益气活血通络法治疗频发室性早搏的疗效观察研究
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摘要
目的
本课题通过临床观察的方式,充分发挥中医药特色,运用全国著名老中医颜德馨教授经典验方益心方采用益气活血通络法治疗频发室性早搏,观察该方对室性早搏患者的疗效及影响,以及对普通心电图、动态心电图各种客观指标的影响,为进一步探讨该方可能作用的靶点及机制奠定临床研究基础,为发现名老中医经验方的作用机理提供现代化客观依据,进而为其产业化开发打下坚实的基础。方法
本研究应用前瞻性研究的方法,按严格的纳入标准选取广东省中医院大德路总院心脏中心门诊频发室性早搏患者75例为研究对象,按照随机对照的原则将其分为治疗组和对照组,病例数分别为40例和35例。治疗组在应用西药的基础上加用颜氏益心方,对照组应用西药常规治疗频发室性早搏,疗程均为3月,观察两组治疗前后患者总体症状、主要症状改善情况,心率、心电图、动态心电图改变状况及对安全性指标肌酐、谷丙转氨酶的影响。
结果
1.治疗后两组室性早搏情况均有改善,两组有效率比较,差异无显著性(P>0.05)。两组治疗后24h动态心电图早搏次数与治疗前相比,统计学比较有差异(P<0.01)；治疗组与对照组治疗后比较,有统计学差异(P<0.05)
2.治疗后两组症状均有改善,两组比较有差异性(P<0.05),治疗组症状改善情况优于对照组。主要症状方面,患者心悸、气短乏力改善情况,经统计学比较,有差异性(P<0.05)
3.治疗组后检查心电图心率HR较治疗前减慢,有统计学差异(P<0.05)；而对照组治疗前后无显著性差异(P>0.05)。而心电图、动态心电图显示治疗组PR间期、QRS波时限及QTC间期变化无显著差异(P>0.05),而对照组用药前后以上指标变化与对照组相比有显著性差异(P<0.01或P<0.05)。
4.两组治疗前后Cr、ALT无显著性差异(P>0.05)；组间治疗后Cr、ALT亦无显著性差异(P>0.05)。
结论
1.根据益气活血通络法应用颜氏益心方治疗频发室性早搏有效；并且可明显改善室性早搏患者的症状,尤其是心悸、胸闷乏力等主要症状方面,从而提高患者的生活质量、改善工作状态。
2.颜氏益心方可明显减少频发室性早搏患者24小时动态心电图室性早搏数量,对PR间期、QRS波群等心电指标无不良影响,反映该方在一定程度上可避免西药的致心律失常的作用。
3.颜氏益心方安全,无明显肝肾功能损害,不产生毒副作用,值得临床进一步推广运用。
Objective
The subject by the way of clinical observation, give full play to the characteristics of Chinese medicine, using of a famous old Chinese classic recipes, Yixin Fang of professor Yan Dexin Qi and blood circulation to pass with frequent premature ventricular contractions treatment, observe the effect on patients with ventricular arrhythmias and the impact on common ECG and 24 hours dynamic ECG effects of various objective indicators, for further study of the possible side effects of the target and mechanism of clinical research laid the foundation for the discovery experience famous traditional Chinese side to provide modern mechanism of objective basis for industrial development and thus lay a solid basis.
Methods
The prospective study application of research methods, selected according to strict inclusion criteria Guangdong Provincial Hospital Heart Center clinic 75 cases of patients with ventricular arrhythmias as the research object, according to the randomization divided into treatment and control groups were 40 cases and 35 cases, the treatment group were Yixin Fang Yan in the control group received conventional therapy ventricular premature beat frequency method, course of 4 weeks before and after treatment were observed in patients with symptoms, heart rate, ECG, Holter and safety indicators to change the situation creatinine, alanine aminotransferase changes.
Results
1. After treatment, the situation had improved ventricular premature beats, the efficiency of the two groups, the difference was not significant (P> 0.05). After treatment, the number of premature 24h Holter compared with that before treatment, compared statistical differences (P<0.01); treatment group compared with the control group after treatment, significantly different(P <0.05).
2. After treatment, both groups showed improvement, statistically significant difference between the two groups (P<0.05), treatment group, improvement of symptoms than the control group. The main symptoms, the patients heart palpitations, shortness of breath and fatigue to improve the situation, by statistical comparison, there are differences (P<0.05).
3. Check the heart rate after the treatment group HR slower than before treatment, were significantly different (P<0.05); while the control group showed no significant difference (P>0.05). The ECG, Holter monitoring, treatment group, PR interval, QRS wave duration and the QTC interval changes were no significant differences (P>0.05), while the control group, changes in these indexes before and after treatment compared with the control group, significant difference (P<0.01 or P<0.05).
4. The two groups before and after treatment Cr, ALT was no significant difference, P> 0.05; group treated Cr, ALT no significant difference, P> 0.05.
Conclusion
1. According to Qi and activating blood and collaterals application, Yixin decoction of Yan effective treatment of frequent premature ventricular contractions; and can significantly improve symptoms of patients with ventricular arrhythmias, especially palpitations, chest tightness, fatigue and other major symptoms, in order to improve the quality of life of patients and improve working conditions.
2. Yixin decoction of Yan could significantly reduce the frequency of premature ventricular contraction premature ventricular contractions in patients with the number of 24-hour ambulatory ECG, PR interval, QRS wave group such as ECG showed no adverse effects to some extent reflect the parties can be avoided western medicine arrhythmogenic role.
3. Yixin decoction of Yan is safety, no significant liver and kidney dysfunction, is worthy of further promotion of the use.
