

Key words：coronary heart disease; percutaneous coronary intervention; ventricular premature beat; Buqi Huoxue formula; heart rate variability; latent transforming growth factor binding protein 2; serum periostin

发布时间：2025-11-30

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