从频发室性早搏分布规律探讨中西医时间医学结合点

通过观察24 h动态心电图频发室性早搏（室早）的时间分布情况，研究频发室早24 h昼夜规律和中医时辰节律，并由子、卯、午、酉4个时辰为切入点，探讨中西医时间医学结合点。方法选取2012年1月至2014年6月在广东省中医院行24 h动态心电图诊断为频发室早者（诊断标准为24 h室早数＞500次）466例，录入患者的基本信息和每小时室早频数结果。将24 h频发室早分布数据视为圆分布资料，用PEMS 3．1统计软件求得其平均角并进行假设检验，统计分析室早发生时间的集中趋势。不同时间室早的比较采用SPSS 20．0统计软件做重复资料测量的方差分析。结果466例患者动态心电图的室早发作高峰时间段在17：49左右，对应于12时辰的酉时（17：00-19：00）；发生室早最少的时间段是子时（23：00-01：00）和卯时（05：00-07：00）。4个时辰的室早个数比较，差异有统计学意义（P＜0．05）。在24 h分布趋势图中，室早发生的高峰时间在18：00，低谷时间在04：00。结论本研究证实了频发室早的发生具有昼夜节律现象，24 h发生的高峰时间与中医酉时相对应，也与心肾精气活动规律和心肾相交关系相符，为中西医时间医学结合作了初步的探索。

Investigation on the bonding point of traditional Chinese and Western Chronomedicine through distribution regularity of frequent ventricular premature beat

Objective To investigate the circadian rhythms of frequent ventricular premature beat within 24 hours and its circadian rhythm of traditional Chinese medicine by observing the tem-poral distribution of frequent ventricular premature beat in 24 h ambulatory electrocardiography （AECG）,and to discuss the bonding point of traditional Chinese and Western Chronomedicine through the 4 time points of Zi（23：00 -01：00）,Mao（05：00 -07：00）,Wu（11：00 -13：00）, and You（17：00 -19：00 ）.Methods Four hundred and sixty-six patients were enrolled in the study who had been diagnosed with frequent ventricular premature beat by AECG in our hospital from January 2012 to June 2014 and the diagnostic criteria was the total number of ventricular pre-mature beats＆gt;500 times/d.Their fundamental data and the number of ventricular premature beats per hour were recorded.The distribution data of frequent ventricular premature beat within 24 hours were regarded as circular distribution,from which the average angle was calculated by PEMS 3.1 statistical software,hypothesis testing was performed and the central tendency of the occurrence time of ventricular premature beat was statistically analysed.With the help of SPSS 20.0 statistical pack-age,comparison of ventricular premature beats numbers among different time points was made by va-riance analysis of repeated measurement.Results Among the enrolled 466 patients,the peak time for the occurrence of ventricular premature beat by AECG was around 17：49,corresponding to You, the period of a day from 17：00 to 19：00,while the least total number of ventricular premature beats fell in Zi（23：00-01：00）and Mao（05：00-07：00）.The differences of the total numbers of ven-tricular premature beats among the 4 time points were statistically significant（P＆lt;0.05）.According to the distribution trend chart within 24 hours,the peak time for the occurrence of ventricular prema-ture beat was 18：00 and the down time was 04：00.Conclusion This study verif