麝香保心丸治疗病态窦房结综合征的疗效及部分机制探讨

目的:观察运用麝香保心丸治疗病态窦房结综合征的临床疗效,并对其进行分析试探讨其机制。方法:选取2016年1月至2017年12月河北省保定市第一中心医院心内科门诊及住院确诊为SSS 76例患者。通过就诊先后顺序,分别纳入观察组和对照组,每组各38例,对照组予口服氯溴酸山莨菪碱,观察组在对照组基础上予口服麝香保心丸。共治疗8周。治疗前后对患者24小时动态心电图的平均心率、食管内电生理检查(SACT、SNRT、cSNRT),Taq Man荧光探针检测Klotho基因中G-395A位点表达。结果:1)治疗后观察组总有效率(89.47%)优于对照组(73.68%)(P0.05)。2)2组治疗前后的24 h Holter平均心率进行比较,2组均较治疗前明显改善(P0.05),且观察组改善程度明显优于对照组(P0.05)。3)治疗后2组的SACT、SNRT、cSNRT均较治疗前明显缩短(P0.05),且观察组改善程度优于对照组(P0.05)。4)治疗后2组组中Klotho基因中G-395A位点的表达均明显下调(P0.05),其中观察组下调程度优于对照组(P0.05)。结论:麝香保心丸可以有效的改善SSS患者的临床症状,其作用机制可能与Klotho基因中G-395A位点的表达下调有关。

Effect and Mechanism of Shexiang Baoxin Pill in Treating Sick Sinus Syndrome

To observe the clinical efficacy of Shexiang Baoxin Pill in the treatment of sick sinus syndrome (SSS) and analyze its mechanism.Methods:From January 2016 to December 2016, 76 patients with SSS were divided into the treatment group and the control group,according to the order of treatment, with 38 cases in each group. The control group was treated with oral anisodamine hydrobromide, and the treatment group was given oral Shexiang Baoxin Pill on the basis of the control group.The treatment last for 8 weeks. Before and after treatment,the average heart rate and esophageal electrophysiology (SACT,SNRT,cSNRT) were measured in 24 hours electrocardiogram and esophageal electrophysiology.And the expression G-395A of Klotho gene was detected by TaqMan fluorescence probe.Results:1) After treatment, the total effective rate of the treatment group(89.47%) was better than that of the control group (73.68%) (P<0.05).2) The average heart rate of the patients in the 24 groups before and after treatment was significantly improved in the two groups(Holter)(P<0.05),and the improvement of the treatment group was significantly better than that of the control group (P<0.05).3) The SACT, SNRT and cSNRT of the treatment group were significantly shorter than those before treatment (P<0.05),and the improvement of the treatment group was better than that of the control group (P<0.05).(4) After treatment,the expression of G-395A in the Klotho gene of the two groups was significantly lower (P<0.05),and the treatment group was significantly lower than the control group(P<0.05).Conclusion:Shexiang Baoxin Pill can effectively improve the clinical symptoms of patients with SSS, and its mechanism may be related to the down-regulation of the expression of G-395A in the Klotho gene.