益心定悸方辅治室性早搏疗效及对左心室功能和心率变异性的影响
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摘要
目的:探究益心定悸方辅治室性早搏疗效及对左心室功能和心率变异性的影响。方法:选取2016年3月～2018年3月我院收治的室性早搏患者120例,采用随机抽签法分为观察组与对照组各60例,对照组予以心内科室性早搏常规治疗,观察组在对照组基础上加用自拟益心定悸方,观察两组患者治疗有效率,治疗前后中医证候积分、左心室功能、心率变异性变化及不良反应发生情况。结果:两组患者治疗有效率分别为91.67%、78.33%,观察组明显高于对照组(P<0.05);治疗后两组患者中医症候积分均较治疗前明显降低(P<0.05),且观察组显著低于对照组(P<0.05);治疗后两组患者左室射血分数(LVEF)较治疗前增高(P<0.05),左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESV)较治疗前降低(P<0.05),且观察组LVEF高于对照组(P<0.05),LVEDD、LVESD低于对照组(P<0.05);治疗后两组患者各心率变异性指标均明显高于治疗前(P<0.05),且观察组24h窦性心博R-R间期标准差(SDNN)、每5min正常R-R间期平均值标准差(SDANN)、相邻R-R间期差值均方根(RMSSD)、相邻R-R差值>50ms个数占总窦性心博数之比(PNN50)均显著高于对照组(P<0.05);两组患者均未发生严重不良反应。结论:益心定悸方辅治室性早搏疗效显著,安全性高,可有效降低室性早搏发生频率,提高左心室功能,改善心率变异性水平,促进患者临床症状恢复。
Objective:To investigate the curative effect of Yixin Dingji prescription in the treatment of ventricular premature beats(VPB) and the influence on left ventricular function and heart rate variability(HRV).Methods A total of 120 patients with VPB who were admitted to the hospital from March 2016 to March 2018 were selected.They were randomly divided into observation group and control group,60 cases in each group.The control group was given routine treatment for VPB in the cardiology department.On the basis,the observation group was treated with self-made Yixin Dingji prescription.The treatment response rates,TCM syndrome scores,left ventricular function and HRV before and after treatment and adverse reactions in both groups were observed.Results The treatment response rate of the observation group was significantly higher than that of the control group(91.67% vs 78.33%)(P<0.05).The TCM syndrome scores of both groups were significantly decreased after treatment(P<0.05),and the scores of observation group were significantly lower than those of the control group(P<0.05).The left ventricular ejection fraction(LVEF) was increased,while the left ventricular end-diastolic diameter(LVEDD) and left ventricular end-systolic diameter(LVESV) were decreased after treatment(P<0.05),and the LVEF of the observation group was higher than that of the control group(P<0.05),the LVEDD and LVESD were lower than those in the control group(P<0.05).The HRV indexes of both groups were significantly increased after treatment(P<0.05).The standard deviation of normal RR intervals(SDNN),standard deviation of 5 min average normal RR intervals(SDANN),square root of the mean of the squared differences between adjacent normal RR intervals(RMSSD) and percent of NN50 in the total number of RR intervals(PNN50) in the observation group were significantly higher than those in the control group(P<0.05).No serious adverse reactions occurred in either group.Conclusion Yixin Dingji prescription is significantly effective and safe in the treatment of VPB.It can effectively reduce the frequency of VPB,improve the left ventricular function and HRV,and promote clinical symptom recovery.
Objective:To investigate the curative effect of Yixin Dingji prescription in the treatment of ventricular premature beats(VPB) and the influence on left ventricular function and heart rate variability(HRV).Methods A total of 120 patients with VPB who were admitted to the hospital from March 2016 to March 2018 were selected.They were randomly divided into observation group and control group,60 cases in each group.The control group was given routine treatment for VPB in the cardiology department.On the basis,the observation group was treated with self-made Yixin Dingji prescription.The treatment response rates,TCM syndrome scores,left ventricular function and HRV before and after treatment and adverse reactions in both groups were observed.Results The treatment response rate of the observation group was significantly higher than that of the control group(91.67% vs 78.33%)(P<0.05).The TCM syndrome scores of both groups were significantly decreased after treatment(P<0.05),and the scores of observation group were significantly lower than those of the control group(P<0.05).The left ventricular ejection fraction(LVEF) was increased,while the left ventricular end-diastolic diameter(LVEDD) and left ventricular end-systolic diameter(LVESV) were decreased after treatment(P<0.05),and the LVEF of the observation group was higher than that of the control group(P<0.05),the LVEDD and LVESD were lower than those in the control group(P<0.05).The HRV indexes of both groups were significantly increased after treatment(P<0.05).The standard deviation of normal RR intervals(SDNN),standard deviation of 5 min average normal RR intervals(SDANN),square root of the mean of the squared differences between adjacent normal RR intervals(RMSSD) and percent of NN50 in the total number of RR intervals(PNN50) in the observation group were significantly higher than those in the control group(P<0.05).No serious adverse reactions occurred in either group.Conclusion Yixin Dingji prescription is significantly effective and safe in the treatment of VPB.It can effectively reduce the frequency of VPB,improve the left ventricular function and HRV,and promote clinical symptom recovery.
