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心血管病防治知识 ›› 2023, Vol. 13 ›› Issue (2): 6-9.

• 临床研究 • 上一篇    下一篇

低强度电刺激耳迷走神经治疗原发性微血管心绞痛的临床研究

熊鹿, 刘云兵, 吴屹   

  1. 电子科技大学医学院附属绵阳医院·绵阳市中心医院,四川 绵阳 621000
  • 出版日期:2023-01-15 发布日期:2023-04-25

Clinical efficacy and safety of low-intensity electrical stimulation of the auricular vagus nerve in treatment of primary coronary microvascular angina

XIONG Lu, LIU Yun-bing, WU Yi   

  1. Mianyang Central Hospital & Mianyang Hospital Affiliated to School of Medicine, University of Electronic Science and Technology of China, Mianyang 621000, China
  • Online:2023-01-15 Published:2023-04-25

摘要: 目的 探讨低强度电刺激耳迷走神经治疗原发性微血管心绞痛的临床效果及安全性。方法 将2018年6月至2020年9月绵阳市中心医院接诊符合纳入标准的130例原发性微血管心绞痛患者按照随机数字表法分为试验组和对照组,每组65例。试验组给予耳迷走神经刺激联合尼可地尔治疗,对照组仅给予尼可地尔治疗,疗程12周。比较两组治疗前后心绞痛症状、西雅图心绞痛量表评分和运动耐量(平板运动总时间和开始运动至ST段压低0.1 mV时间)的变化,观察不良反应发生情况。结果 治疗期间两组不良反应发生率差异不具有统计学意义(P>0.05);试验组心绞痛发作持续时间、发作次数、疼痛程度均低于对照组,差异具有统计学意义(P<0.05)。治疗12周后,试验组西雅图心绞痛量表评分高于对照组,差异具有统计学意义(P<0.05);试验组平板运动总时间、开始运动至ST段压低0.1 mV时间均长于对照组,差异具有统计学意义(P<0.05)。结论 低强度电刺激耳迷走神经能提高原发性微血管心绞痛患者运动耐量,改善临床症状和生活质量,无明显不良反应。

关键词: 原发性微血管心绞痛, 电刺激, 耳迷走神经, 心脏自主神经

Abstract: Objective To investigate the clinical efficacy and safety of low-intensity electrical stimulation of the auricular vagus nerve in treatment of primary coronary microvascular angina. Methods A total of 130 eligible patients with primary coronary microvascular angina, who were admitted to Mianyang Central Hospital from June 2018 to September 2020, were enrolled and divided into study group and control group using a random number table, with 65 patients in each group. The patients in the study group received electrical stimulation of the auricular vagus nerve combined with nicorandil, while those in the control group received nicorandil alone, and the course of treatment was 12 weeks for both groups. The two groups were compared in terms of the changes in angina symptoms, Seattle Angina Questionnaire (SAQ) score, and exercise tolerance (including the total time of Treadmill exercise and the time from start of exercise to 0.1 mV depression of ST segment) after treatment, and adverse reactions were observed for both groups. Results There was no significant difference in the incidence rate of adverse reactions during treatment between the two groups (P>0.05), and compared with the control group, the study group had a significantly shorter duration of anginal attack and significantly lower frequency and degree of pain of angina attack (P<0.05). Compared with the control group after 12 weeks of treatment, the study group had a significantly higher SAQ score (P<0.05) and significantly longer total time of Treadmill exercise and time from start of exercise to 0.1 mV depression of ST segment (P<0.05). Conclusion Low-intensity electrical stimulation of the auricular vagus nerve can improve exercise tolerance, clinical symptoms, and quality of life in patients with primary coronary microvascular angina, with little adverse effect.

Key words: Primary coronary microvascular angina, Electrical stimulation, Auricular vagus nerve, Cardiac autonomic nerve