本课题通过临床观察的方式,充分发挥中医药特色,运用全国著名老中医颜德馨教授经典验方益心方采用益气活血通络法治疗频发室性早搏,观察该方对室性早搏患者的疗效及影响,以及对普通心电图、动态心电图各种客观指标的影响,为进一步探讨该方可能作用的靶点及机制奠定临床研究基础,为发现名老中医经验方的作用机理提供现代化客观依据,进而为其产业化开发打下坚实的基础。方法
本研究应用前瞻性研究的方法,按严格的纳入标准选取广东省中医院大德路总院心脏中心门诊频发室性早搏患者75例为研究对象,按照随机对照的原则将其分为治疗组和对照组,病例数分别为40例和35例。治疗组在应用西药的基础上加用颜氏益心方,对照组应用西药常规治疗频发室性早搏,疗程均为3月,观察两组治疗前后患者总体症状、主要症状改善情况,心率、心电图、动态心电图改变状况及对安全性指标肌酐、谷丙转氨酶的影响。
结果
1.治疗后两组室性早搏情况均有改善,两组有效率比较,差异无显著性(P>0.05)。两组治疗后24h动态心电图早搏次数与治疗前相比,统计学比较有差异(P<0.01)；治疗组与对照组治疗后比较,有统计学差异(P<0.05)
2.治疗后两组症状均有改善,两组比较有差异性(P<0.05),治疗组症状改善情况优于对照组。主要症状方面,患者心悸、气短乏力改善情况,经统计学比较,有差异性(P<0.05)
3.治疗组后检查心电图心率HR较治疗前减慢,有统计学差异(P<0.05)；而对照组治疗前后无显著性差异(P>0.05)。而心电图、动态心电图显示治疗组PR间期、QRS波时限及QTC间期变化无显著差异(P>0.05),而对照组用药前后以上指标变化与对照组相比有显著性差异(P<0.01或P<0.05)。
4.两组治疗前后Cr、ALT无显著性差异(P>0.05)；组间治疗后Cr、ALT亦无显著性差异(P>0.05)。
结论
1.根据益气活血通络法应用颜氏益心方治疗频发室性早搏有效；并且可明显改善室性早搏患者的症状,尤其是心悸、胸闷乏力等主要症状方面,从而提高患者的生活质量、改善工作状态。
2.颜氏益心方可明显减少频发室性早搏患者24小时动态心电图室性早搏数量,对PR间期、QRS波群等心电指标无不良影响,反映该方在一定程度上可避免西药的致心律失常的作用。
3.颜氏益心方安全,无明显肝肾功能损害,不产生毒副作用,值得临床进一步推广运用。
Objective
The subject by the way of clinical observation, give full play to the characteristics of Chinese medicine, using of a famous old Chinese classic recipes, Yixin Fang of professor Yan Dexin Qi and blood circulation to pass with frequent premature ventricular contractions treatment, observe the effect on patients with ventricular arrhythmias and the impact on common ECG and 24 hours dynamic ECG effects of various objective indicators, for further study of the possible side effects of the target and mechanism of clinical research laid the foundation for the discovery experience famous traditional Chinese side to provide modern mechanism of objective basis for industrial development and thus lay a solid basis.
Methods
The prospective study application of research methods, selected according to strict inclusion criteria Guangdong Provincial Hospital Heart Center clinic 75 cases of patients with ventricular arrhythmias as the research object, according to the randomization divided into treatment and control groups were 40 cases and 35 cases, the treatment group were Yixin Fang Yan in the control group received conventional therapy ventricular premature beat frequency method, course of 4 weeks before and after treatment were observed in patients with symptoms, heart rate, ECG, Holter and safety indicators to change the situation creatinine, alanine aminotransferase changes.
Results
1. After treatment, the situation had improved ventricular premature beats, the efficiency of the two groups, the difference was not significant (P> 0.05). After treatment, the number of premature 24h Holter compared with that before treatment, compared statistical differences (P<0.01); treatment group compared with the control group after treatment, significantly different(P <0.05).
2. After treatment, both groups showed improvement, statistically significant difference between the two groups (P<0.05), treatment group, improvement of symptoms than the control group. The main symptoms, the patients heart palpitations, shortness of breath and fatigue to improve the situation, by statistical comparison, there are differences (P<0.05).
3. Check the heart rate after the treatment group HR slower than before treatment, were significantly different (P<0.05); while the control group showed no significant difference (P>0.05). The ECG, Holter monitoring, treatment group, PR interval, QRS wave duration and the QTC interval changes were no significant differences (P>0.05), while the control group, changes in these indexes before and after treatment compared with the control group, significant difference (P<0.01 or P<0.05).
4. The two groups before and after treatment Cr, ALT was no significant difference, P> 0.05; group treated Cr, ALT no significant difference, P> 0.05.
Conclusion
1. According to Qi and activating blood and collaterals application, Yixin decoction of Yan effective treatment of frequent premature ventricular contractions; and can significantly improve symptoms of patients with ventricular arrhythmias, especially palpitations, chest tightness, fatigue and other major symptoms, in order to improve the quality of life of patients and improve working conditions.
2. Yixin decoction of Yan could significantly reduce the frequency of premature ventricular contraction premature ventricular contractions in patients with the number of 24-hour ambulatory ECG, PR interval, QRS wave group such as ECG showed no adverse effects to some extent reflect the parties can be avoided western medicine arrhythmogenic role.
3. Yixin decoction of Yan is safety, no significant liver and kidney dysfunction, is worthy of further promotion of the use.
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