引文
[1]陈联中.苓桂术甘汤合生脉饮治疗老年频发室性早搏疗效及对心率变异性、心率震荡的影响[J].现代中西医结合杂志,2017,26 (31):3498~3500
[2]田小超,何伟亮.胺碘酮联合养心定悸胶囊对慢性心力衰竭合并室性早搏患者心功能及血管内皮功能的影响[J].中国医药导报,2018,15(8):40~43
[3]高仲录.自拟益肾健脾复脉法对心悸患者静息心率水平及心肌缺血症状的影响[J].四川中医,2016,34(12):70~73
[4]刘春燕,沈琳,于永梅,等.复律宁颗粒治疗气阴两虚型或心血亏虚型心悸(室性早搏)的临床研究[J].中华中医药杂志,2017,32(12):5675~5677
[5]陆再英,钟南山.内科学.第7版[M].人民卫生出版社,2009:204~205
[6]国家中医药管理局.中医病证诊断疗效标准[S].南京大学出版社,1994:27
[7]郑筱萸.中药新药临床研究指导原则[S].中国医药科技出版社,2002:74~77
[8]张一乐,史苗颜,徐燕.五参口服液对气阴两虚型室性期前收缩心率变异性影响的临床研究[J].上海中医药杂志,2016,50(1):45~47
[9]王阶,李勇,李军,等.室性早搏中医诊疗指南临床应用评价研究[J].中华中医药杂志,2016,31(6):2210~2213
[10]李超,张争强,舒云,等.周立华教授化痰祛瘀法治疗心悸应用体会[J].陕西中医,2016,37(12):1650~1652
[11]周小雄,刘敏超,叶桃春,等.冼绍祥教授论治心悸经验介绍[J].辽宁中医药大学学报,2017,19(8):83~86
[12]李萍,郝伟.炙甘草汤治疗气阴两虚型心悸50例[J].四川中医,2016,34(10):107~109
[13]王凤,徐华英,杜文婷,等.益气养阴不同方药治疗快速性室性早搏气阴两虚证的系统评价[J].中国中医急症,2016,25(1):54~57
[14]谢皛,褚福永.养心定悸胶囊对不稳定型心绞痛冠脉介入术后患者室性早搏及心率变异性的影响[J].中西医结合心脑血管病杂志,2017,15(4):448~451
[2]田小超,何伟亮.胺碘酮联合养心定悸胶囊对慢性心力衰竭合并室性早搏患者心功能及血管内皮功能的影响[J].中国医药导报,2018,15(8):40~43
[3]高仲录.自拟益肾健脾复脉法对心悸患者静息心率水平及心肌缺血症状的影响[J].四川中医,2016,34(12):70~73
[4]刘春燕,沈琳,于永梅,等.复律宁颗粒治疗气阴两虚型或心血亏虚型心悸(室性早搏)的临床研究[J].中华中医药杂志,2017,32(12):5675~5677
[5]陆再英,钟南山.内科学.第7版[M].人民卫生出版社,2009:204~205
[6]国家中医药管理局.中医病证诊断疗效标准[S].南京大学出版社,1994:27
[7]郑筱萸.中药新药临床研究指导原则[S].中国医药科技出版社,2002:74~77
[8]张一乐,史苗颜,徐燕.五参口服液对气阴两虚型室性期前收缩心率变异性影响的临床研究[J].上海中医药杂志,2016,50(1):45~47
[9]王阶,李勇,李军,等.室性早搏中医诊疗指南临床应用评价研究[J].中华中医药杂志,2016,31(6):2210~2213
[10]李超,张争强,舒云,等.周立华教授化痰祛瘀法治疗心悸应用体会[J].陕西中医,2016,37(12):1650~1652
[11]周小雄,刘敏超,叶桃春,等.冼绍祥教授论治心悸经验介绍[J].辽宁中医药大学学报,2017,19(8):83~86
[12]李萍,郝伟.炙甘草汤治疗气阴两虚型心悸50例[J].四川中医,2016,34(10):107~109
[13]王凤,徐华英,杜文婷,等.益气养阴不同方药治疗快速性室性早搏气阴两虚证的系统评价[J].中国中医急症,2016,25(1):54~57
[14]谢皛,褚福永.养心定悸胶囊对不稳定型心绞痛冠脉介入术后患者室性早搏及心率变异性的影响[J].中西医结合心脑血管病杂志,2017,15(4):448~451