Clinical Observation And Experiment Study Of YXDJ Capsule On The Treatment Of Ventricular Arrhythmia

Objective:To observe the therapeutic effect of Yangxin Dingji?YXDJ?capsule on ventricular premature beats?VPB?after stent implantation in coronary heart disease?CHD?,and to measure the bioche-mical indexes related to oxidative stress in ventricular arrhythmias rats,and to analyze the anti-arrhythmia mechanism of YXDJ capsule.Methods:Adopted 86 patients with ventricular premature beats after coronary stent implantation were randomly divided into observation group and treatment group.The observation group,containing 43patients,was administrated routinely by Metoprolol medication,and the treatment group containing 43 patients also,was treated with Metoprolol plus oral YXDJ capsule continually for 28 days.The time-domain indexes of heart rate variability?HRV?was observed:standard deviation of R-R interval of sinus rhythm?SDNN?,standard deviation of mean R-R interval?SDANN?and mean square root of interval difference?rMSSD?.The indexes of heart rate turbulence:the change of initial concussion?TO?and turbulence slope?TS?.Seventy SD rats,age 6-7 weeks and body weight 180-250g,were randomly divided into normal group,model control group,reference control group,positive control group,YXDJ capsule low,medium and high dose group,with 10 rats in each group.In the experiment,YXDJ capsule administrated with 0.5,1.0,2.0 g/kg in the low,middle and high dosage groups,Propranolol Hydrochloride with 15 mg/kg in the positive control group,Shensong Yangxin capsule with 0.5 g/kg in the in the control group,and the blank and the model control group administration with 0.5 g/kg solvent.Each group was treated by intragastric administration,once a day for7 consecutive days,using the same volume solvent 1 mL/100 g weight.After the last administration,10%chloral hydrate 0.35 mL/100g was injected intraperitoneally for anesthesia,Lead II electrocardiogram was recorded.After the electrocardiogram was stabilized,the rest of the animals were injected with epinephrine hydrochloride injection 100 ug/kg through femoral vein to establish ventricular arrhythmia model.The time of ventricular premature beats?VP?and ventricular tachycardia?VT?was observed and recorded,and the duration of ventricular tachycardia?VT?and arrhythmia was calculated.After the ECG detection,the animals fed continually three days,and were injected intraperitoneally with isoprenaline 20mg/kg per day once time.At the end of administration one hour,the blood of abdominal aorta was taken after electrocardiogram examination,and the activity of T-SOD and the content of MDA were measured.Na⁺-K⁺-ATP enzyme,Ca²+-ATP enzyme,glutathione peroxi-dase?GSH-Px?activity and tissue NO content.Combined with the change rule of sensitive biochemical indexes,the mechanism of action was analyzed.Result:Of the 86 patients,3 were lost and 1 was excluded.The number of the control group was 40,and the number of the treatment group was 42.In the treatment group,24 cases were markedly effective,11 cases were effective,7 cases were ineffective,the total effective rate was 83.3%.In the control group,16 cases were markedly effective,9 cases were effective,15 cases were ineffective,the total effective rate was 62.5%.There was statistical signifi-cance between the two groups?P<0.05?.Comparison before and after self-medication:treatment group rMSSD:[?31.26±24.13?vs.?22.47±14.15?ms,P=0.03],treatment group TO[?-2.39+1.85?vs.?-1.37+2.54?%,P=0.04],treatment group TS[vs.?3.83+1.02??2.84+2.01?MS/RR,P=0.04],control group rMSSD:[?30.29+18.36?vs.?21.38+15.89?,P=0.02];Compared with the control group,SDANN[?149.81+23.5 vs.133.63+25.12?ms,TO[?-2.39+1.85?vs.?-1.07+1.99?%,P=0.02]and TS[?3.83+1.021?vs.?3.07+2.13?MS/RR,P=0.04]in the treatment group were significantly lower than those in the control group.The time of ventricular premature?VP?and ventricular tachycardia?VT?in lead II ECG of animal experiment was delayed compared with the model control group,and the time of VP was significantly delayed?P<0.05?;the duration of ventricular tachycardia?VT?and arrhythmia was shortened,but there was no statistical significance.The time of ventricular premature?VP?and ventricular tachycardia?VT?were delayed in the high dose YXDJ group,and the time of ventricular premature?VP?was significantly delayed?P<0.01?;the duration of ventricular tachycardia was shortened,but no statistical difference was found.According to gender statistics,the results showed that the time delay of ventricular premature onset in male rats of high dose group of YXDJ capsule was very significant?P<0.01?,which was more obvious than that in female rats.VP and VT in middle and low dose groups were improved in different degrees,but there was no significant difference.Compared with the blank control group,the SOD activity and MDA content in serum of model control group were decreased?P<0.01?,and the activities of Na⁺-K⁺-ATPase and Ca²⁺-ATPase,NO and GSH-Px in myocardium were decreased?P<0.05,P<0.05,P<0.01,P<0.05?.Compared with the model control group,SOD activity in serum of propranolol group?positive control group?increased?P<0.05?,MDA content decreased,but there was no statistical difference.Na⁺-K⁺-ATPase and GSH-Px activity in myocardium increased significantly?P<0.05,P<0.05?,Ca²⁺-ATPase activity and NO content increased,but there was no significant difference.Significant statistical difference.In Shensong Yangxin Capsule group?control group?,SOD activity in serum increased?P<0.05?,MDA content decreased?P<0.05?,GSH-Px activity in myocardium increased?P<0.05?,Na⁺-K⁺-ATPase and Ca²⁺-ATPase activity increased,but there was no significant difference between the two groups.The activities of GSH-Px and Ca²⁺-ATPase in myocardium were significantly increased?P<0.01?,while the activities of Na⁺-K⁺-ATPase and NO in myocardium were all increased,but there was no statistical difference between them.The NO content and GSH-Px activity in weaving showed an upward trend,and there was no significant difference between them.Conclusion:YXDJ capsule combined with metoprolol has a significant effect on ventricular premature beats after coronary stent implantation.It can increase heart rate variability?HRV?,restore sinus heart rate turbulence?HRT?,and reduce the incidence of ventricular arrhythmia in coronary heart disease.Alleviating adrenaline-induced ventricular arrhythmias and improving serum SOD,MDA and myocardial GSH-Px,Ca²⁺-ATPase activity may be related to reducing intracellular oxygen free radical damage,calcium overload and myocardial energy metabolism disorders.