炙甘草汤联合替米沙坦、美托洛尔治疗扩张型心肌病合并室性期前收缩的临床疗效观察
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摘要
目的观察炙甘草汤联合替米沙坦、美托洛尔治疗扩张型心肌病合并室性期前收缩的临床疗效。方法将60例扩张型心肌病合并室性期前收缩的患者按照入院时间编码,奇数组为观察组,偶数组为对照组。对照组给予常规西药治疗,观察组给予常规西药治疗+炙甘草汤。两组均治疗10 d为1个疗程。观察治疗第1、5、10天时心电图QT离散度、24 h动态心电图、左室舒张末期容积、左室射血分数、NT-Pro BNP、疗效判定等主要指标,中医证候积分等次要指标,及血尿粪三常规、肝肾功等安全性指标的变化。结果在缩短QT间期、减少室早发作次数、提高左室舒张末期容量、提高总的治疗效果、降低中医证候积分方面观察组效果明显优于对照组;在减少多源性室早发生、短阵室速发生方面两组效果相当。两组患者安全性比较无显著差异。结论炙甘草汤联合替米沙坦、美托洛尔治疗扩张型心肌病合并室性期前收缩临床疗效显著。
Objective Clinical observation of baked Radix glycyrrhizae decoction combined with telmisartan and metoprolol in the treatment of dilated cardiomyopathy complicated with premature ventricular contraction. Methods Sixty patients with dilated cardiomyopathy complicated with premature ventricular contraction were coded according to the admission time. The odd group was the observation group,while the even group was the reference group. The reference group was given conventional western medicine,while the observation group was given conventional western medicine plus baked Radix glycyrrhizae decoction. The two groups were treated for 10 days as a course of treatment. Changes of main indicators,including QT dispersion,24-hour ambulatory electrocardiogram,left ventricular end diastolic volume,left ventricular ejection fraction,NT-ProBNP,and efficacy evaluation were observed on the1 st,5 th and 10 th day after treatment. Changes of other secondary indicators such as Chinese medicine syndrome score,and changes of safety index such as hematuria,fecal three routine,liver and kidney function were also observed in the same time. Results Compared between the two groups,the effects of shortening the QT interval,reducing the number of prematue ventricular attacks,increasing the left ventricular end-diastolic volume,improving the overall treatment effect and reducing the TCM syndrome score were significantly better than those of only western medicine. The effect of combined Chinese and western medicine is comparable to that of pure western medicine in reducing polygenic ventricular premature and short array ventricular tachycardia,while there was no significant difference in safety between the two groups. Conclusion Baked Radix glycyrrhizae decoction combined with telmisartan and metoprolol in the treatment of dilated cardiomyopathy complicated with premature ventricular contraction has a significant clinical effect.
Objective Clinical observation of baked Radix glycyrrhizae decoction combined with telmisartan and metoprolol in the treatment of dilated cardiomyopathy complicated with premature ventricular contraction. Methods Sixty patients with dilated cardiomyopathy complicated with premature ventricular contraction were coded according to the admission time. The odd group was the observation group,while the even group was the reference group. The reference group was given conventional western medicine,while the observation group was given conventional western medicine plus baked Radix glycyrrhizae decoction. The two groups were treated for 10 days as a course of treatment. Changes of main indicators,including QT dispersion,24-hour ambulatory electrocardiogram,left ventricular end diastolic volume,left ventricular ejection fraction,NT-ProBNP,and efficacy evaluation were observed on the1 st,5 th and 10 th day after treatment. Changes of other secondary indicators such as Chinese medicine syndrome score,and changes of safety index such as hematuria,fecal three routine,liver and kidney function were also observed in the same time. Results Compared between the two groups,the effects of shortening the QT interval,reducing the number of prematue ventricular attacks,increasing the left ventricular end-diastolic volume,improving the overall treatment effect and reducing the TCM syndrome score were significantly better than those of only western medicine. The effect of combined Chinese and western medicine is comparable to that of pure western medicine in reducing polygenic ventricular premature and short array ventricular tachycardia,while there was no significant difference in safety between the two groups. Conclusion Baked Radix glycyrrhizae decoction combined with telmisartan and metoprolol in the treatment of dilated cardiomyopathy complicated with premature ventricular contraction has a significant clinical effect.
引文
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[9]邝志斌.炙甘草汤对慢性病毒性心肌炎小鼠病历损伤的影响[J].中国现代药物应用,2015,9(6):268-269.
[10]王志,徐瑞鑫.炙甘草汤加减对急性心肌缺血大鼠心电图和血清酶学指标的影响[J].中国老年学杂志,2014,34(11):3083-3085.
[11]谭现花.炙甘草汤对反复力竭运动大鼠心肌保护作用的研究[J].山东体育科技,2013,35(4):79-81.
[2]张艳婷.扩张型心肌病左室重构与心功能及室性心律失常的相关性分析[D].山西医科大学,2015.
[3]张柳,韩艳华,陈海英. QT离散度与心律失常关系的探讨[J].白求恩医科大学学报,2001,27(2):126.
[4]中华医学会心血管病学分会,中华心血管病杂志编辑委员会,中国心肌病诊断与治疗建议工作组.心肌病诊断与治疗建议[J].中华心血管病杂志,2007,35(1):5-16.
[5]中华医学会心电生理和起搏分会,中国医师协会心律学专业委员会.室性心律失常中国专家共识[J].中国心脏起搏与心电生理杂志,2016,30(4):283-325.
[6]张伯臾.中医内科学[M].上海:上海科学技术出版社,2006:103-107.
[7]周承志,吴成云,杨波,等.炙甘草汤对正常家兔心室肌电生理特性的影响[J].湖北中医药大学学报,2015,17(2):22-23.
[8]高原,朱明军,朱初麟,等.炙甘草汤浸膏粉溶液对豚鼠心室肌细胞动作电位的影响[J].中华中医药杂志,2014,29(4):1248-1250.
[9]邝志斌.炙甘草汤对慢性病毒性心肌炎小鼠病历损伤的影响[J].中国现代药物应用,2015,9(6):268-269.
[10]王志,徐瑞鑫.炙甘草汤加减对急性心肌缺血大鼠心电图和血清酶学指标的影响[J].中国老年学杂志,2014,34(11):3083-3085.
[11]谭现花.炙甘草汤对反复力竭运动大鼠心肌保护作用的研究[J].山东体育科技,2013,35(4):79-81.